Don’t Push When You Pee!

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Welcome to Life Without Leaks, a podcast by the National Association for Continence. NAFC is America’s leading advocate for people with bladder and bowel conditions, with resources, connections to doctors, and a welcoming community of patients, physicians, and caregivers. All available at nafc.org. 

We’ve all been there. The baby’s crying upstairs, so you need to speed up your bathroom visit to get to her quickly. You’re racing to your next meeting, and you only have a minute to stop for the bathroom. You’re late for your doctor’s appointment, but you just need to make a pit stop before you leave. Sometimes having to pee gets in the way of our daily lives. 

If you’re someone who’s moving so fast that you push when you pee, you could be setting yourself up for some trouble down the road.

You see when your bladder is working normally, it relaxes the pelvic floor and abdominal muscles when you need to pee. Those relaxed muscles are what naturally allow the flow of urine to occur. You should not be actively pushing the urine out by bearing down or by tensing your pelvic floor muscles because that can actually lead to a number of potential problems.

You could be starting to create muscle confusion. Over time, if you’re constantly pushing out your pee when you should just be relaxing your muscles to allow urination to occur naturally, you’ll be training your muscles to think that each time you need to pee, you should be activating the pelvic floor rather than relaxing it, and that sets you up for more problems down the road.

You could be creating hypertonic pelvic floor issues. If you already suffer from a hypertonic pelvic floor – that is pelvic floor muscles that are too tense – pushing out your pee could aggravate the muscles even more and lead to other conditions like pain or overactive bladder. 

Women may develop a prolapse. Over time consistent pushing when you pee or poop may cause your pelvic floor muscles to weaken, leading to pelvic organ prolapse, a condition where one of your pelvic organs, like the bladder, uterus, or rectum, collapses into the vaginal canal. 

Or you could develop or worsen hemorrhoids. Hemorrhoids are swollen veins inside and outside the anus and rectum that can become painful and cause bleeding. There are lots of causes for hemorrhoids, but straining while on the toilet can contribute to them. 

Sometimes the need to push isn’t simply because you’re in a rush. If you feel like you have to push even when you’re not pressed for time, there could be something else going on that you need to have treated. 

In men, for example, BPH, or benign prostatic hyperplasia, can sometimes cause swelling to occur in the prostate, leading to a weak flow or even trouble getting urination started at all. And when that happens, it’s not surprising that men naturally try and push their urine out. 

For women, pelvic organ prolapse can result in pelvic organs protruding into, or even through the vaginal canal, making it difficult to start urination and causing them to push to get it going.

So what should you do if you feel like you absolutely have to push when you urinate? The first thing is see a doctor. They’ll help you identify what may be causing your issue, and they can help you find a treatment path that makes sense for your particular condition and symptoms. 

Of course, we all rather not have this issue in the first place. The good news is that there’s a recommended way to empty your bladder that can reduce your likelihood of creating or contributing to problems down the road. Start by taking a deep breath, fully relax and be present during the process. 

Next, make sure that you’re in the right position. Sit up properly on the toilet, no hovering, with your knees above your hips, and your palms on your knees. This helps to relax the pelvic floor, making the whole process easier. A stool is a good way to help get you in proper position. 

Finally practice double voiding. That is, pee twice. By doing so, you’ll ensure that you’ve fully emptied your bladder. Simply wait on the toilet an extra minute after you’ve already urinated, and then relax and try again, or get up, walk around for a bit, then sit down and try once more. The most important thing is to not strain during the process. 

It might seem strange to take such a conscious approach to a natural process that you’ve been doing without much thought your entire life, but sometimes reexamining those things we do without thinking can have a profound effect on your wellbeing.

For more information on this subject or on any of the bladder or bowel conditions you might be facing, visit us online NAFC.org. 

Life Without Leaks has been brought to you by the National Association for Continence. Our music is Rainbows by Kevin McLeod. More information about NAFC is available online at NAFC.org.