Bladder Urgency in Winter

Written by Caitlin Daley, Pelvic Floor Physiotherapist

Have you noticed an increase in your visits to the toilet since the weather has cooled down?

For some of us, frequent toilet visits can feel like a slight bother; while for others it’s crippling urgency, and fear of leaking before arriving at the toilet.

Cold induced diuresis is a medical term that describes an increase in urine output in response to the cold weather.

Why does this happen? It comes down to re-direction of blood volume.

When the temperature significantly cools down, our body re-directs blood flow to the central organs, prioritising the oxygen delivery to places like the heart instead of our toes, which makes perfect sense.

With the change in blood flow (more blood in a smaller space), comes an increase in blood pressure. To maintain homeostasis i.e. to balance this out, our kidneys kick into gear, filtering more fluid into the bladder to eliminate it from the body.

When the bladder stretches slowly, such as when we consume fluid gradually throughout the day, we should feel a “mild” first urge to visit the to toilet. This urge is usually something we can defer, until the second “moderate to strong” urge reminds us to go and empty our bladder.

With sudden changes in temperature and the re-directed blood flow, the volume of fluid arriving at the bladder is suddenly increased. This causes a stretch on the bladder wall, stimulating a spinal reflex that causes the muscular wall of the bladder to contract i.e. empty the bladder.

Here we can feel sudden, and intense urgency to urinate.  For those with a history of bladder urgency or incontinence, this can result in increased episodes of leakage, or a ‘set back’ in their treatment of Overactive bladder.

What can we do about urgency associated with the cold weather?

1.        Dress appropriately
It seems obvious but wearing enough to keep warm as you change environments, e.g. from inside to outside can make a difference in your thermoregulation, and reduce the sudden changes in blood distribution

2.        Try not to ‘hold on’ if you experience a moderate urge

If you are about to leave the shops for example and feel you should visit the toilet, we recommend doing so rather than ‘holding on’, especially if you know that cold weather is a trigger for your urgency and/or incontinence.

3.        Drink adequate amounts of fluid

Some people start reducing their fluid intake if they feel worried about urgency or incontinence. Whilst this may seem like a great idea, urine that is less ‘diluted’ is irritating on the bladder wall, contributing to more bladder wall contractions, and higher sensation of urge.

In addition to this, due to lack of sweating during the colder months, many people do not consume enough fluid or electrolytes after activity.

As a guide we suggest drinking to thirst, checking your urine colour is lightly coloured, and consuming a wide range of bladder-friendly fluids (herbal tea, water, soups etc).

Lastly remember that Pelvic Floor Physiotherapists are trained to help with bladder urgency, with or without incontinence, and frequency of urination whether it be during the day or night.

Reach out to our Physiotherapist today with a FREE 10 minute Discovery Call today.

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