Do you get up several times each night, causing lack of energy and poor memory? As a women’s health physical therapist who treats patients with these conditions, I know how life-altering it is to suffer from urinary frequency or urge incontinence.

I teach urge suppression techniques, which can actually make that urge feeling disappear without even using the bathroom. Whereas relaxing (letting go of) the pelvic floor muscles makes urination start, the reverse is also true. Strong pelvic floor muscle contractions (squeezing) stop the bladder from contracting, making the urge go away.

Taking control

Since the brain is part of the problem, it also needs to be part of the solution. Mind distraction techniques allow you to stop thinking of going to the bathroom—mind over bladder. Here is the amazingly effective, step-by-step recipe to urinate less often, day and night:

  1. Stay still by sitting or standing. Do not move or race to the bathroom. This will only make the bladder contract harder and make the pelvic floor exercises less effective, causing leakage.
     
  2. Do six strong pelvic floor muscle contractions, holding for two seconds each. It may take a few weeks of exercise to get your pelvic floor strong enough to stop your bladder from contracting.
     
  3. Do not think about the bathroom. This defeats the purpose, because the brain is too vulnerable to the power of suggestion. Focus on something other than going to the bathroom, such as a detailed “to-do” list. A categorical topic (such as menu planning for your next meal) that can be used repeatedly is ideal. At night, a rote prayer, memorized song, or counting backwards works best, in order to lull you back to sleep.
     
  4. Take two deep breaths with long exhalations to send a relaxation response to your overactive bladder.
     
  5. Repeat all of the above steps, if necessary, to make the urge fully disappear. 
     
  6. Then, you have two choices. Walk quietly to the bathroom. Do not rush. Keep squeezing the pelvic floor muscles while walking slowly. Keep the mind focused on something other than going to the bathroom. Or choose to delay urinating.
     
  7. Use a daily voiding diary to gradually achieve longer and longer time periods between trips to the bathroom. Start with what is currently comfortable and increase by half-hour increments per week, until a normal three-to-four hour interval is achieved with zero nighttime voids.

Certain beverages (like caffeine, alcohol, and orange juice) irritate the bladder and make urgency worse. So does drinking too little, which causes dark concentrated urine that irritates the bladder more than clear urine would.

Most of my patients are extremely skeptical at first, but these urge suppression techniques do work. Try them today. Before long, you can shop without mapping every bathroom in town, because you’ll have better bladder behavior.