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Many people notice bladder changes at different stages of life. These changes are common and can usually be managed and often cured.
We explain how a healthy bladder works and the simple steps you can take to feel more comfortable, confident and in control. This information is a guide for people of all ages, genders, cultures and backgrounds.
Understanding healthy bladder control
The bladder holds urine (wee) until you are ready to go to the toilet. A healthy bladder:
- usually empties 4 to 6 times a day
- holds 400-600ml of urine (wee)
- prompts a gradual urge to urinate (wee) as it fills, while giving you enough time to get to the toilet
- may wake you up once at night to use the toilet
- empties fully without leaking.
If holding on is hard or urine (wee) sometimes leaks, this could be a sign of incontinence. Incontinence affects people of all ages, genders, cultures and backgrounds and can be prevented, managed and often cured.
Noticing bladder changes
Even if it feels like ‘just a little’ or manageable, small bladder changes are worth noticing as early action can help prevent bigger issues. Common changes include:
- leaking some urine (wee) when you cough, sneeze, laugh, lift or exercise
- choosing to wear a pad ‘just in case’
- regularly going to the toilet ‘just in case’
- rushing to the toilet and not always getting there in time
- feeling worried about finding a toilet quickly
- waking up more than once at night to use the toilet
- dribbling urine (wee) after going to the toilet
- a urine (wee) stream that stops and starts
- leaking urine (wee) during sleep.
If you’re noticing changes like these, now is a good time to talk to a nurse continence specialist, pelvic health physiotherapist or GP (doctor) to explore support options.
1 in 4 people living in Australia aged 15 years and over experience incontinence and many find that the right help makes a real difference.
Causes of urinary (wee) incontinence
Many life factors can place extra pressure on the bladder or pelvic floor. Understanding these factors can help you look after your bladder health.
Pelvic floor muscle weakness
Pelvic floor muscles help control the bladder so you can choose when and where to urinate (wee). Sometimes these muscles need extra support or strengthening through pelvic floor exercise to help with bladder control, especially with:
- constipation and straining (pushing hard)
- long-term coughing
- heavy lifting or high-impact exercise
- pregnancy and childbirth (women*)
- getting older
- menopause (women)
- prostate surgery (men*) or pelvic surgery.
* References to ‘women’ or ‘men’ include anyone with similar health needs, regardless of sex at birth or gender identity. Read our Gender inclusivity statement.
Urgency and overactive bladder
Some people may experience strong, sudden urges to use the toilet and not get there in time. Sometimes we don’t know the cause. For some people, it may be made worse by:
- drinking lots of coffee, tea, fizzy, sugary or alcoholic drinks
- urinary tract infections
- medical conditions such as diabetes, stroke, multiple sclerosis or Parkinson’s disease
- constipation
- an enlarged prostate
- going too often to the toilet ‘just in case’.
Bladder not emptying fully
This is called urinary retention and may happen with:
- an enlarged prostate
- a blocked urethra (wee tube)
- nerve changes that affect the bladder or pelvic floor muscles
- prolapse (when the uterus (womb) or other pelvic organs press into the vagina)
- medical conditions such as diabetes, stroke, Parkinson’s disease or multiple sclerosis
It may feel like:
- needing to strain to pass urine (wee)
- a slow or weak urine (wee) stream
- feeling like the bladder isn’t empty after going to the toilet
- a sudden need to go to the toilet
- frequent urinary tract infections.
If it’s hard to empty your bladder regularly, talk to a nurse continence specialist, pelvic floor physiotherapist or GP (doctor). Early support is important to prevent harm to the bladder and kidneys.
Practical steps to improve bladder control
1. Talk to a continence health professional
Book an appointment with a continence nurse, pelvic health physiotherapist or GP (doctor) to check how your bladder is working. They will ask about:
- your toileting habits – how and when you pass urine (wee) and faeces (poo)
- any medicines, vitamins or supplements you take – it’s a good idea to take your medicines with you to the check-up
- your fluid intake, including alcohol and caffeine
- whether you have constipation or sometimes leak urine (wee) or faeces (poo)
- how bladder issues may be affecting your daily life.
They may suggest some tests such as a physical check, urine (wee) or blood tests, an x-ray or ultrasound or refer you to a specialist for other tests.
Treatment will depend on the cause but may include keeping a bladder diary or doing a bladder training program.
2. Keep a bladder diary
You may be asked to keep a bladder diary for 3 or more days to help spot patterns, identify any issues and find the most effective ways to manage them. The bladder diary helps you keep track of:
- when you go to the toilet
- how much urine (wee) you pass
- how strong the urge was each time
- whether any urine (wee) leaked before reaching the toilet.
Download a bladder diary and take it with you when you visit your health professional.
3. Bladder training program
Bladder training can help your bladder hold more urine (wee) and reduce that sudden feeling of urgency by teaching your body to wait longer between toilet trips. A nurse continence specialist or pelvic health physiotherapist can work with you to create a personalised plan and check for any other causes of symptoms such as a urinary tract infection.
Most people see real improvement in around 3 months with regular support from their health professional.
During bladder training, you’ll learn:
- pelvic floor muscle exercises
- techniques to delay urgency
- healthy bladder and bowel habits.
4. Pelvic floor exercises
Regular pelvic floor exercises can help improve bladder control, ease sudden urges and help you reach the toilet in time. Doing pelvic floor exercises correctly is a learned skill that involves tightening, holding and fully relaxing the muscles. Getting this technique right can make a big difference to your results. A pelvic health physiotherapist or nurse continence specialist can teach you the proper technique.
Call the National Continence Helpline on 1800 33 00 66 for free advice on how to exercise and relax your pelvic floor muscles, or to find a continence health service near you.
5. Healthy bladder habits
These simple habits can support bladder health:
– eat high-fibre foods such as wholegrains and vegetables
– drink when you feel thirsty – water is best
– move your body (exercise) every day
– practice good toilet habits – go when your bladder feels full, sit comfortably on the toilet (see diagram), take your time and relax.
These steps can make help you feel more confident and in control, sometimes within weeks.
Tracking progress
Try a quick weekly check to track your progress:
- Do I know how to squeeze and relax my pelvic floor?
- Did I do pelvic floor exercises most days this week?
- Am I drinking enough water?
- Am I eating enough high-fibre foods?
- Did I move my body each day?
- Did I notice any strong, sudden urges to go to the toilet?
- Was there a longer time between toilet visits than when I went “just in case” or because the urge was strong?
- Was there less need to rush to the toilet?
- Did I experience fewer leaks?
When to seek help or advice
A nurse continence specialist, pelvic health physiotherapist or GP (doctor) can support you if you notice changes such as:
- leaking when you cough, sneeze, laugh, lift or exercise
- wearing a pad or going to the toilet ‘just in case’
- getting up more than once a night to go to the toilet
- having bladder, pelvis or back pain
- finding it hard to fully empty your bladder
- feeling a bulge or pressing down into the vagina (prolapse)
- having new symptoms after prostate or pelvic surgery.
‘I’m grateful for the information I received – knowing that I can do something to manage incontinence. It’s no longer something I just have to live with.’
National Continence Helpline caller
Need help now?
- Call the National Continence Helpline on 1800 33 00 66. It’s free and confidential and staffed by nurse continence specialists. They can give advice and help you find a pelvic health physiotherapist near you. You can ask for an interpreter who speaks your language.
- Find a pelvic health physiotherapist in our directory of physiotherapists.
- For other service providers, including physiotherapists, nurse continence specialists, urogynaecologists and more, use our Find a service provider directory.
Resources
Resources you can download. Some are available to order in print format.
This content has been reviewed by subject matter experts in line with Continence Health Australia’s established process. Read about our clinical content review protocol.