5 things your bladder is trying to tell you about your health

You may not realize it, but your bladder offers a window into your overall health. From how often you go to whether — and how well — you can hold it, your urine output provides clues about possible health problems. And they don’t always have to do with your urinary tract. Problems with your cardiovascular and nervous systems, for example, often trigger bladder symptoms.

For older adults, there are some benchmarks to aim for if you want a clean bill of health for your bladder. “Using the restroom every 3 to 4 hours and being able to hold 10 to 16 ounces of fluid is a sign your bladder is healthy,” says Niket Sonpal, M.D., a gastroenterologist and internist in New York City.

If this doesn’t hold true for you, there may be an underlying issue at play. Changes in your bladder habits are something to bring up with your provider during your Annual Wellness Visit, says Dr. Sonpal — or sooner if the symptoms are getting in the way of your daily activities.

Here are the signs to look for and what they might mean for your health. Plus, the steps you may need to take if something is off.

1. You feel a burning sensation when you urinate

If urinating is painful, you may have a urinary tract infection (UTI).

UTIs are common in both older men and women. Men ages 70 and older may be at a higher risk of UTIs because of problems going to the bathroom and/or emptying the bladder, notes the Urology Care Foundation. Meanwhile, women face greater odds of developing a UTI after menopause, due to lower amounts of bacteria-killing estrogen, according to the Urology Care Foundation.

Dehydration and/or high blood sugar (as with Type 2 diabetes) may also increase your risk of a UTI, according to the Urology Care Foundation.

Left untreated, a UTI can spread to your kidneys and cause a more serious infection. So if you notice a burning sensation when you urinate, be sure to visit your health care provider. They will test your urine for bacteria and prescribe antibiotics and lifestyle changes if needed.

2. You leak urine

Accidentally leaking urine is known as urinary incontinence. According to Dr. Sonpal, many factors can cause leakage, including:

• UTIs
• Excessive caffeine or alcohol
• Constipation
• Being overweight
• Aging

As you get older, your bladder and pelvic muscles can become weak or overactive, making it difficult to control the flow of urine. In older men, leakage may also be caused by an enlarged prostate. What’s more, diseases like multiple sclerosis, diabetes and Parkinson’s can damage the nerves that control the bladder, according to the National Institute on Aging (NIA).

If you’re having difficulty controlling your bladder, talk to your provider. They can pinpoint the cause of your problem and offer solutions.

Possible fixes can include lifestyle changes like losing weight and cutting caffeine and alcohol. Avoiding foods that cause constipation may also help. Your provider may also suggest practicing pelvic floor exercises to strengthen the muscles that support your bladder and urethra (the tube that carries urine from your bladder to the outside of your body).

“Pelvic floor exercises can assist in holding urine in the bladder and prevent urine from leaking out,” Dr. Sonpal says.

You can get started with Kegel exercises, which are squeeze-and-release moves that both men and women can do anywhere, anytime. In a 2019 review of 31 well-designed Kegel studies, researchers from the University of Montreal concluded that pelvic-floor muscle training “can cure or improve symptoms of stress urinary incontinence and all other types of urinary incontinence.”

Here’s how to do them:

1. Start with an empty bladder. 
2. Identify the pelvic-floor muscles by tightening and relaxing the same muscles you’d use to hold in urine.
3. While sitting or lying down, tighten your pelvic floor muscles. Hold the “squeeze” as you count to 5. Then, fully relax and count to 5. Repeat 10 times. Gradually increase the squeeze and relax periods to 10 counts each. 

Do this routine 3 times a day.

3. You urinate often

Frequent trips to the bathroom could mean you drink a lot of fluids, use diuretics or are overdoing the caffeine. It could also signal a more serious issue, like diabetes or complications of sickle cell anemia (a genetic disorder that is not always detected when you’re young), according to Dr. Sonpal.

Frequent urination can also be a symptom of a UTI or interstitial cystitis (also known as painful bladder syndrome), the Cleveland Clinic notes. In women, the need to urinate often may signal pelvic organ prolapse (when these organs drop or shift out of their normal positions). Meanwhile in men, an enlarged prostate may be the culprit.

Talk to your provider if you’re emptying your bladder more than 8 to 10 times a day. They may perform a fasting glucose test to diagnose diabetes, and/or a blood test to check for sickle cell anemia. They will also check for potential lifestyle causes (like drinking too much caffeine), as well as prostate or pelvic issues.

4. Your urine is pink, red or brown

Ideally, your urine should be light yellow. Anything other than that and you should pay attention.

If you notice your urine is pink or reddish — and you haven’t eaten rhubarb or beets — there’s likely blood in your urine. This could be a sign of an infection, kidney stones, non-cancerous tumors or bladder cancer, Dr. Sonpal says.

Kidney stones are common in older adults. Having kidney stones can also lead to an infection and other serious complications, especially in older adults. Treatment is based on the size, type and location of the stones.

Bottom line: see your provider about pink or red urine as soon as possible.

If your urine is brown or dark yellow, you may be dehydrated. Try to drink more fluids and cut back on the caffeine, suggests the Mayo Clinic. See your provider if the color doesn’t lighten within 2 days.

There’s no magic number of glasses of water to drink to prevent dehydration. Everyone’s needs are different, and the United States Department of Agriculture doesn’t put out water guidelines for adults. Still, Dr. Sonpal says it’s a good idea to drink a glass of water with every meal and snack.

5. You struggle to urinate

If you rarely feel the need to urinate, suddenly can’t urinate or have trouble emptying your bladder, you may have urinary retention.

This condition is serious and can be caused by certain cancers, tumors or bladder stones, according to Dr. Sonpal. Bladder stones, for example, can block the flow of urine.

You may also have urinary retention if your bladder isn’t strong enough to release all of your urine, notes the National Institute of Diabetes and Digestive and Kidney Diseases.

Urinary retention is also a potential side effect of diabetic neuropathy, a type of nerve damage that can occur if you have diabetes. High blood sugar levels can injure nerves in your body. The damage is often in the legs and feet, but it can also be in the urinary tract, according to the Mayo Clinic.

In any case, urinary retention calls for immediate attention, Dr. Sonpal says. Your provider will perform a physical exam and series of tests to diagnose it.