Are Frequent Bathroom Breaks Normal at My Age?

October 31, 2011

ToiletIt’s one of the most common and embarrassing problems for many of us as we get older– keeping control of our urine output. Other than sex, it seems like urination is the topic most people don’t want to talk about when they come to the doctor. As we age, it’s normal to have some problems urinating, but those problems are probably not what you think. Because few people talk about it, patients often do not realize what is normal and what is not normal.

The process of making urine is pretty fascinating. It’s the body’s process of removing waste. Basically, urine is a liquid that is secreted by the kidneys. While traveling through the kidneys, urea, water and other waste combines to form urine.  Urine then travels through two tubes  to the bladder. The bladder is the final stop for urine before you use the bathroom to void. When the bladder becomes full and it starts to stretch, a nerve tells the brain it’s time to urinate.


What's Normal?

You might be surprised to learn that the capacity of the bladder is only one to two cups. That’s not a lot of space, and is important to keep in mind when you are having urinary problems. Age does work against us in maintaining normal bladder function. Increased age is associated with decreased bladder capacity and decreased bladder function. So as we get older, those factors are going to impact our ability to make, hold and control urine.

It’s also good to know that the normal pattern of urination is a decrease in urine output at night.  In other words, you should be voiding more times during the day rather than at night. If I asked most people, what’s considered a normal number of times to go to the bathroom a day, most people have no clue.  Some cannot even remember how many times they go a day!

So what’s the answer? When should you become concerned about the number of times you go to the bathroom? In terms of a total day, seven is the magic number – meaning it’s normal to urinate up to seven times a day.  It’s abnormal to urinate eight or more times a day.


Men vs. Women

Problems with urinating are usually thought of as a condition affecting women. That’s mostly true and in general twice as many women than men are affected. It’s partly due to their anatomy as well as the impact pregnancies have on the urinary system.

However, you’ll be surprised to learn that for some urination problems, that ratio changes as we age. Men also have problems urinating, and like women it occurs throughout their lifetime. The problems increase as men age. One doesn’t usually begin to notice problems until around age 60. By age 60, about 20 percent of men experience problems with urinating. By 85 years of age, however, the prevalence is almost 35 percent. This is not surprising since the majority of men’s urinating problems are related to benign prostatic hypertrophy (BPH).

 

No one wants to admit he/she has a problem with bladder control. So here are the questions I ask patients to determine if bladder control is normal:

  • Do you have or ever had loss of urinary control?
  • Do you ever leak or lose urine when you cough, laugh, or sneeze?
  • How often do you have difficulty holding your urine until you can get to the bathroom?
  • Do you ever use pads, tissue or cloth in your underwear to catch urine?

If you answer yes to any of those questions, you need more tests.

I’ve realized over time that it is when people get up to pee at night that they start to worry something might be wrong. Regardless of age, you should not be getting up more than twice a night to relieve your bladder. Any more often than twice a night is not normal, and requires a trip to the doctor’s office. Getting up at night to pee can indicate more serious disease such as diabetes, congestive heart failure, kidney disease, sleep apnea, or even Parkinson’s. Don’t dismiss it as a normal part of aging!

If you are having problems urinating, you are not alone. But you need to talk to your doctor! Less than half of women and less than 20 percent of men who have urinary problems ever seek care! That’s a tragedy since urinary problems significantly impact one’s quality of life. It’s associated with depression, work-related absences, and in the elderly increases the risks of accidental falls.


Want more explanations to those aging concerns? Check out "Is This Normal? The Essential Guide to Middle Age and Beyond"!


More on Aging:

What's a Blue Zone? Am I Living in One?

Top 10 Countries with the Highest Life Expectancy

Are You Younger Than Your Years?


Photo Source: Thinkstock/Polka Dot


John J. Whyte, MD, MPH is the Chief Medical Expert & Vice President for Continuing Medical Education where he develops, designs and delivers health programming.
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