‘I’m a Urologist, Here’s Why Your Overactive Bladder Gets Worse During the Winter’

Maybe the days of bundling up in layers to fling yourself down a medium-sized hill on a sled are behind you. Maybe they aren’t! Either way, if you’ve spent some time in cold temperatures, you may have experienced the infamous ‘Now-That-I-Have-Five-Layers-On-I-Have-To-Pee’ conundrum. Sometimes it’s a coincidence or plain old forgetfulness, but if you’re one of the 33 million Americans who deal with overactive bladders, you might have noticed that things get a little bit worse when the temperature drops.

What is overactive bladder

Overactive bladder, also known as OAB, is not a disease in and of itself but instead a group of symptoms that include sudden uncontrollable urges to urinate, frequent bathroom use through the day or night, and unintentional loss of urine, according to the Mayo Clinic. “A sign of an overactive bladder is an unusual urge to find a bathroom as soon as possible or the feeling of having to go more frequently than usual throughout the day,” says Heather Jeffcoat, DPT, pelvic floor physical therapist and owner of FeminaPT. “You should be voiding urine 5 to 8 times per day, and in most cases, not at all at night,” she adds.

It’s important to note that OAB is different from the leakage that happens when you’re sneezing or laughing—that’s called stress urinary incontinence, and your urethra controls it. On the other hand, overactive bladder results from muscle spasms and bladder and pelvic floor weakness. When your bladder is full, nerves in the area send signals that tell your brain you have to pee, according to the Mayo Clinic. The brain responds by relaxing the pelvic floor and the urinary sphincter muscles while contracting the bladder, which allows you to pee. This contraction and relaxation balance is delicate, but OAB symptoms arise when your bladder spasms randomly or at an inappropriate time.

Yes, OAB symptoms can change with the weather

If your symptoms worsen in the winter, you’re not alone. A 2019 study published in the International Urology Journal found that that cold weather agitated OAB symptoms more so than moderate and warm temperatures. “Cold weather causes a lower body temperature, which can tense the muscles around the bladder,” says Dr. Jeffcoat. Since OAB is caused by bladder and muscle spasms, cold weather can prime you for more instances of bladder spasms and resulting urgency or incontinence. You also sweat less, which means more moisture is sent to the kidneys instead of excreted through the pores.

Cold weather also causes a bodily process called cold-induced diuresis, according to Aleece Fosnight, MSPS, PA-C, medical advisor to Aeroflow Urology. This is a warmth-conserving process your body initiates when it is cold to stave off hypothermia. It does this by withdrawing blood away from the skin and extremities and concentrating it around your organs. The body does this, Fosnight says, to preserve your existing body heat and keep your internal organs warm.

So how does winter weather create more pee? Your body redistributes blood from your skin and extremities to circulate your internal organs. This results in more blood reaching your kidneys faster, which creates more urine. “If you are filtering more blood, you are filtering more fluid out of your body which is why it is vital to replenish and increase fluid, especially water, intake during the winter months,” says Fosnight. “Some people aren’t a fan of drinking cold water in the winter months, and so I will suggest room temperature or even hot lemon water (if citrus isn’t an irritant for you) to help hydrate,” she says.

How do you deal with overactive bladder symptoms?

Part of the reason that so many people experience OAB symptoms is because of stigma and a lack of awareness of treatment, according to the Urology Care Foundation. The most important thing you remember this winter is that a stronger urge to pee isn’t in your head, and you don’t have to be ashamed.

Talk to your doctor about your symptoms

If you can, talking to a doctor about your symptoms could help get to the bottom of what might be causing it. Sometimes stigma or embarrassment is what holds people back from getting treatment so just remember that you’re always allowed to explain what’s going on with a professional.

Hydrate appropriately

Drinking water is vital for your bladder health, but drinking too little or too much can aggravate existing OAB symptoms. Fosnight explains that drinking enough water is important for your overall health and assists in preventing UTIs. Drinking the appropriate amount of water isn’t going to worsen your symptoms, according to Dr. Jeffcoat. Overhydrating can worsen symptoms in some cases, so follow the Mayo Clinic guidelines on how much water you should drink for your body weight or talk to your doctor.

Avoid bladder irritants

Acidic beverages can irritate the bladder and urethra, so consider reducing these if you are experiencing symptoms. Additionally, alcohol and caffeine are diuretics that stimulate the urge to pee. Reducing your consumption of these beverages can help you manage OAB symptoms, according to the Mayo Clinic.

Consider trying bladder training or peeing schedules

“As long as they do not have a urinary tract infection, patients should work on delaying their urinary urge, if even for a few minutes,” says Dr. Jeffcoat. “Peeing at each urge will change the signaling to your bladder that it is more full with less fluid. Always try to delay and aim to pee between 5 to 8 times per day.” She adds that you can work with a licensed pelvic floor therapist to develop a strength-training routine. This can assist your ability to control your bladder urges.

Keep a log

Track your symptoms as they appear or worsen, so you can share what’s going on with your doctor and look for signs of a urinary tract infection (UTI), says Fosnight. UTIs are infections of the urinary tract that cause burning, urgency, frequent urination, and pain. OAB can have similar symptoms, so you want to be able to tell the difference between the two.

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