Women - Why Do We Pee When We Squat?

Why do you pee when you squat?

For some of us women, we not only have the curse of a chipmunk bladder but also have issues of leakage. Again, aside from the FUPA article, this is pretty much the least talked about thing ever.

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No one wants to talk about their peeing habits or their loss of bladder control while on a machine, for various reasons. I know the mental anguish can be quite embarrassing, and then there's all that pee. On a bench. You had to wipe up. In front of everyone.

However, if it's happened to you, then you want some answers, like... Holy god, am I a freak of nature? Or... Why me?

You are not a freak of nature. As far as the why me... Ask yourself this: why not you?

There are several different reasons you may pee when you squat. Here are some.

Why Do We Pee When We Squat?

Reason #1 - Overactive Bladder

When you have an overactive bladder, you basically have a strong urge to urinate that you cannot control. About 33 million Americans struggle with an overactive bladder.

Holy cow! Women are more affected than men due to pregnancy and pelvic floor weakening due to pregnancy.

Symptoms of an overactive bladder

• Uncontrollable need to urinate frequently.
• Involuntary loss of urine.
• Have to urinate often.
• Waking up at night more than once (well, if you don't drink a liter before bedtime - thats pretty standard).

Some of the symptoms can be controlled. If you are drinking a lot of alcohol or caffeine, this can be a factor in an overactive bladder.

Caffeine is a diuretic and makes you urinate. Taking meds that increase urine production, urinary tract infections and bladder stones can cause an overactive bladder as well.

Basically, the muscles that control bladder function start to act involuntarily and hence you pee on a machine before you can get to the gym bathroom.

Lifestyle changes can improve an overactive bladder (alcohol and caffeine reduction and don’t chug two liters before going to the gym) and almost mitigate these symptoms unless...

Medical causes of an overactive bladder

• Stroke and nervous system problems
• Multiple sclerosis (MS)
• Parkinson’s

Diabetes and bladder stones can cause an overactive bladder. Men with an enlarged prostate can experience an overactive bladder.

Reason #2 - Urinary Tract Infections (UTI)

Well, urinary tract infections are just that - infections. UTIs are caused when bacteria reach the bladder through the urethra, which is the tube that connects the bladder to the outside world. Women are more prone to UTI’s because of their short urethra.

• Wiping wrong (you know who you are, ladies).
• Sex.
• Loss of estrogen after menopause.

Each of these makes it more likely that bacteria will travel through the urethra to your bladder.

What to Watch For

Urinary tract infections can actually be a killer. As a nurse, I have seen people die from UTIs that go untreated. Bacteria can get to the kidneys and the bloodstream if it isn’t treated with antibiotics.

Once it goes into the bloodstream it is called sepsis or urosepsis. It is extremely hard to treat when you have sepsis and can affect other organs and structures.

Reason #3 - Stress Incontinence (SI)

Don’t cough. You know what will happen... Yes, a flood.

Some of you reading this totally understand why someone would wear a pad 24/7 even when not on their menses. Intuitively, us women know that when a sneeze is coming on, we do what? We cross our legs.

Yes, because most women that have had children or have been overweight, or basically have lousy pelvic floor muscles, know that we are going to pee any time we cough, sneeze, laugh too hard or squat.

Causes can be weakened pelvic muscles, previous pelvic surgery, problems with the muscles in the bladder, or problems with the urethral sphincter. The increase in abdominal pressure when we cough or sneeze causes pressure on the bladder and if your muscles are weakened, urine is expelled. This can happen with squats, abdominal exercises or any other exercise that causes you to “bear down.”

Things you can do to improve stress incontinence are Kegel exercises. Pretend like you are stopping the flow of urine midstream. I do this while I am driving and stopped at stop signs.

What? no one can tell unless I am making a weird face...

Weight loss is another way you can improve stress incontinence. Decreasing the intra-abdominal pressure that weight loss brings helps tremendously. Take it from a former fluffy girl, it happens a lot less than it used to.

Timed voiding. This means you record when you pee and it gives you an idea of your bathroom patterns so that you can pee when you know you usually do.

This goes hand in hand with bladder training, in which you stretch out the intervals at which you go to the bathroom by waiting a little longer before you go.

If the above doesn’t give you relief from SI, then the next step is a device that is inserted into the vagina called Pessary. It’s a ring that puts pressure on the urethra that keeps it where its supposed to be, hence decreasing urine leakage. This is one step before surgery is needed.

If your pee is free-flowing once you started bearing down to squat, just spitballing here, but you may need surgery. This is, of course, the last resort. There are side effects of surgery like infections as well as it can cause worsened incontinence or an inability to urinate.

How to Differentiate Between UTI, OAB, and Stress Incontinence

Usually, pain. Pain upon urination is likely a UTI. However, some people never even know they have a UTI, so then what? Well, smell your pee. No, don’t hunker down and smell it - It should be pretty malodorous all on its own. Also, the color may be dark and cloudy. This would indicate UTI.

So, if you have a UTI, get treated for god sakes. Antibiotics and something for bladder spasms will likely take care of the issue unless it has traveled to the kidneys. Speaking with a physician and getting the right antibiotics are key. This will likely take care of your “squat and pee” scenario.

However, if you have OAB, hold your horses. If you don’t have any serious disease process, then you need to think about other stuff, like lifestyle changes. Stop drinking a liter of coffee in the morning to get you going. Don’t drink water like it’s going out of style at like 10 pm and wonder why you wet the bed.

Stress incontinence is a bit different. Many things will improve stress incontinence. One being, lose weight if you need to. Do Kegel's if needed. If it gets bad, bladder training and surgery may be needed.

These are usually a last resort and honestly, I don’t know too many women that would squat or do abdominal exercises if they know they are going to be in a sea of urine when they do.

Well, unless they are way hard core, and for you ladies out there that are, kudos to you! Just squat in the last squat rack so I don’t have to smell it, will ya?