Do You Have "Pee Anxiety"? A Doctor Explains the Condition That Even Kim Kardashian Struggles With
"I hope it doesn't get the best of me," Kardashian said of her stressful bathroom problem.
If you've ever passed a bathroom and felt like you just had to go in and pee, or woken up one too many times during the night for a bathroom trip, you know that the urge to go can sometimes be complicated, and even stressful. But for what it's worth, you happen to be in the company of one of the biggest influencers in the world. Us Weekly reports that Kim Kardashian recently opened up about her bathroom problem on Keeping Up with the Kardashians.
"I hope my pee anxiety does not get the best of me," Kardashian said, adding that "I travel with a cup in the backseat of the car with a Ziploc of wet wipes."
If you're wondering, What exactly is pee anxiety?, you're not alone. We asked Nick Tadros, MD, to answer our most burning questions about pee anxiety (although if your pee is actually burning, it might signal a urinary tract infection, so get that checked out). Read on to find out about this, ahem, unusual health condition.
READ THIS NEXT: Never Do This When You're Passing a Bathroom, Doctors Warn.
Anxiety can affect your bathroom routine.
Everyone pees, but do you know what's going on in your body when it happens? Medline Plus explains that blood brings waste, called urea, to the kidneys, where it's filtered and then travels to the bladder. "The bladder stores urine until you are ready to urinate," their experts explain. "If your urinary system is healthy, your bladder can hold up to 16 ounces (two cups) of urine comfortably for two to five hours."
So if the bladder can hold that much urine, how often should a person have to pee? There's actually no simple answer to that. "Some people might urinate ten times a day," urologist Petar Bajic, MD tells the Cleveland Clinic. "Others may hear nature's call only four times over a 24-hour timeframe." Any time in between can be normal too, Bajic says. But if there's a change in your bathroom habits, that can signify something serious—or it could be a sign of "pee anxiety."
Different conditions can cause the frequent need to urinate.
Whether you feel that you're urinating too frequently or not enough, your pee can tell you a lot about your overall wellness. While you might think there's an obvious reason for changes in bathroom habits—dehydration causing a decrease in urination, or discomfort due to a UTI—the underlying condition isn't always so clear. And if it's your urine that isn't so clear (it looks cloudy and/or discolored), this could signal kidney problems, while a dark brown color can indicate liver disease.
Tadros says a frequent urge to urinate can stem from many different things. "Some of the most common are overactive bladder, enlarged prostate (men), diabetes, urinary tract infections, [and] medications (diuretics or 'water pills')," he explains, adding that congestive heart failure is another potential cause of frequent urination. That's because a weakened heart may no longer efficiently pump blood, which can result in a buildup of fluids, Edo Paz, MD told Best Life.
Anxiety and stress can also cause either the urge to urinate, or concern that you might have to pee at a time when you don't have easy access to a bathroom.
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There are different types of "pee anxiety."
While there is no one definition of "pee anxiety," Tadros explains that it can be "many things, but often causes the need for frequent urination, especially when you're anxious, or during an event [such as] going out with friends, or big presentation that can be stressful."
What's happening in your body when you have this type of anxiety? "We don't know for sure, but when you feel anxious, this sends signals to your body to start the 'flight or fight' response," says Tadros. "This tightening of the pelvic floor directly affects the bladder, and since the bladder can only do two things—squeeze or not squeeze—it reacts to the tight floor muscles by contracting as well." This increases the resting muscle tone of the pelvic floor muscles, which results in the urge to pee.
Another type of urination-related anxiety, called shy bladder syndrome, or paruresis, makes it "difficult or impossible" to use public restrooms or pee with anyone nearby, according to the Cleveland Clinic.
Here's how to address bathroom-related anxiety.
Kardashian told People magazine about her experience with "pee anxiety" at the 2019 Met Gala, when she wore an extremely form-fitting Thierry Mugler dress. "If I have to pee, it's a problem," Kardashian fretted. "Honestly, if it's an emergency, I think I pee my pants and then have my sister wipe my leg up."
Tadros suggests medication or behavioral therapy as alternate solutions. "But there are other steps to take that can help as well," he advises. "Avoiding bladder irritants such as caffeine and alcohol, limiting fluid intake for a few hours before an event that causes 'pee anxiety,' and finally there are medical and surgical treatments that may help as well if the symptoms are severe."
Speak with your doctor "if you have other medical issues such as recurrent UTIs [or] diabetes" and your anxiety about urination is having an effect on your "quality of life or daily function," he advises.