Is It Bad That I Can’t Pee in a Steady Stream?
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Being in a bustling public restroom can really turn your attention toward your own pee: Suddenly you’re hyperaware of the notes you’re hitting amid the splash cacophony. Or maybe you’re noticing your pee’s duration because you’re in a rush—say, there’s a line of folks waiting, or you just want to spend as little time as possible in that haven for germs. Zoned in on your own flow, you’re more likely to catch anything out of the ordinary, like little breaks in the action that you can’t quite control.
We’re talking about when your pee stops and starts, or comes out in bursts rather than a consistent stream—technically called urinary intermittency or urinary hesitancy. When you consider the full slate of events that have to happen in synchrony for you to pee, it’s not so surprising that they don’t always coincide perfectly, Betsy Greenleaf, DO, a New Jersey–based board-certified urogynecologist and member of the plusOne wellness collective, tells SELF. When your bladder fills up, its stretch receptors send a signal to your brain that it’s time to pee, at which point you go to the bathroom; then your brain tells your urethral sphincter (which holds urine in) and your pelvic floor muscles to relax, your bladder squeezes, and voila: Pee is peed.
Any misstep along that whole chain of command can ultimately affect your flow, Dr. Greenleaf says, potentially leaving you peeing in spurts. Below, experts spill the most common reasons why your pee can stop and start, how to know when you should get that checked out by a professional, and tips for steadier streaming.
What are the most common causes of stop-and-start peeing?
1. You’re pee shy or on high alert about something else.
Remember that public restroom scenario? Being ultra-aware of your own pee could make you feel self-conscious or uncomfortable, especially if other people are nearby. In extreme cases, this might manifest as shy bladder syndrome, which can make it nearly impossible to pee anywhere outside of your home. But any lesser form of pee shyness, or even worries about unrelated things, can also disrupt your flow, according to Dr. Greenleaf.
Feeling stressed or anxious activates your sympathetic nervous system (a.k.a. fight-or-flight mode), which is designed to help you respond to a threat—but also slows down body processes that aren’t essential to that response, like digestion and, yes, peeing. Which makes sense: “If you were, say, being attacked by a lion, you wouldn’t be like, ‘Excuse me, lion, while I go over here and pee,’” Dr. Greenleaf says. By the same token, if you’re constantly on edge, the cascade of events necessary for peeing—including the relaxation of your pelvic floor muscles—won’t happen as smoothly, which can lead to that on-and-off trickling.
2. Your pelvic floor muscles are super tight.
Maybe you’re not actively stressed while peeing, per se, but you carry a ton of tension in your pelvic floor from prior emotional trauma. Or perhaps you have a hypertonic (or overactive) pelvic floor from an injury to the area or a condition affecting your abdomen, like irritable bowel syndrome or endometriosis. No matter the cause, such tightness of those muscles could mean that they spasm or don’t quite release all the way when you pee, Dr. Greenleaf says.
The same thing can happen when you hover your butt over a toilet seat, she adds. That squat posture often involves flexing—you guessed it—your pelvic floor muscles, which can make it tough to get a good flow going.
3. You’re taking a decongestant.
Were you today years old when you learned that oral decongestants can cause your urethra (the tube you pee from) to contract? Because, same. More specifically, the drug pseudoephedrine (which is the active ingredient in Sudafed and included in allergy medications with a “D” in their name, like Zyrtec-D and Claritin-D) can “cause an increased sphincter tone,” Julie Drolet, MD, a board-certified urogynecologist in New York City, tells SELF. Meaning if you take a high dose of pseudoephedrine or pop it consistently (say, during flu season or when your allergies act up), the muscle that lets urine move into your urethra can become more active, making it tougher to empty your bladder or to do so in one fell swoop.
4. You have a urinary tract infection (UTI).
Having a UTI can be miserable for a lot of reasons—you might as well be peeing flames, and the pain in your pelvis can be tough to endure. But it can also really mess with your stream.
“You might have the sensation that you need to use the bathroom very frequently, but there’s only a little urine that wants to come out,” Dr. Drolet says. The infection can cause both swelling and irritation of the urethra and bladder weakness (making it less capable of pushing out urine), all of which can lead to inconsistent dribs and drips.
5. Something’s up with your bladder.
A variety of bladder issues could interfere with your usual rush. It’s possible that your bladder “has become a little floppy and isn’t pushing the way it’s supposed to,” Dr. Greenleaf says, which can often happen with years of holding in pee for hours on end. (This tends to affect workers who can’t just leave in the middle of their shift, like teachers and nurses.) “If you stretch out the bladder too much, it becomes harder for the bladder to contract.”
Another possibility is prolapse, which is when the bladder drops within the pelvis due to a weakened pelvic floor (often caused by pregnancy or childbirth). In this lower position, it can press on the urethra or otherwise cause it to become kinked, which can block the typical flow of urine, Dr. Drolet says. A similar thing can happen with an enlarged prostate in people with a penis or a colon that’s especially blocked up (meaning, full of poop); both nearby organs can push against the urethra, partially cutting off pee’s ability to pass.
There’s also always the small chance that something inside your bladder is interfering with your pee stream, like a bladder stone (a clump of mineral build-up) or a benign or cancerous growth, Dr. Greenleaf says, but these would typically show up with other symptoms too (more on that below).
6. You have some form of nerve damage.
Again, the process of peeing hinges on nerve signals firing between your pelvis and brain. That means if anything is blocking those channels, you might experience pee that stops and starts. “It could be either the nerves in your pelvis are affected, or the nerves anywhere along your spinal cord—which runs from your tailbone to your brain—are compressed,” Dr. Greenleaf says. (So anything from a herniated disc in your lower back to a neck injury could affect your bladder function.)
For similar reasons, neurological conditions like multiple sclerosis, Parkinson’s, and stroke can also mess with your typical flow, as can diabetes (which can cause nerve damage over time as a result of consistently high blood sugar), Dr. Greenleaf says. All that said, there’s a very low chance that any issues in the bathroom would be your first or only symptom of any of these conditions.
When to see a doctor about stop-start peeing
The main things to consider are how long it’s been happening, whether it’s affecting your normal pee schedule, and if it’s coinciding with other symptoms. Some sporadic peeing that’s short-lived and doesn’t interfere with your ability to fully empty your bladder probably isn’t anything to worry about. But if it’s been going on for a couple of weeks—or it’s been a few days but it’s getting progressively worse (especially to the point of not being able to urinate)—or it’s associated with any other symptoms, like a burning sensation when you go, blood in your pee, periods of incontinence (i.e., leaking without control), or sexual issues like having trouble reaching orgasm, it’s time to see a doctor, Dr. Greenleaf says.
The good news is, there’s plenty that a gynecologist or urologist can do to get to the bottom of it. For starters, they can quickly decipher whether a UTI is to blame. They can also take a look inside your urethra or bladder via a cystoscopy (using a tube with a tiny camera) and rule out any kind of growth or stone that might be blocking things up. There’s even urodynamics testing, which your doctor can use to see how well your bladder is contracting and releasing and where your flow may be getting interrupted.
Treatment could be as straightforward as clearing up an infection with antibiotics, cutting back on decongestants if you use them regularly, or working with a physical therapist to relax your pelvic floor muscles. Your doctor can guide you on the best plan to get you peeing freely again.
Golden tips for a healthy and consistent pee flow
When and how you go can be the difference between an unsteady trickle and a continuous torrent. The experts we spoke with have a few tips for nailing the latter:
1. Strike a balance between peeing the second you need to and holding it. You don’t want to un-potty-train yourself by going immediately when the urge hits, every single time, Dr. Drolet says. That essentially teaches your bladder to hold increasingly less. But, as noted above, you also don’t want to go hours and hours with a full tank, either, because that can stretch your bladder out. Peeing about eight times a day is considered normal, says Dr. Greenleaf, but the exact number will vary depending on how many drinks you’re downing.
2. Fully sit on the toilet to pee. Dr. Greenleaf recommends taking a seat to relax those pelvic floor muscles and let your personal spigot more easily turn on. (If you’re wigged out by the idea in a public bathroom, you can always place toilet paper or a seat cover on the toilet, if available, to avoid direct contact with your skin—and so long as you wash your hands post-pee, there’s a low chance you’ll transfer any bad actors into your body.)
3. Do not rush it. “I tell all my patients, ‘There’s no emergency to pee,’” Dr. Drolet says. “You should never have to force the urine out.” Again, pee happens when the signal from your brain tells your urethra it’s safe to open the floodgates—but if you’re trying to make the pee come out extra fast, you might be pushing against a still partially closed urethra, which can send pee back up into your kidneys, Dr. Greenleaf says, increasing your risk of not only an inconsistent flow but a kidney infection. Your best course of action is to do as your urethra naturally wants to do when peeing, and chill out for a sec.
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Originally Appeared on SELF
