Andrew Siegel MD 10/31/2020 Happy Halloween!
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Winter Urinary Urgency and Frequency
Daylight Saving Time ends tomorrow. Daylight hours are waning rapidly, temperatures are dropping, and Winter lurks right around the corner. Fact: Cold weather provokes urinary urgency and frequency. This happens during the Winter season or when one is exposed to a cold environment, e.g., a chilly blast of air when opening the freezer door in the frozen section of the supermarket, an air conditioner blasting cold air, or when shivering while sitting in a chairlift on a ski resort. Today’s entry explores the rationale behind this bizarre phenomenon.
There are several good reasons for seasonal cold-related urinary urgency and frequency:
LESS SWEATING IN WINTER
In winter months, one generally perspires (“sensible” water loss) significantly less than during summer months. Furthermore, because of cooler ambient temperatures during the winter, there is less “insensible” fluid loss—the loss of water through skin evaporation and from breathing that is not recognized as water loss. With decreased sensible and insensible perspiration, the body must maintain fluid balance with increased urine production. The increased urine production that balances the decreased sensible and insensible losses causes more rapid bladder filling and more urinary urgency and frequency.
INCREASED LIQUID CONSUMPTION
In an effort to stay warm during winter months many people rely on hot beverages including soups, coffee, tea, and hot chocolate. In addition to the increased fluid load, coffee, tea and hot chocolate contain caffeine (or a caffeine-like ingredient) that has a diuretic effect that causes the kidneys to increase urine output. Between the increased volume of fluid intake and the diuretic effect of caffeine, urine production ramps up and again, the faster the bladder fills up, the more urinary urgency and frequency will likely result.
COLD-INDUCED INVOLUNTARY BLADDER CONTRACTIONS, A.K.A. “CHILL” URGENCY
An involuntary bladder contraction occurs when the bladder muscle contracts at inappropriate times, “squeezing without its owner’s permission.” This causes a strong sense of urgency to urinate and the need to hustle to the bathroom. Involuntary bladder contractions are one of the key contributing factors to what is referred to as “overactive bladder.” Numerous triggers can induce involuntary bladder contractions, including exposure to running water, putting the key in the door to one’s home, and exposure to cold.
Published scientific studies have demonstrated a seasonal variation in overactive bladder symptoms. In Winter there clearly is an increased prevalence of the number of patients experiencing urgency and frequency and an increased number of daily frequency and incontinence episodes. The bottom line is that overactive bladder symptoms worsen in the winter.
COLD-INDUCED DIURESIS
The human body is masterful at maintaining a stable equilibrium and heat conservation. With cold exposure, blood vessels to the skin and non-vital organs constrict (narrow) to maintain blood flow to the vital internal core organs. Because the blood volume does not change, the same volume circulates through less blood vessels, resulting in an increase in blood pressure. This is sensed by the kidneys resulting in increased production of urine (diuresis) to reduce blood volume and blood pressure. This diuresis induces urinary urgency and frequency.
Bottom Line: Less sensible and insensible water loss plus increased intake of caffeinated beverages plus “chill” urgency plus cold-induced diuresis adds up to a perfect storm for more frequent peeing in winter months. Now you understand why.
Wishing you the best of health,
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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery. He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area,Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States. His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families.
Video trailer for Prostate Cancer 20/20
Preview of Prostate Cancer 20/20
Andrew Siegel MD Amazon author page
PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families is now on sale at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours).
Dr. Siegel’s other books:
PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food
MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health
THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health
Tags: Andrew Siegel MD, involuntary bladder contraction, overactive bladder, urinary frequency, Winter urinary urgency
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