To Pee Or Not To Pee

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Is it “strengthening” to hold, or are we doing ourselves harm if we do? Dr. Heba Shaheed explains in this short video:

A flood of reasons not to hold

Humans should urinate 4–6 times daily, but for many people, the demands of modern life often lead to delaying urination, raising questions about its effects on the body.

So first, let’s look at how it all works: the bladder is part of the urinary system, which includes the kidneys, ureters, urethra, and sphincters. Urine is produced by the kidneys and transported via the ureters into the bladder, a hollow organ with a muscular wall. This muscle (called the detrusor) allows the bladder to inflate as it fills with urine (bearing in mind, the main job of any muscle is to be able to stretch and contract).

As the bladder fills, stretch receptors in that muscle signal fullness to the spinal cord. This triggers the micturition reflex, causing the detrusor to contract and the internal urethral sphincter to open involuntarily. Voluntary control over the external urethral sphincter allows a person to delay or release urine as needed.

So, at what point is it best to go forth and pee?

For most people, bladder fullness is first noticeable at around 150-200ml, with discomfort occurring at 400-500ml (that’s about two cups*). Although the bladder can stretch to hold up to a liter, exceeding this capacity can cause it to rupture, a rare but serious condition requiring surgical intervention.

*note, however, that this doesn’t necessarily mean that drinking two cups will result in two cups being in your bladder; that’s not how hydration works. Unless you are already perfectly hydrated, most if not all of the water will be absorbed into the rest of your body where it is needed. Your bladder gets filled when your body has waste products to dispose of that way, and/or is overhydrated (though overhydration is not very common).

Habitually holding urine and/or urinating too quickly (note: not “too soon”, but literally, “too quickly”, we’re talking about the velocity at which it exits the body) can weaken pelvic floor muscles over time. This can lead to bladder pain, urgency, incontinence, and/or a damaged pelvic floor.

In short: while the body’s systems are equipped to handle occasional delays, holding it regularly is not advisable. For the good of your long-term urinary health, it’s best to avoid straining the system and go whenever you feel the urge.

For more on all of this, enjoy:

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Want to learn more?

You might also like to read:

Keeping your kidneys happy: it’s more than just hydration!

Take care!

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  • Getting antivirals for COVID too often depends on where you live and how wealthy you are

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    Medical experts recommend antivirals for people aged 70 and older who get COVID, and for other groups at risk of severe illness and hospitalisation from COVID.

    But many older Australians have missed out on antivirals after getting sick with COVID. It is yet another way the health system is failing the most vulnerable.

    CGN089/Shutterstock

    Who missed out?

    We analysed COVID antiviral uptake between March 2022 and September 2023. We found some groups were more likely to miss out on antivirals including Indigenous people, people from disadvantaged areas, and people from culturally and linguistically diverse backgrounds.

    Some of the differences will be due to different rates of infection. But across this 18-month period, many older Australians were infected at least once, and rates of infection were higher in some disadvantaged communities.

    How stark are the differences?

    Compared to the national average, Indigenous Australians were nearly 25% less likely to get antivirals, older people living in disadvantaged areas were 20% less likely to get them, and people with a culturally or linguistically diverse background were 13% less likely to get a script.

    People in remote areas were 37% less likely to get antivirals than people living in major cities. People in outer regional areas were 25% less likely.

    Dispensing rates by group. Grattan Institute

    Even within the same city, the differences are stark. In Sydney, people older than 70 in the affluent eastern suburbs (including Vaucluse, Point Piper and Bondi) were nearly twice as likely to have had an antiviral as those in Fairfield, in Sydney’s south-west.

    Older people in leafy inner-eastern Melbourne (including Canterbury, Hawthorn and Kew) were 1.8 times more likely to have had an antiviral as those in Brimbank (which includes Sunshine) in the city’s west.

    Why are people missing out?

    COVID antivirals should be taken when symptoms first appear. While awareness of COVID antivirals is generally strong, people often don’t realise they would benefit from the medication. They wait until symptoms get worse and it is too late.

    Frequent GP visits make a big difference. Our analysis found people 70 and older who see a GP more frequently were much more likely to be dispensed a COVID antiviral.

    Regular visits give an opportunity for preventive care and patient education. For example, GPs can provide high-risk patients with “COVID treatment plans” as a reminder to get tested and seek treatment as soon as they are unwell.

    Difficulty seeing a GP could help explain low antiviral use in rural areas. Compared to people in major cities, people in small rural towns have about 35% fewer GPs, see their GP about half as often, and are 30% more likely to report waiting too long for an appointment.

    Just like for vaccination, a GP’s focus on antivirals probably matters, as does providing care that is accessible to people from different cultural backgrounds.

    Care should go those who need it

    Since the period we looked at, evidence has emerged that raises doubts about how effective antivirals are, particularly for people at lower risk of severe illness. That means getting vaccinated is more important than getting antivirals.

    But all Australians who are eligible for antivirals should have the same chance of getting them.

    These drugs have cost more than A$1.7 billion, with the vast majority of that money coming from the federal government. While dispensing rates have fallen, more than 30,000 packs of COVID antivirals were dispensed in August, costing about $35 million.

    Such a huge investment shouldn’t be leaving so many people behind. Getting treatment shouldn’t depend on your income, cultural background or where you live. Instead, care should go to those who need it the most.

    Doctor types on laptop
    Getting antivirals shouldn’t depend on who your GP is. National Cancer Institute/Unsplash

    People born overseas have been 40% more likely to die from COVID than those born here. Indigenous Australians have been 60% more likely to die from COVID than non-Indigenous people. And the most disadvantaged people have been 2.8 times more likely to die from COVID than those in the wealthiest areas.

    All those at-risk groups have been more likely to miss out on antivirals.

    It’s not just a problem with antivirals. The same groups are also disproportionately missing out on COVID vaccination, compounding their risk of severe illness. The pattern is repeated for other important preventive health care, such as cancer screening.

    A 3-step plan to meet patients’ needs

    The federal government should do three things to close these gaps in preventive care.

    First, the government should make Primary Health Networks (PHNs) responsible for reducing them. PHNs, the regional bodies responsible for improving primary care, should share data with GPs and step in to boost uptake in communities that are missing out.

    Second, the government should extend its MyMedicare reforms. MyMedicare gives general practices flexible funding to care for patients who live in residential aged care or who visit hospital frequently. That approach should be expanded to all patients, with more funding for poorer and sicker patients. That will give GP clinics time to advise patients about preventive health, including COVID vaccines and antivirals, before they get sick.

    Third, team-based pharmacist prescribing should be introduced. Then pharmacists could quickly dispense antivirals for patients if they have a prior agreement with the patient’s GP. It’s an approach that would also work for medications for chronic diseases, such as cardiovascular disease.

    COVID antivirals, unlike vaccines, have been keeping up with new variants without the need for updates. If a new and more harmful variant emerges, or when a new pandemic hits, governments should have these systems in place to make sure everyone who needs treatment can get it fast.

    In the meantime, fairer access to care will help close the big and persistent gaps in health between different groups of Australians.

    Peter Breadon, Program Director, Health and Aged Care, Grattan Institute

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Hold Me Tight – by Dr. Sue Johnson

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    A lot of relationship books are quite wishy-washy. This one isn’t.

    This one is evidenced-based (and heavily referenced!), and yet at the same time as being deeply rooted in science, it doesn’t lose the human touch.

    Dr. Johnson has spent her career as a clinical psychologist and researcher; she’s the primary developer of Emotionally Focused Therapy (EFT), which has demonstrated its effectiveness in over 35 years of peer-reviewed clinical research. In other words, it works.

    EFT—and thus also this book—finds roots in Attachment Theory. As such, topics this book covers include:

    • Recognizing and recovering from attachment injury
    • How fights in a relationship come up, and how they can be avoided
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    This book lays the groundwork for ensuring a strong, secure, ongoing emotional bond, of the kind that makes/keeps a relationship joyful and fulfilling.

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  • No, COVID-19 vaccines don’t cause ‘turbo cancer’

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    What you need to know

    • COVID-19 vaccines do not cause “turbo cancer” or contain SV40, a virus that has been suspected of causing cancer.
    • There is no link between rising cancer rates and COVID-19 vaccines.
    • Staying up to date on COVID-19 vaccines is a safe, free way to support long-term health.

    Myths that COVID-19 vaccines cause cancer have been circulating since the vaccines were first developed. These false claims resurfaced last month after Princess Kate Middleton announced that she is undergoing cancer treatment, with some vaccine opponents falsely claiming Middleton has a “turbo cancer” caused by COVID-19 vaccines.

    Here’s what we know: “Turbo cancer” is a made-up term for a fake phenomenon, and there is strong evidence that COVID-19 vaccines do not cause cancer or increase cancer risk.

    Read on to learn how to recognize false claims about COVID-19 vaccines and cancer.


    Do COVID-19 vaccines contain cancer-causing ingredients?

    No. Some vaccine opponents claim that COVID-19 vaccines contain SV40, a virus that has been suspected of causing cancer. This claim is false.

    A piece of SV40’s DNA sequence—called a “promoter”—was used as starting material to develop COVID-19 vaccines, but the virus itself is not present in the vaccines. The promoter does not contain the part of the virus that enters the cell nucleus, so it poses no risk.

    COVID-19 vaccines and their ingredients have been rigorously studied in millions of people worldwide and have been determined to be safe. The National Cancer Institute and the American Cancer Society agree that COVID-19 vaccines do not increase cancer risk or accelerate cancer growth.

    Why are cancer rates rising in the U.S.?

    Since the 1990s, cancer rates have been on the rise globally and in the U.S., most notably in people under 50. Increased cancer screening may partially explain the rising number of cancer diagnoses. Exposure to air pollution and lifestyle factors like tobacco use, alcohol use, and diet may also be contributing factors.

    What are the benefits of staying up to date on COVID-19 vaccines?

    Staying up to date on COVID-19 vaccines is a safe way to protect our long-term health. COVID-19 vaccines prevent severe illness, hospitalization, death, and long COVID.

    The CDC says staying up to date on COVID-19 vaccines is a safer and more reliable way to build protection against COVID-19 than getting sick from COVID-19.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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    This book is in some ways not as marketable as some; it doesn’t have lots of colorful healthy food on the cover; it doesn’t even have a “woman laughing alone with salad” (you know the stock photo trope), let alone someone looking glamorous in a labcoat with a stethoscope draped over their shoulder despite listening to hearts not being a regular part of their job as an immunologist or such.

    What it does have, instead, is a lot of very useful information, and much more than you’ll usually find in a book for laypeople.

    For example, you probably know that for fighting inflammation, a green salad is better than a cheeseburger, say, and a black coffee is better than a glass of wine.

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    She also talks a lot of “pharmacy in your kitchen”, in other words, what herbs, spices, and plant extracts we can enjoy for (evidence-based!) benefits on top of our default healthy diet free (or at least mostly free, for surely none of us are perfect) from inflammatory agents.

    Not content with merely giving a huge amount of information, she also gives recipes and a meal plan, but honestly, it’s the informational chapters that are the real value of the book.

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  • I’m iron deficient. Which supplements will work best for me and how should I take them?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women are low in iron compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant.

    The body needs iron to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration.

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    How do I pick the right iron supplement?

    The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need.

    The sweet spot is between 60-120 mg of elemental iron. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain.

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    In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). The iron salts you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%).

    These formulations all work similarly, so your choice should come down to dose and cost.

    Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency.

    Should I take tablets or liquid formulas?

    Iron contained within a tablet is just as well absorbed as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference.

    The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term.

    What should I eat with my iron supplement?

    Research has shown you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone.

    If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it.

    Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other vitamin C-rich foods.

    A woman pours orange juice into a glass next to a bowl of strawberries and kiwifruit.
    Taking your supplement alongside foods rich in vitamin C, like orange juice or kiwifruit, can help your body absorb the iron. Anete Lusina/Pexels

    On the other hand, tea, coffee and calcium all decrease the body’s ability to absorb iron. So you should try to limit these close to the time you take your supplement.

    Should I take my supplement in the morning or evening?

    The best time of day to take your supplement is in the morning. The body can absorb significantly more iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest.

    Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can limit your ability to absorb it. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop.

    Our research has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes).

    My supplements are upsetting my stomach. What should I do?

    If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily.

    Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study has shown taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects.

    Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success.

    It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, iron can be toxic, so you don’t want to be consuming additional iron if your body doesn’t need it.

    If you think you may be low on iron, talk to your GP to find out your best options.

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    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Vital Aspects of Holistic Wellness

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