The way we respond to the need to urinate can become a habit—sometimes beginning in childhood or early adulthood. These habits may include avoiding public restrooms, holding urine when busy, urinating “just in case,” hovering over the toilet, or pushing to empty the bladder.

A 2023 study asked 338 women age 65 and older when they first noticed certain toileting habits, bladder triggers, urinary urgency, and leakage. The researchers found that some behaviors often began early in life, while others became more common during or after midlife.

Habits That Often Started Early

Many women reported developing certain restroom habits during their teens or young-adult years. These included:

• Worrying about the cleanliness of public toilets
• Avoiding public restrooms
• Urinating before leaving home
• Hovering or crouching over a toilet away from home
• Delaying urination when busy

These behaviors may be influenced by restroom cleanliness, limited access to toilets, school or workplace rules, and concerns about privacy or safety.

Changes That Often Appeared After Age 45

Other behaviors were more likely to begin during perimenopause, menopause, or later adulthood. These included:

• Urinating without a strong need, often called going “just in case”
• Trying to keep the bladder empty to avoid urgency or leakage
• Pushing or straining to begin, continue, or finish urinating

In the study, urinary urgency and leakage also most often began after age 45. On average, women recalled urgency beginning at about age 46 and leakage beginning at about age 53.

Everyday Situations Can Trigger an Urge

Some people notice a sudden need to urinate in response to a particular situation—even when the bladder did not feel especially full moments earlier. Common triggers reported in the study included:

• Hearing running water
• Arriving home or putting a key in the door
• Seeing or being near a familiar bathroom
• Thinking about using the bathroom
• Drinking caffeine
• Getting out of bed or standing up from a chair

These are sometimes called urinary urge cues. The brain may learn to connect a place, sound, thought, or activity with the urge to urinate. Most women in the study reported noticing these triggers later in life, around the same period when urgency and leakage became more common.

What Does This Mean for Your Bladder Health?

The study suggests that bladder habits develop throughout life. Some are understandable responses to unclean restrooms, limited bathroom access, busy schedules, or fear of leakage. However, repeatedly holding urine, frequently urinating without a true urge, or regularly straining may be patterns worth discussing with a healthcare professional.

Becoming aware of your own habits and triggers is a useful first step. Notice whether you routinely:

• Wait until the urge is extreme
• Use the bathroom every time you leave home, even without an urge
• Hover instead of sitting and relaxing
• Push or strain to empty your bladder
• Experience sudden urges in response to specific sounds or places

The researchers noted that toileting behaviors can change and that learned bladder cues may also be modifiable. Better access to safe, clean, and comfortable restrooms is another important part of supporting bladder health.

An Important Limitation

This research does not prove that these habits cause urinary urgency or leakage. The participants were older women recalling events from earlier in their lives, so their memories may not have been exact. The results also may not apply to every woman or to men. The study is best viewed as a reminder that bladder health is shaped by habits, life stages, and the environments in which people live and work.

Source: O’Connell KA, Newman DK, Palmer MH (2023) When did they start? Age of onset of toileting behaviors and urinary cues as reported by older women, Women’s Health Reports, Jul 28, 4(1), 387–399