Podcast Summary: What's That Rash?

Episode: Why do some people pee more often?
Date: December 23, 2025
Host: ABC News
Guest Expert: Norman Swan

Overview

This episode of "What's That Rash?" explores why some people need to pee more often, what controls bladder function, and whether it's possible—and safe—to train yourself to urinate less frequently. Host and guest Dr. Norman Swan answer listener questions about nighttime urination, bladder training, pelvic floor exercises (including Kegels), misconceptions about "holding on," and the evidence for herbal supplements.

Key Discussion Points & Insights

Bladder Basics & Nighttime Urination

• Listener question: Christine is bothered by needing to get up twice a night to urinate while camping, though at home she can sleep through. She has changed her habits and asks about products to help pee less (03:40).
• Two main control points:
  • Bladder Volume: How much urine your bladder can physically hold.
  • "Holding" Mechanism: Your ability to delay urinating by engaging pelvic floor muscles.
• Physiological explanation: Kidneys filter blood to make urine, which collects in the bladder. Normally, a hormone (antidiuretic hormone) reduces urine production at night (05:35–06:17).

Anatomy and Bladder "Alarms"

• The Trigone: A triangular area inside the bladder, responsible for sending urgent signals to the brain to urinate. In people with frequent urges, the trigone can be overactive—signaling when the bladder isn't full (06:17–07:18).
• Sphincters & Pelvic Floor: Critical for "holding on," especially after childbirth or with age, which weakens these supports and can lead to incontinence (07:18–08:27).

Kegel Exercises and Pelvic Floor Training

• What are you lifting?
  • Kegel exercises strengthen the "pelvic hammock" (muscles and ligaments supporting the bladder and other pelvic structures), not just the sphincter (08:27–08:56).
• Why do them?
  • Both to prevent incontinence and, over time, to improve bladder control.
  • Noted for treating stress incontinence post-birth and as everyone ages.
• Notable quote:
  • "It's essentially gym for the pelvis, gymnasium for the pelvis, trying to strengthen all that and restore function." – Norman, 08:56

Bladder Training: Can you teach yourself to pee less?

• Yes, but...
  • This means urinating less frequently, not necessarily producing less urine overall.
  • Continence nurses can teach "bladder training" by gradually delaying urination, which retrains the trigone to signal at a higher bladder volume (13:45–14:59).
• Holding on is NOT automatically bad:
  • Contrary to some beliefs, incrementally holding on longer is not bad for your bladder or kidneys—as long as there are no underlying obstructions or infections.
• Notable quote:
  • "If you hold on, you can progressively train your bladder to hold more urine and you're not going to cause kidney failure by doing that. And that's the core process." – Norman, 13:47

When to See a Doctor

• Immediate checkup needed if: You suddenly start needing to urinate more often, especially overnight, and it’s a change from your normal pattern.
• Possible causes: Kidney problems, infections, early diabetes, or for men, prostate issues (such as incomplete emptying/04:17).
• Notable quote:
  • "It's not normal to be from having a normal bladder function to peeing a lot, and you need to get that checked out in case it's a sign of something going wrong." – Norman, 04:50

Devices & Supplements for "Peeing Less"

• Biofeedback and Devices:
  • There are pelvic floor training devices and biofeedback mechanisms, often used post-birth or for incontinence (11:08–11:39).
  • Example: Brian Johnson's use of an electromagnetic pelvic floor machine to improve nighttime bladder control (09:16).
• Supplements:
  • Some use herbal products, e.g. pumpkin seed, often marketed toward men for prostate health.
  • Evidence is limited; no known effective dosage; likely harmless but results are uncertain (11:57–12:25).

UTI and Holding Urine

• Is holding on risky for infections?
  • Normal, incremental holding is not associated with a higher risk of urinary tract infection if you empty your bladder soon after (15:10–15:28).

Gender Differences & Aging

• After childbirth and with age:
  • Pelvic support is weakened, so both men and women can experience more bladder issues over time (07:26–08:27).
• Prostate issues in men:
  • Enlargement can lead to weaker stream, residual urine, and more frequent urges.

Memorable Moments & Notable Quotes

• On the oddity of Kegels:
  • "Do I shut my eyes and think of a sandy beach somewhere?" – Norman, joking about meditation with Kegels, 01:17
• On male obsession with pee stream strength:
  • "Why do men care so much about how far they can pee?" — Host
  • "That's the other side of an enlarged prostate... strength of your stream drops." — Norman, 10:37
• On Kegel exercises:
  • "It's essentially gym for the pelvis, gymnasium for the pelvis, trying to strengthen all that and restore function." — Norman, 08:56

Timestamps for Important Segments

• Kegel Exercise Demonstration: 01:05–02:19
• Main Listener Questions Introduced: 02:40–03:50
• Why Frequent Urination Needs a Checkup: 03:50–04:50
• Bladder Anatomy & Trigone Explanation: 05:35–07:18
• Pelvic Floor Weakness & Aging: 07:26–08:27
• Benefit of Kegel/Pelvic Training: 08:27–08:56
• Supplements and Products: 11:39–12:25
• Bladder Training – How it Works: 13:45–14:59
• UTI Risk with Holding On: 15:10–15:28
• Summary & Advice: 15:28–16:08

Bottom Line / Takeaways

• Seek medical advice if:
  • You have a new increase in urination, especially at night.
• Bladder training can work:
  • Gradually holding on longer and regular pelvic floor (Kegel) exercises can help you go less often.
• Supplements aren’t a proven solution:
  • Some are harmless, but evidence is limited.
• Pelvic floor strengthening benefits everyone:
  • Not just postpartum women or the elderly.
• Don’t worry about “holding on” in moderation:
  • It’s not harmful if done gradually and not caused by an underlying problem.

For more health questions, listeners are encouraged to email the show.