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How can the weather impact your bladder health?




Do you find that there are certain seasons or weather types which exacerbate your bladder

symptoms? A quick google search pulls up many articles and chat rooms in which people have

questioned why their symptoms worsen in winter or summer, and detail the additional

precautions they take to avoid flare-ups during these seasons. Frustratingly, the impact that

weather can have on your symptoms has not been researched enough, but there are some

studies and theories that we can talk about which may help you understand your symptoms

more.


The evidence

Weather and bladder health


To begin, there is evidence that during summer your chances of contracting urinary tract

infections (UTIs) may be higher. A large study of women in the US found that warmer weather

increased the risk of UTIs in a dose-response fashion. Dose-response means that as the dose

(warm weather) increases, the response (risk of UTIs) also increases. A dose-response

relationship is particularly interesting because this suggests that the dose is somehow causing

the response. The study found that on days when the prior week’s average temperature was

between 25 and 30C, the incidence of UTIs increased by 20 - 30%, in comparison to when the

prior week’s temperature was 5 to 7.5C (1).

On the other hand, two studies suggest that winter leads to more severe bladder symptoms.

One study investigated the impact of weather on UTI symptoms in Korean men and found that

urinary frequency and urgency was greater in winter; those who participated in the study during

winter months voided greater volumes of urine than those studied in summer (2). In addition,

another study from Japan gave questionnaires to participants and found that for those living in a

subtropical area their frequency, urgency, and nocturia (urinating at night) was more severe in

winter (3).


Weather and pain


There is evidence to suggest that colder temperatures can increase a person’s perception of

pain intensity. A scandinavian study gave questionnaires to 31 men who had chronic pelvic pain

asking about their symptoms across different weather types and seasons (4). The results found

that the participants perceived their pain to be 3 times more severe in the winter months and

that they believed lower temperatures exacerbated symptoms. In terms of your bladder

symptoms, it may be that the sensations of painful urination, muscle spasms and abdominal

pain are more severe in winter.


The theory

How is the weather having an impact?


In terms of how the weather could be making these impacts, there are different theories which

include physiological differences in the body resulting from cold temperatures, as well as

lifestyle changes that people adopt in response to winter and summer.


Vasoconstriction - When you are cold your blood vessels constrict (this can also occur when

you are emotionally stressed) which stops the secretion of a hormone (vasopressin) which leads

to increased urination. Vasoconstriction can also reduce blood flow in your body which can

increase stiffness and pain.


Dehydration - In summer, you sweat more and are more likely to become dehydrated. As a

result, your urine will be less diluted and more acidic which can make it more painful to pass.

This acidity also produces an environment in which bacteria can thrive and therefore result in a

UTI. Another way that dehydration increases risk of UTIs is that it leads to less urination, which

means bacteria has more time to grow in your urethra. Evidence of the role of dehydration in

UTIs comes from a study which found that increasing water consumption, to tackle dehydration,

decreased hospital admissions for UTIs by 36% in British care homes (5).


Sleep quality - Many people experience poorer sleep quality in the summer and it is commonly

understood that tiredness can increase an individual's perception of pain severity.


Decreased physical exercise - You may find that in summer because it’s so hot outside you

exercise less, or contrarily you may be more sedentary in winter to avoid venturing into the cold

or the dark as we experience less daylight hours. Sitting for prolonged periods of time has been

found to be associated with a higher risk of bladder symptoms (6), however this study only

investigated men and the underpinnings of this mechanism are not well understood.


Mood - It is commonly understood that psychological factors such as increased stress can alter

the way your brain perceives pain. Individuals who are feeling happy and positive may

experience pain less intensely than those who are depressed and stressed. It may be that the

gray skies, colder temperatures and lack of sunshine are making you feel depressed which is

worsening your perception of your bladder pain.


It is important to note that these mechanisms do not appear by themselves but they interact with each other. For example, lack of sleep quality could make you feel more stressed and make you slower to complete work tasks, which leads to sitting down for longer and when you’ve finally finished work, you may decide to stay in and watch TV rather than go on a run. It may be some or all of these factors which contribute to your experience of symptoms worsening during

specific weather types.


References


(1) Simmering, J. E., Polgreen, L. A., Cavanaugh, J. E., Erickson, B. A., Suneja, M., & Polgreen,

P. M. (2021). Warmer Weather and the Risk of Urinary Tract Infections in Women. Journal of

Urology, 205(2), 500-506. https://doi.org/doi:10.1097/JU.0000000000001383

(2) Choi, H. C., Kwon, J. K., Lee, J. Y., Han, J. H., Jung, H. D., & Cho, K. S. (2015). Seasonal

variation of urinary symptoms in Korean men with lower urinary tract symptoms and benign

prostatic hyperplasia. The world journal of men's health, 33(2), 81-87.

(3) Yoshimura, K., Kamoto, T., Tsukamoto, T., Oshiro, K., Kinukawa, N., & Ogawa, O. (2007).

Seasonal alterations in nocturia and other storage symptoms in three Japanese communities.

Urology, 69(5), 864–870. https://doi.org/10.1016/j.urology.2007.01.037

(4) Hans Hedelin, Karin Jonsson & Dan Lundh (2012) Pain associated with the chronic pelvic

pain syndrome is strongly related to the ambient temperature, Scandinavian Journal of Urology

and Nephrology, 46:4, 279-283, DOI: 10.3109/00365599.2012.669404

(5) Lean, K., Nawaz, R. F., Jawad, S., & Vincent, C. (2019). Reducing urinary tract infections in

care homes by improving hydration. BMJ open quality, 8(3), e000563.

https://doi.org/10.1136/bmjoq-2018-000563

(6) Park, H. J., Park, C. H., Chang, Y., & Ryu, S. (2018). Sitting time, physical activity and the risk of

lower urinary tract symptoms: a cohort study. BJU International, 122(2), 293-299.

https://doi.org/https://doi.org/10.1111/bju.1414

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