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