The Coffee Connection

By Kelly James-Enger

Do you rely on a cup or two of coffee to start your day? Do you enjoy a nonfat latte as an afternoon pickup? If you have bladder control problems, those coffee breaks can make your symptoms worse. What's the connection? And what can you do if you're hooked on your morning mocha?

The Caffeine Connection

While coffee is often singled out as the culprit for triggering urinary problems, it's actually the caffeine that's the problem. "Caffeine is a diuretic [which makes you produce more urine] and women who have overactive bladder symptoms tend to have more symptoms if their bladders fill quickly," explains Mary McLennan, M.D., associate professor and director of the division of urogynecology at Saint Louis University School of Medicine.

While women with overactive bladders may be more sensitive to caffeine, women with stress urinary incontinence may also notice its effects. Because your kidneys are producing more urine and your bladder is stimulated when you consume caffeine, you're more likely to experience that "having to go" right away feeling (also called urinary urgency) and you may have to urinate more frequently. To top it off, coffee's acidity can irritate your bladder, too.

Studies examining urinary symptoms and lifestyle factors reveal a connection between caffeine and incontinence complaints. Regular caffeine drinkers tend to complain more about urinary urgency, urinating frequently and feeling that their bladders are not completely emptying, says Dr. McLennan. However, not every woman who consumes caffeine will have problems, and there are women with stress urinary incontinence or overactive bladder symptoms who don't use caffeine at all.

How Much Coffee Can You Consume?

If you think caffeine may be aggravating your urinary symptoms, Dr. McLennan recommends you keep a diary to determine how much caffeine you're consuming and to identify any related effects. (The diary is similar to what you'd keep if you were experiencing symptoms of an overactive bladder or stress urinary incontinence.) Chart how much you drink, when you drink, and how frequently and how much you urinate. If you notice that you have to go to the bathroom more frequently or have wetting accidents when you drink coffee but can't bear to forego your java, try reducing the amount you consume at one time. Have a cup of coffee in the morning and one at lunch rather than two or three cups in the morning.

If symptoms are still problematic, you'll have to look for ways to decrease your caffeine intake. Switch to decaf (keep in mind that brands vary in their caffeine content) or drink half-caf (half regular coffee, half decaf); that may make a difference.

"People don't realize they drink so much caffeine," says Dr. McLennan. "When they look at their caffeine intake, including tea, coffee, dark beverages, and chocolate as well, they may find that they could cut out any of those and then they're going to be okay." Cutting back on caffeinated beverages while drinking more water, herbal non-caffeinated teas, and other caffeine-free beverages can make the transition easier.