Dr. Susie Gronski
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If You Need To Tinkle, Please Don't Sprinkle!

Ok ladies! How many times have you gone into a bathroom stall only to be grossed out by seeing sprinkles of pee all over the toilet seat? You probably do one of the following: suck it up and wipe it, hover over the toilet seat praying that your butt cheeks don't make contact with the seat, or move over to the next stall. But most likely, it probably won't be any different in the next stall either. 

My message to you today is DON'T HOVER OVER THE TOILET SEAT! I know what you're thinking right now "hell no, public bathrooms are so gross". I've heard this time and again before from many of my female patients who refuse to sit down on the toilet seat in public restrooms. The common misconception is that the toilet seat is the dirtiest part of the whole bathroom. In fact, it's the least germ infested cesspool. 

Dr. Charles Gerba, otherwise know as Dr. Germ, is a microbiologist from the University of Arizona who published a study in 2005 that analyzed the germ content of various public sites. Categories included: shopping malls, daycares, offices, personal environments, and activities such as gyms, air/bus travel, restaurants, movie theaters, playgrounds, and doctors. After collecting 1,061 samples, guess what the researchers found? The toilet seat is NOT the germiest of contact surfaces. Surprisingly, children's playground equipment came in as number one. Second, were bus rails and armrests. Shopping car handles came into third. Public bathrooms ranked 7 out of 10 on the list of sites swabbed. 

In an earlier study of his, Dr. Germ and his colleagues also discovered that women's restrooms were far more contaminated with bacteria than the men's, can you believe that?! We all know that men's bathrooms smell worse and look dirtier, but researchers found that there was moree.coli bacteria found in women's restrooms than in men's. They speculated that women spend more time in the bathroom than men do. The germiest hot spots found were the sanitary napkin disposals, the floor, and the sink, all in that order.

So why am I telling you all this? To convince you that sitting on a public toilet is OK. Aside from the bacteria infested fears we have and the annoyance of seeing pee all over a toilet seat, hovering over a toilet seat isn't healthy for your bladder or your pelvic health.

Let me explain. Your bladder works opposite in relation to your pelvic floor muscles. When your pelvic floor muscles relax, like when sitting on the toilet, the bladder gets a signal to empty and the muscle that controls the bladder squeezes to help with bladder emptying. When you're finished peeing,  wiping and standing up, the pelvic floor muscles return to their normal resting tone, giving the brain a signal that it's ok to start filling again. There are moments where you can buy yourself some time from emptying the bladder, like if you really have the urge go but the nearest bathroom is a couple of blocks away. You can relax the bladder muscle by performing some quick flicksQuick flicks are done by quickly contracting your pelvic floor muscles (like stopping the flow of urine) followed by immediate relaxation. Repeat this about 10 times in a row to tell the bladder muscle to relax until you can get to the nearest bathroom. 

When you hover over the toilet you not only get pee running down your thigh, but you also start learning some poor bladder habits.

Hovering over a toilet can cause:

  1. Incomplete bladder emptying- when you hover, you're using all of your core stabilizing muscles to keep you squatting, many of which work together with your pelvic floor causing the pelvic floor muscles to tighten instead of relaxing. When this happens the bladder muscle gets a false signal preventing it from fully emptying, which means you might have the urge to go again very soon.
  2. Urinary urgency-frequency- as described in bullet 1, when you don't completely empty your bladder you end up with more concentrated urine stored in the bladder, which can cause irritation to the bladder lining. Think of putting a sour patch kid inside your mouth, what happens? You purse your lips, squeeze your cheeks and squint your eyes because it's so sour. The lining of the bladder is just as sensitive as the inside of your mouth so it's not going to want to keep concentrated urine in it for very long, causing you to have a strong  urge to pee more frequently. 
  3. Overactive pelvic floor muscles- your pelvic floor muscles work in 3 positions: contracted, relaxed, and stretched. A contracted position is like doing a kegel (stopping the flow of urine and gas). A relaxed position is the normal resting tone that these muscles have throughout the day. After doing a contraction and letting go, your muscles should return to their normal resting level. For some, this may be a difficult task to accomplish without some guidance from a pelvic floor therapist. Lastly, stretched, which should happen when you have to fart or poop.  I like to describe this to my patients using an elevator analogy. The lobby is the resting position, the 1st floor is the contracted position, and the basement/garage level is the stretched position.
  4. Bacterial infections- The tube that empties your bladder is called the urethra. Its tiny opening is found above the vaginal opening. When you hover, the muscles around the urethra do not relax all the way, causing some of the bacteria from the urine to be stored in this tube. Over time, this can irritate the lining of the urethra and cause symptoms of a UTI (urinary tract infection). Often times, the urine that is clamped in the urethra will also leak out once you're fully standing causing you to have sensations of urinary leakage and damp underwear. When this happens too often, psychologically, we freak out. So what do we do? We start wearing a panty liner for protection. Wearing a panty liner is the worst thing that you can do. Menstrual pads are not meant to absorb urine usually creating a fun environment for bacteria to party in. Bacteria love dark, warm, moist places and what better place to party in than the vagina!

How to overcome your fear of public toilets?

  • Use toilet seat covers, if available
  • Carry disposable disinfectant wipes with you so that you can wipe down the toilet seat before sitting
  • Tear off some toilet paper to place down on the seat
  • Remember that the dirtiest objects in a public restroom are the sanitary napkin disposals, the floor, and the sink.
  • Be brave! Grit your teeth, close your eyes and just go for it!

I hope that the next time you use a public restroom, you remember this post, smile, and confidently sit on the toilet seat knowing that you're optimizing your bladder and pelvic health and not leaving a mess for the next lady that walks into the stall. 


Kelly A Reynolds , Pamela M Watt , Stephanie A Boone & Charles P Gerba (2005) Occurrence of bacteria and biochemical markers on public surfaces
International Journal of Environmental Health Research, 15:3, 225-234, DOI: 10.1080/09603120500115298


 

The blog content on this website is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.