Why Women Over 60 Can Hold It All Day but Not All Night (It’s Not What You Drink After 6 P.M.)
It’s always the same three numbers. 11:40. 1:55. 3:20. On a bad night there’s a fourth one around five, and then there’s no point going back to sleep.
Here is the strange part. In the daytime, I am fine.
I can drive three hours to my sister’s in Laredo without stopping. I can cook all Sunday, do the dishes, chase the grandkids, and not think about a bathroom until supper.
Then I lie down, and my bladder turns into somebody else’s.
I’m 71. I live in San Antonio, on the same street for 38 years. I want to say something clearly, because when I finally told my doctor, she handed me a pamphlet about pads. I don’t leak. I never have.
My problem was never the day. I could hold it all day. I just couldn’t hold it all night, and nobody could tell me why.
So I did what every woman my age is told to do.
The six o’clock rule.
My doctor said it. My sister said it. Every magazine in every waiting room said it. Stop drinking in the evening.
So I did. Coffee only before ten. No iced tea with supper. Nothing at all after six.
I even put a strip of masking tape on the cabinet where I keep the glasses, so I would stop forgetting.
I went to bed with a dry mouth. I woke up at night with a dry mouth. And I still got up. Two, three, four times.
That is the part that made me feel a little crazy. If it was the water, cutting the water should have fixed it. I had cut it down to almost nothing.
So where was all of it coming from?
“Three years of nothing to drink after five. Headaches every evening and a mouth like cotton at 2 a.m. I was still up at one and at four. Week three on the softgel I was up once, and I have my iced tea with supper again.”Barbara K. · 69 · Columbus, OH
The answer came from next door.
The nurse next door.
Margit has lived next to me for eleven years. She is 74, born in a farming village in Styria, Austria. For thirty years she worked the night shift at a nursing home on the north side of San Antonio.
One morning she saw me getting the paper at six in my robe, looking the way I looked. She asked how many times I’d been up. I said four. She didn’t laugh.
“But you hold it fine in the day?” she asked. I said yes, all day long. She nodded like she already knew the answer.
“Thirty years of night shifts,” she said. “You learn one thing. Old bodies make water at night.”
She came back that afternoon with a plastic measuring pitcher, the kind they use on the ward, and a little spiral notebook.
“Three days,” she said. “Every time you go, day or night, you measure it and write it down. Then we talk.”
What three days in a notebook showed me.
I felt silly doing it. I did it anyway.
In the daytime, I went every three or four hours. A normal amount each time.
At night it was a different story. I went to bed at ten with almost nothing to drink since six. And between bedtime and sunrise, I made more than I had made in the whole day.
Margit tapped the night column with her pen.
“There it is,” she said. “That isn’t a weak bladder. That’s a flood. A Night Flood.”
Here is how she explained it to me, sitting at my kitchen table with a pan dulce she didn’t touch.
See what Margit told me to take →
It isn’t your age. It’s the tap that stopped turning down.
When you are young, your body has a night setting. Around bedtime, your brain sends out a hormone signal that tells the kidneys to slow down and make less, so you can sleep straight through.
Think of it as a tap that turns itself down every night.
After sixty, that signal gets weaker. For a lot of women it fades a little more every year. The tap stays open, and the kidneys keep making water at night almost the way they do at noon.
Doctors have a name for it, nocturnal polyuria. In older adults they diagnose it when more than a third of a whole day’s urine is made at night. Mine was more than half.
In one group of night-wakers who kept a diary like mine, close to nine in ten turned out to have this. Most of them had been told it was their age, or their bladder, or what they drank.
That is the Night Flood. And it finally explained the thing I couldn’t make sense of. My bladder holds all day because in the daytime the tap is set right. At night the tap stays open, the bladder fills by two, and it wakes me up.
Then there is the second half, and the second half is what made it so much worse.
A bladder over sixty gets twitchy. The muscle in its wall starts sounding the alarm before it is actually full. So the Night Flood fills it fast, and the twitchy wall rings the bell early. Two problems, stacked on top of each other, every night.
“I can drive three hours to my daughter’s in Savannah without a stop. Then I get in that bed and I’m up every two hours. I thought it was my nerves. Week five, I slept from eleven to almost six, and my daughter asked me what I’d done different.”Gwendolyn T. · 74 · Macon, GA
Why drinking less made it worse.
This is the part that made me angry.
When you stop drinking, your urine doesn’t stop. It just gets stronger. Darker, more concentrated, what Margit called “strong tea.” And strong tea irritates the lining of the bladder.
An irritated bladder wall rings the alarm even earlier.
So for two years I did the one thing that made my bladder jumpier, and it did nothing at all to the tap. The flood still came every night. It just came stronger.
That’s not even counting the headaches, or the constipation, or the dizzy feeling when I stood up too fast in a dark bedroom. Margit said that on the night shift, she saw more falls on the way to the bathroom than anywhere else.
I asked her the obvious question. If drinking less doesn’t work, what does? You can’t reach in and turn a tap you can’t see.
She smiled and went home to get something from her pantry.
What her grandmother put on everything.
In Styria, where Margit grew up, farmers grow a special pumpkin whose seeds have no shell. They press those seeds, cold, into a dark green oil so thick it looks black in the bottle.
Her grandmother put it on potato salad, on eggs, even on vanilla ice cream. And when the old women in the village started getting up at night, they took it by the spoonful.
That isn’t just grandmother talk.
In Germany, pumpkin seed has been an approved remedy for an “irritable bladder” since the 1980s. In 2012 the European Medicines Agency recognized its traditional use for bladder problems that come with an overactive bladder.
And in Japan, researchers gave men and women with an overactive bladder pumpkin seed oil for twelve weeks. Their bladder scores dropped at six weeks, and dropped again at twelve.
Here is how Margit put it, in her nurse voice.
“You can’t turn the tap back down with a glass of water. But you can stop the bell from ringing at half full.”
Cold-pressed pumpkin seed oil carries plant sterols that work on the bladder wall itself. They don’t block nerves and they don’t dry you out. They calm the twitch, so the bladder holds what the night sends it, longer, before it calls you.
So why had nobody ever told me? Margit shrugged. “It’s a salad oil. Nobody can patent a pumpkin. Nobody gets rich telling you.”
“My cardiologist said drink more and my sister said drink less. I did the notebook like the article says. My nights were double my days. I stopped fighting the water and started the softgel with supper. Down to one trip by week four.”Nora F. · 77 · Grand Rapids, MI
Calm the alarm, not the water →
Why my first bottle did nothing.
Let me save you the mistake I made. I went to the drugstore and bought the cheapest pumpkin seed oil capsules on the shelf.
Margit read the label and handed it right back. “Hot-pressed,” she said. “Dead oil.”
Those plant sterols are fragile. Heat breaks them down, the way boiling ruins fresh herbs. A lot of cheap oil is pressed hot or pulled out with solvents, because it squeezes more oil out of every ton of seeds.
It’s still oil. It just isn’t the oil that does the work.
What I take now is one softgel a day with supper. 1,000 mg of cold-pressed pumpkin seed oil. One, not three. It goes down easy, and I don’t have to remember anything at bedtime.
And Margit gave me three rules that cost nothing. I follow them with the softgel, and I’d tell anyone to start with them tonight.
1. Drink your water. Most of it before four o’clock, but never go to bed thirsty. Thirsty makes the alarm louder.
2. Feet up at four. Water pools in your ankles all day and comes back to the bladder when you lie down. Put your feet up for an hour in the late afternoon, so it comes back before bed instead of at two.
3. Last trip right before the light goes out. Not an hour before. Right before.
See the one I take with supper →
What changed, and when.
Week one, nothing. I want to be honest about that. I was still up at two and at three.
Week two, I noticed the five o’clock trip was gone. I woke up at 6:20 and the sun was already on the curtains.
Week four, I was up once. Once, around three, and back asleep before I could start worrying about it.
Week six was the real test. I went to Houston for my granddaughter’s first birthday and slept in the guest room next to the nursery.
Last year, in that same room, I flushed at two in the morning and woke up the baby and my daughter both. I lay there afterward feeling like a burden in my own daughter’s house.
This year nobody heard a thing. I didn’t get up.
I still have my glass of water with supper. I took the tape off the cabinet.
“I don’t leak, I never did, and I was tired of being handed pamphlets about pads. My problem was 3 a.m. Six weeks in, I sleep through most nights. I put my feet up at four like Margit says, too. My husband says I stopped snapping at him.”Teresa P. · 66 · Tampa, FL
Don’t buy one pouch.
One pouch is thirty softgels, thirty nights. Most women notice the first change somewhere between week two and week four, and the real difference after that. One pouch runs out right when it starts.
That is the worst place to stop. You paid for the slow part and quit before the good part.
Here is the arithmetic. Three pouches come as Buy 2, Get 1 Free. Five come as Buy 3, Get 2 Free. Going from three to five gets you two more pouches for the price of one, and it’s the one most women choose.
Per night, that comes to less than a cup of coffee. One pouch on its own also doesn’t ship free, because free shipping is for the bundles.
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