Women and Paruresis

Every woman has experienced the irritation of walking into a public toilet and finding a long queue for the next vacant cubicle. But for women with paruresis the anxiety is increased, as many of them experience great difficulty in peeing when they know there is aqueue. The anxiety appears to be even greater when someone in the queue is specifically waiting for them.

When they do reach the toilet, some women find that they need to wait until someone operates a hand dryer or flushes another toilet before they are able to pee - if indeed they can, for some women find it impossible in this sort of situation. It can even affect their ability to pee if the walls of the toilet cubicle don’t reach the floor especially if the next cubicle is occupied.

Many women with increased urination anxiety experience particular problems around holidays. They often can’t pee on moving vehicles such as trains, boats, coaches or planes, and so restrict their plans for travel, missing out on experiences that other people take for granted. Those who can’t avoid travelling often spend weeks beforehand worrying how they will manage.

Home is usually a place of safety where women with paruresis can feel able to relax and function normally. However, even home can cause difficulties if there are guests; some women report feeling anxious and uncomfortable or even being unable to use their own toilet when there are other people in the house.

It can be difficult and embarrassing for women to admit to having paruresis. Most hide the issue from all but their closest friends, some even from close family members. But not speaking about it means women can think that they are the only ones experiencing difficulties.

They often express great relief when they discover that it is a known medical condition and that there are other women with the same urination anxiety. They find it helps to compare experiences and support other women having difficulty urinating once they have taken the step of acknowledging their own paruresis.

Some women find it useful to use catheters from time to time as a backup. A catheter is a thin, flexible tube which can be inserted into the bladder to allow urine to drain away into the toilet. There is a potential risk of causing infection. For that reason it is advisable to consult your GP and ask for a continence nurse to help you to learn the correct technique for inserting a catheter. Women who use them suggest new users practice in the comfort of their own home before trying to use them away from home. This is especially important for using catheters when flying or on a train. The limited space in those toilets and the potential for sudden bumps can make using a catheter challenging. A continence team recently offered these useful tips:

• Take disinfectant wipes and wipe down the top and bottom of the seat before you sit down.
• Once you’ve opened the catheter, hold it between your teeth. Aircraft and trains can be bumpy and so you can’t put it down safely. These catheters are sterile so should never be put down on a surface.
• Carry all your stuff in a drawstring makeup bag that opens flat. Put this in the hand basin so you have everything to hand before you start.
• Use a mirror and a head torch if necessary to ensure you can see clearly.

Some women find that having a catheter discreetly tucked in their handbag can be enough to allow them to relax enough to pee normally. It can break the cycle of overthinking about what you would do if you weren’t able to pee – you could use a catheter, so that stress is eliminated.

For more information about catheters visit Coloplast Catheter Guides

Feedback from the women who attend our workshops indicates that the Cognitive Behavioural Therapy (CBT) approach is as effective for women as it is for men.

For more information about the ways that women may experience paruresis visit the Shy Bladder Video Series.