By Kelley Smith
For Women's Health Foundation
The following is an actual conversation I have had with my husband (H) more than once. At the risk of being labeled "odd," or "really odd," or "odd beyond belief," I'm going to share it with you. Don't judge.
Me: Why don't men sit on toilets to pee?
H: Because they don't.
Me: But don't urinals make you uncomfortable?
Me: Really? Because a lot of men seem to be very uncomfortable with even giving another guy a hug, so it's really interesting to me that these same men are fine urinating next to each other. I mean, the whole men's restroom is bizarre. It's like a homoerotic Roman bath, where you just casually expose your penis to strangers … every day … several times a day, in fact.
H: I don't even know where to begin with this.
Why don't men sit to pee?
The above conversation obviously never answered this question. Apparently, healthy men can empty their bladders very effectively sitting or standing. However, sitting is still the best practice for men with urinary issues (urinary urgency, frequency, weak stream, etc.).
When a healthy man chooses to stand among his peers to pee (versus sitting in a private stall), I can only conclude that he is trying to relive his glorious, madcap fraternity days—a conclusion that has been met with many an eye roll by my husband.
How should women pee?
There are certainly times when standing to void would be ideal. Sitting on a filthy public toilet (in a stall without seat covers and not enough toilet paper for wiping and covering the seat) is unappealing at best.
Squatting or hovering over the public toilet seat is an option, but not always realistic. Some people, like me, don't have the strongest thigh muscles. Perhaps I should exercise someday.
But if you can squat, should you? Well, let's say you shouldn't make it a regular practice. For women, sitting is the best way to empty the bladder. The goal each time you urinate is to void as much as possible. Excess urine in the bladder can lead to a urinary tract infection.
Sitting allows the pelvic floor muscles to relax, which reduces pressure on the urethra (the urine tube that carries pee to the outside world) and allows smooth voiding. The pelvic floor muscles act as a sling that wrap around the urethra, vagina and anus. When the pelvic floor muscles are contracted or stretched tightly (as they are when squatting over a toilet), they compress the urethral opening. This reduces urine flow. When you sit on the toilet, your pelvic floor muscles stay relaxed and the urethral sphincter is left wide open for easy, complete urination. Got it?
WHF Founder and Executive Director Missy Lavender demonstrates. Don't worry, these two minutes are completely G-rated:
Speaking of public bathrooms...
Wouldn't it be nice to stand to pee when faced with an impossibly dirty public toilet? Don't fool yourself with toilet seat covers. Only the plastic, rotating ones offer real protection.
You actually can stand, which is surprisingly effective for women. It will take you a bit longer than sitting, but you will be able to eliminate the same amount of pee as you would sitting down. Remember: We already know that the same cannot be said for squatting. Squatting leads to reduced urine flow.
The million dollar question: How do I stand to pee without getting urine all over my legs, the seat, the floor?
Enter pee devices. Yes. There are funnels available that will let women pee while standing without making a mess. The GoGirl funnel is reusable, while the Stand Up funnel is disposable and biodegradable.
In hiking circles, these funnels are called female urination devices, or FUDs, and they can come in quite handy on the trail. There are many brands and variations available, and Backpacker.com rates the top choices for various hiking adventures.
If you can't bring yourself to use a funnel, it is OK to sit on a public toilet. It may not be your happiest moment, but it is highly unlikely you will catch any germs from sitting on a toilet seat.
Stand up to pee or sit down to pee—your choice. But, please don't start peeing in front of strangers. We'll let men keep that curious behavior to themselves.
Kelley Smith is a former high school biology teacher and earned her medical degree in 2003. This blog was originally published in August 2014 and has been updated with the latest information.