Public Restrooms: To Squat Or Not To Squat?
Women's Health

Public Restrooms: To Squat Or Not To Squat?

Growing up in a Black household, I was taught that my butt should never grace the surface of a public toilet (if you know, you know). Even when I was a little girl, my mom made sure I knew to cautiously drape the commode with enough toilet paper so I wouldn’t feel even an inch of the germ-laden porcelain. I mean, it was serious business.

And as an adult, squatting over a public toilet is practically second nature. When nature calls, I don’t even think twice about it. The mere thought of my naked tush touching a toilet that has been sat on by hundreds (thousands?) of others is enough to make my stomach turn.

However, thanks to social media, I’ve learned that hovering over the toilet while going number one (and probably number two), can actually cause more harm than good. We’ve enlisted the expertise of Dr. Mukta Chauhan, DPT, pelvic floor physical therapist, and Dr. Sabrina Baxter, DPT, pelvic floor specialist, for their insight on this restroom woe.

​Can sitting on a public toilet cause harm to the skin?

"I would just say that the idea of sitting on a toilet seat with your bare skin and especially not knowing the hygiene condition of the toilet or how the person before you used the toilet…you can feel a little squeamish about it. I admit I am one of those people,” Dr. Mukta said. “[But] we have millions of microorganisms that live on our skin anyway. So, it's not like we are harming ourselves by contracting more germs. But obviously, we want to stay clean. So, I personally like to either wipe the toilet seat or put toilet paper on top of it."

"But if people are mostly concerned about catching an infection [such as UTIs or yeast infections], your vulva is not coming in contact with the seat. It's a completely untouched part when you're sitting on the toilet,” Dr. Mukta continued. “It's your thighs or the outer part of your butt that's touching the toilet seat. You’re not going to catch an infection unless you have an open wound or something like that on your skin. Then you may have to be extra careful. But other than that, under normal circumstances, you're not going to catch an infection by sitting on a toilet seat."

​I’ve read that squatting while using the restroom can be detrimental to pelvic health. Is this true?

"I wouldn't call it detrimental – I myself have done it on occasion,” Dr. Baxter said. “But I wouldn't make this a habit. Your pelvic floor muscles want to relax when you are ready to let go. [For example], when it's time to pee and poop, your muscles want to be turned off so that you can easily evaluate. Hovering over the toilet constantly can cause the muscles to work overtime, fatigue them and contribute to weakness down the road.”

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What does the pelvic floor consist of?

"The pelvic floor is a set of muscles that act as a hammock on the bottom of the pelvis," Dr. Baxter described. She explained that the pelvic floor is responsible for the five major functions below:

  • Sphincter control, [which refers to the] opening and closing of the urinary and anal sphincters
  • Sexual function (“Yes, better pelvic health means better orgasms!”)
  • Stabilization, [which] stabilizes your pelvis, hips, and low back
  • Internal organs support (“Don't strain when you pee or poop-- you could cause a prolapse!”)
  • “Sump pump,” [which] circulates lymph, blood, oxygen, and nutrients

“Squatting over a toilet – especially if you don’t have good strength in your legs – means that you won’t be able to hold that position well without the help of your pelvic floor muscles,” Dr.Mukta clarified. “Your pelvic floor muscles are actually contracting and stabilizing your posture and [you] are not going to be able to completely relax for you to void. The reason why we have some people develop similar symptoms as a UTI if they continuously use the toilet in a squat position is because of pelvic floor dysfunction."

​What is pelvic floor dysfunction?

“Pelvic floor dysfunction is basically when the pelvic floor muscles stay in a state of hyperactivity or overactivity for various reasons. [It occurs] when these muscles are not working at their optimum level,” Dr. Mukta explained. “People think that leaking only happens when the pelvic floor muscles are weak, but a tight pelvic floor can cause leaking – if it’s tight, it’s not going to be able to completely close. Leaking, urgency [and] frequency, constipation, pelvic pain, nerve issues, burning sensations, pain with sitting, lower back pain, hip pain, groin pain, and buttock pain, can all happen because of pelvic floor dysfunction.”

“And people may also realize that when they are hovering, they may have to push the pee out rather than keep it coming out naturally,” Dr. Mukta noted. “That's just an indication that their pelvic floor muscles are not completely relaxed. You need to sit down completely so the pelvic floor muscles are able to relax so you can void fully. If you have any pain or burning sensations, leaking, urgency/frequency kind of symptoms, just go see a pelvic floor physical therapist.”

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