How to treat an overactive bladder

With an overactive bladder—whether stress incontinence or urge incontinence—you may experience symptoms like leaking urine or a sudden need to run to the restroom
June 19, 2019

Whether you call it an overactive bladder—frequent and sudden urination or leaking urine—or not, you are not the only person experiencing this issue. Actually, overactive bladders are very common. Women around the age of menopause are most likely to experience symptoms of an overactive bladder. Still, although overactive bladders are significantly more common in older women, 18 percent of those aged 20–24 and 10 percent of those aged 15–19 experience symptoms as well.

When should you ask for help with your overactive bladder?

Urinary incontinence is the loss of bladder control. “In women specifically, urge incontinence and stress incontinence are the two most common types of overactive bladders,” said Jason McKnight, MD, MS, primary care physician and clinical assistant professor at the Texas A&M College of Medicine’s Texas A&M Family Medicine Residency Program. “You should speak with your primary care provider anytime you feel the need to urinate and do not make it to the restroom in time or anytime you do not feel the need to urinate then leak urine.”

In the majority of situations, a primary care provider can successfully treat an overactive bladder. If the bladder muscles are too active, you may have a strong urge to use the restroom when you have little urine in your bladder. If your bladder muscles are too weak, then you may have small accidents when you sneeze or lift something heavy. A successful treatment can be a combination of lifestyle changes, medications and exercises.

Do I have a UTI or an overactive bladder?

“A common cause of urinary complaints, especially a change in your urination pattern, is a urinary tract infection, or UTI,” McKnight said. “If you visit with your healthcare provider and discuss a change in your urination such as an increased urge to urinate or leakage of urine, they will likely test for a UTI first. If you have a UTI, your symptoms will likely be quick and easy fix.”

UTIs can cause feelings of pain when urinating, cloudy urine, lower abdominal pain and an increased urge to urinate. If you test negative for a UTI, your provider will ask questions about when you notice your bladder symptoms. “Leaking urine or peeing a little when laughing or coughing is a sign of stress incontinence,” McKnight explained. “Suddenly needing to pee and not reaching the bathroom in time is a sign of urge incontinence. Both types of incontinence are treatable.”

Overactive bladder symptoms

Stress incontinence is when a physical movement like sneezing or laughing puts too much stress on your bladder, and you urinate as a result. This type of overactive bladder is not related to psychological stress.

“Women who are overweight or who have given birth vaginally are more likely to struggle with stress incontinence,” McKnight said. “Similarly, certain medications and lifestyles that include a lot of high-impact activity can exacerbate symptoms.”

Unlike stress incontinence, urge incontinence does not have a defined cause or trigger. However, it is known to be related to an overactive bladder muscle called the detrusor muscle. Someone with urge incontinence will feel sudden, strong urges to urinate as their bladder squeezes or spasms. They may also leak urine during those sudden spasms. In severe cases, they can empty their entire bladder during a spasm.

Overactive bladder treatments

Treatments for stress incontinence and urge incontinence range from lifestyle adjustments to medications. If you are overweight, your health care provider may suggest losing any extra pounds.

For stress incontinence, they may recommend certain pelvic floor exercises or medications that help strengthen the muscles. For urge incontinence, health care providers may recommend specific bladder training and certain medications to make the bladder less irritable. These exercises and trainings reteach the bladder to properly function.

Sometimes, women have symptoms of both types of incontinence. In these circumstances, providers do a combination of urge and stress incontinence treatments.

How to ask your health care provider about your overactive bladder

“If you are having this problem, do not be embarrassed,” McKnight said. “Your provider can help you navigate different treatments to help you regain control.” He encourages you to ask your primary care provider for help. “If you do not mention the problem, then your primary care provider will not know to help.”

If you notice other problems with your urine like blood or a loss of the sensation of going to the bathroom, then bring it up with your provider. Those symptoms can be symptoms of bigger health problems that need to be addressed.

— Mary Leigh Meyer

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