Woman opening bathroom door

You Asked: How do you manage overactive bladder?

July 16, 2015

It’s normal to use the restroom a few times an hour. I must just drink a lot of water. Doesn’t everyone?

Sound familiar?

If so, you may be one of the nearly 30 percent of men and 40 percent of women in the United States living with overactive bladder (OAB). An embarrassing phrase to even voice aloud, OAB – while imposing – is actually quite common.

Overactive bladder occurs when nerve signals between the bladder and brain tell the bladder to empty even when it isn’t full. It can also happen when bladder muscles are too active. This sudden, strong urge to urinate is caused when the bladder muscles contract to pass urine before the bladder is full.

“Overactive bladder is very prevalent and often undertreated,” said Timothy Boone, M.D., Ph.D., vice dean of Texas A&M Health Science Center College of Medicine Houston campus and chairman of the department of urology for Houston Methodist Hospital. “People should be concerned if they go to the bathroom eight or more times a day.”

The major symptom of OAB is a sudden, strong urgency to urinate that you can’t ignore. This “have-to-go” feeling – known as “urgency incontinence” – breeds fear that you will leak urine if you don’t go immediately. Other symptoms of overactive bladder include:

  • Frequent urination: Urinating eight or more times in 24 hours.
  • “Nocturia”: Otherwise known as disrupted sleep. A person with nocturia will wake up two or more times a night to urinate.
  • Lifestyle Adjustments: Do you scout restroom locations immediately when you’re in public? Do you avoid social situations because you’re worried about how many times you may need to go? When you make concessions for your urinary patterns you probably have a case of overactive bladder.

While overactive bladder can occur at any time, the risk of OAB increases as you age. According to the National Association for Continence (NAFC), one in five adults over the age of 40 experiences OAB or chronic symptoms of urgency or frequency. Eighty-five percent of those suffering from overactive bladder are women.

Why are women more prone to OAB? The NAFC says this is largely because menstruation, pregnancy and menopause can lead to changes in estrogen levels and weakened pelvic-floor muscles. Likewise, OAB symptoms in men could be caused by an enlarged prostate or damage from prostate cancer surgery.

“Women are more likely to have an OAB at younger ages, but, by the age of 60, women and men will experience it at an equal rate,” Boone said.

Overactive bladder is a needy enemy. According to Boone, those living with overactive bladder often shy away from social events and everyday activities fearing there may not be a restroom available when they need one. “This feeling of isolation coupled with too little sleep may lead to bigger problems like depression and anxiety,” Boone said.

Luckily, there is hope. A variety of treatments can help manage overactive bladder. A health care provider may prescribe treatment for OAB or refer the patient to a urologist to determine the best method of treatment.

Lifestyle changes – or behavioral therapy – are usually the first tactic used to manage OAB. First, you will be asked to limit food and drinks that are bladder irritating. Coffee, tea, artificial sweeteners, caffeine, alcohol, soda and citrus fruit are often the culprit behind exacerbated OAB symptoms. By eliminating these foods and then adding them back one at a time, you can determine which food and drinks may worsen symptoms.

Delayed voiding is another technique health care providers may recommend. “By waiting to void you are training the bladder to wait and not give in to every urge to urinate,” Boone said. “Gradually, you will be able to wait longer between bathroom visits.”

Losing weight, increasing your fiber intake and establishing a fluid intake schedule will also help you control overactive bladder symptoms. If lifestyle changes aren’t alleviating your symptoms, your health care provider may prescribe medication to stop the bladder muscles from contracting when it isn’t full.

The Urology Care Foundation stresses those experiencing overactive bladder symptoms shouldn’t let myths about the condition prevent them from seeking the help they need.

  • OAB is not “just part of being a woman.”
  • OAB is not “just having an ‘enlarged’ prostate (BPH).”
  • OAB is not “just a normal part of getting older.”
  • OAB is not caused by something you did.
  • Surgery is not the only treatment for OAB.
  • There are treatments for OAB that can help with symptoms.
  • There are treatments that many people with OAB find helpful.
  • There are treatments that can help, even if your symptoms aren’t severe or if you don’t have urine leaks.

Your life shouldn’t revolve around the next sprint to the restroom. If you experience chronic urgency, contact your health care provider for further examination and testing. Discuss your options to treat OAB and have the confidence to take a long trip or laugh until you cry. Overactive bladder doesn’t have to rule your life.

— Lauren Thompson

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