It’s hard enough trying to find time to get together with our friends between family obligations, work, and (attempted) training. We shouldn’t let the worry of always having a toilet nearby stop us from finally getting those much-needed laughs. For 33 million adults in the U.S. — and 4 in 10 women — this fear is real. The culprit? Overactive bladder (OAB).
OAB is the sudden and urgent feeling that you need to pee, even when your bladder is not full. OAB is common. And more than one in three people with OAB also suffer from urge incontinence – when you feel a sudden and urgent need to pee that you can’t stop.
OAB often occurs in people over 65, but women often experience it earlier, in their 40s. In a recent study by HealthyWomen, three out of four women with OAB reported negative impacts from living with the condition, including poor sleep, worries about where to find restrooms during social activities, and concerns about intimacy.
In the same study, more than one in two women said they believed OAB symptoms were just a normal part of aging, but that’s not true. OAB is a condition that can be managed by managing symptoms and making certain lifestyle changes.
Here’s what you need to know about OAB so you can get the treatment you deserve—and turn off the bathroom radar.
What are the symptoms of OAB?
Symptoms of OAB include:
- The sudden urge to pee, even when you have just gone, which can sometimes cause urine to leak (called urge incontinence).
- Peeing more than eight times in 24 hours.
- Nocturia, or getting up multiple times at night to pee.
How does a healthy bladder work?
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The bladder is part of the urinary tract. The urinary tract also includes two kidneys, two ureters, a urethra and internal and external sphincters.
Your kidneys filter blood to remove waste products in the form of urine. As the kidneys work to fill your bladder with urine, your bladder muscles remain relaxed and your sphincters remain tense and closed. When you need to pee, your brain sends a signal to the sphincters to relax and then tells the bladder muscles to tense so that the pee can be pushed through the urethra and out of the bladder.
What causes OAB?
Researchers don’t know the exact cause of OAB. But there are a few different factors that could be behind it.
If you don’t have OAB, your brain receives the signal that it’s time to go to the bathroom as soon as your bladder fills. But when you suffer from OAB, your brain receives the signal before the bladder is full and the muscles contract, signaling that it’s time to go.
Sometimes the bladder muscles tense on their own. This is called involuntary bladder contraction or bladder spasm. When spasms occur, your bladder pushes out the urine it contains, which can cause a sudden, urgent need to urinate or even leakage of urine. Some reasons for bladder spasm include neurological diseases, inflammation or blockages such as pelvic organ prolapse or kidney stones.
Certain neurological diseases, such as Parkinson’s disease or multiple sclerosis (MS), affect the body’s ability to control its nervous system and normal functions. These disorders can affect the brain’s connection to the bladder and cause OAB. Other physical trauma such as nerve damage, abdominal or lower back injuries, or infections such as urinary tract infections (UTIs) can increase OAB symptoms. Being overweight or obese also increases the risk of OAB due to extra pressure pushing on the bladder.
Sometimes medications are the cause of OAB. Diuretics, or water pills used to treat high blood pressure and fluid retention, may cause the bladder to fill more frequently than usual. Alpha-blockers used to treat high blood pressure can relax the bladder muscles, making urine flow easier and increasing the feeling of urgency.
OAB can also be caused by certain lifestyle factors such as caffeine or alcohol consumption; Smoke; or eating certain foods such as acidic, spicy foods or artificial sweeteners. Both drinking too much and too little water can cause OAB by irritating the bladder. Balance is important – women should drink about nine cups of fluids per day, plus the fluids they naturally get from food. Constipation can also increase OAB symptoms.
During perimenopause and menopause, your body reduces the amount of the hormone estrogen it produces. This can weaken the pelvic floor muscles and lead to OAB. The impact can be even greater if you have given birth, as birth – both vaginal and cesarean – can also weaken the pelvic floor muscles. OAB can also occur when weakened pelvic floor muscles lead to pelvic organ prolapse
.
The connection between OAB and cognitive decline
Cognitive decline is the reduced ability to think, learn, remember, reason, and make decisions. Although research has shown that people with OAB, particularly women, tend to have poorer cognitive health than people without OAB, researchers don’t yet know why. One theory is that the decline could be due to poor sleep quality with waking and peeing during the night.
Additionally, depression, a known risk factor for cognitive decline, has also been linked to OAB. People with OAB may have signs of depression because OAB can affect sleep as well as your lifestyle and social interactions. However, the connection is still unclear, and some studies also suggest that OAB could be one of the first signs of cognitive decline or dementia
.
When is it time to see a healthcare provider?
OAB will not go away on its own. There are several treatments available that can help, including lifestyle changes, medications, nerve stimulation, and surgery.
If you experience symptoms of OAB, you should talk to your doctor about your options. Keeping a bladder diary that records what you eat and drink and how often you feel the need to urinate can help you guide the conversation with your medical team.
This educational resource was created with support from Sumitomo Pharma America.
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