Overactive bladder: your common questions answered

What are the symptoms of an overactive bladder?

An overactive bladder can cause the following symptoms.

• An immediate, strong need to pee that you can’t control.
• Needing to pee very often (more than eight times in 24 hours).
• Waking up in the night to pee, also known as nocturia.
• Leaking urine after a sudden need to pee (urge incontinence).

These symptoms can be uncomfortable and can interfere with your daily life. It’s important to seek help from your doctor if you’re showing ongoing symptoms.

Urinary tract infections (UTI) can also cause frequent and urgent urination. These symptoms should resolve after a course of antibiotics. These must be prescribed by a doctor or pharmacist.

Why do I have an overactive bladder?

There generally isn’t a known direct cause for an overactive bladder. But there are certain factors that increase your risk. These include the following.

• 1. Pregnancy and childbirth
  Overactive bladder is more common in women who have had children, and had a vaginal birth.
• 2. Neurological conditions
  Conditions like Parkinson’s disease or multiple sclerosis can affect nerve signals that control your bladder. This can lead to an overactive bladder.
• 3. Menopause
  Decreasing levels of the hormone oestrogen can affect the tissues of the bladder and urethra, which can cause an urgent or frequent need to pee.
• 4. Medications
  Certain medications can cause increased urination and relaxed bladder muscles. These may include diuretics and alpha-blockers, used to treat high blood pressure.
• 5. Ageing
  Some people may notice their bladder becomes weaker as they get older. The natural ageing process can cause changes to bladder muscles. Bladder capacity can also decrease with age.

Certain lifestyle factors can also give you symptoms of an overactive bladder, such as:

• drinking too much alcohol or caffeine
• drinking too many fluids
• not drinking enough fluids (dehydration)
• being constipated
• certain irritating foods, such as spicy or acidic foods

How can I manage overactive bladder?

There isn’t necessarily one way to ‘fix’ bladder overactivity. But there are things you can do to manage symptoms.

Bladder retraining

Bladder retraining is a method used to treat bladder urgency and frequency. This can be managed by a specialist nurse or health physiotherapist. It aims to gradually increase the intervals between peeing, over a period of weeks and months.

Lifestyle changes

Certain lifestyle changes can help to improve your bladder control. These may include reducing your alcohol and caffeine intake, cutting down alcohol, staying hydrated, and stopping smoking. You should also manage any constipation.

Medications

Your doctor can prescribe you a type of medication to help relax your bladder muscles, called antimuscarinics. These help reduce the sensation of needing to pee.

An alternative to these is a medication called mirabegron, which can help relax bladder muscles.

Pelvic floor exercises

Strengthening the pelvic floor is recommended for all women. It will help prevent stress incontinence (leaking of urine with exertion, coughing or sneezing) and urgency incontinence in women with overactive bladder.

If all treatment options have failed and symptoms are severe, other options include botox administration to the bladder, nerve stimulation treatment and in rare cases, major surgery on the bladder.

If you’re worried about an overactive bladder or incontinence, speak to your doctor about your symptoms and concerns. They’ll help you to find the most suitable treatment or refer you to a specialist who can help.