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Overactive Bladder: Causes, Symptoms, and Treatment Options


Overactive bladder (OAB) is a common yet often misunderstood condition that affects millions of people worldwide. It can significantly impact one's quality of life, cause embarrassment, anxiety, and disruption to daily activities. In this blog post, we'll delve into what overactive bladder is, its symptoms, causes, and the various treatment options available to manage this condition effectively.

What is Overactive Bladder (OAB)?

Overactive bladder is a medical condition characterized by a sudden, involuntary contraction of the muscles in the bladder wall, leading to an urgent need to urinate (urgency), frequent urination (frequency), and sometimes, urinary incontinence (involuntary leakage of urine). It's important to note that overactive bladder is not a normal part of aging, although it is more common in older adults.

Symptoms of Overactive Bladder:

The symptoms of overactive bladder can vary, but typically include some combination of these:

  1. Urgency: A sudden and intense need to urinate that may be difficult to control.

  2. Frequency: Urinating more often than usual. Going to the bathroom more than eight times in a 24-hour period or more than once every 2 hours.

  3. Nocturia: Waking up two or more times during the night to urinate.

  4. Urinary Incontinence: Involuntary leakage of urine, which may range from a few drops to a large amount.

older women laughing and walking on the beach

Causes of Overactive Bladder:

Several factors can contribute to the development of overactive bladder, including:

  1. Aging: Changes in bladder muscle function and bladder capacity can occur with age.

  2. Neurological Disorders: Conditions such as Parkinson's disease, multiple sclerosis, or stroke can affect nerve signals to the bladder.

  3. Bladder Abnormalities: Conditions such as bladder stones or tumors can irritate the bladder and cause overactivity.

  4. Urinary Tract Infections: Infections can lead to irritation of the bladder lining, resulting in symptoms of overactive bladder.

  5. Lifestyle Factors: Certain habits such as excessive caffeine or alcohol consumption, obesity, and poor toileting habits can contribute to OAB.

Treatment Options for Overactive Bladder:

Managing overactive bladder involves a combination of lifestyle modifications, behavioral therapies, and, in some cases, medication or medical procedures. Here are some common treatment options:

  1. Behavioral Therapies: Techniques such as bladder training, scheduled voiding, and pelvic floor muscle exercises (Kegel exercises) can help improve bladder control and reduce symptoms.

  2. Lifestyle Modifications: Avoiding bladder irritants such as caffeine and alcohol, maintaining a healthy weight, and staying hydrated can help alleviate symptoms of overactive bladder.

  3. Medications: Your healthcare provider may prescribe medications such as anticholinergics or beta-3 agonists to relax the bladder muscle and reduce urgency and frequency of urination. These often have a side effect of constipation.

  4. Neuromodulation: In cases where conservative treatments are ineffective, neuromodulation therapies such as sacral nerve stimulation or percutaneous tibial nerve stimulation (PTNS) may be considered to regulate bladder function.

  5. Botox Injections: Botulinum toxin injections into the bladder muscle can help relax the bladder and reduce urgency and incontinence episodes in some patients.

  6. Surgical Interventions: In rare cases, surgical procedures such as bladder augmentation or urinary diversion may be recommended for severe cases of overactive bladder that have not responded to other treatments.

faucet with running water

Pelvic Floor Therapy For Overactive Bladder:

Pelvic floor therapy should be a first treatment option for overactive bladder. In pelvic floor therapy we can:

  1. Test your pelvic floor muscles

    1. Kegels aren't always necessary. Sometimes people have tight pelvic floor muscles that are pushing on the bladder making it feel the need to urinate. Other times the pelvic floor muscles are functioning just fine and aren't part of the problem.

  2. Teach you bladder retraining

    1. This is where we teach you how to tune into what urge is from a full bladder and what isn't, how to increase the time between bathroom trips and how to successfully delay the urge until a bathroom is available to urinate.

  3. Teach you bladder irritants.

    1. Coffee, tea, caffeine, fizzy drinks, alcohol, citrus, tomatoes and more are all considered potential bladder irritants. That doesn't mean you need to cut all of these out of your diet.

    2. I like to teach people all the other techniques first, and then we can look at diet and figure out if any foods or drinks are bladder irritants for you.

  4. Teach you how to stay hydrated without increasing OAB symptoms.

    1. My #1 tip is to sip water throughout the day instead of drinking a lot all at once.

    2. When we consume a large amount of liquid at once that liquid hits the bladder all at once and sends a strong urge to need to urinate. If we sip a little bit at a time, then the bladder fills up slower and the urge to urinate won't come on as strong.


Overactive bladder can significantly impact one's quality of life, but there are treatments to alleviate symptoms. If you're experiencing symptoms of OAB, I recommend starting with pelvic floor therapy. It is non-invasive, effective and has no negative side effects.

I created a free online bladder class that teaches you three ways to decrease bladder leakage and overactive bladder symptoms. This is a resource to teach you more in depth and give you a glimpse of how pelvic floor therapy can help.

Click the link to sign up to get the free bladder class emailed to you.

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