For anyone with an overactive bladder (OAB), “normal” activities can fill you with dread. A long walk with a friend, a drive in the country, or a shopping trip—any of these could transform from a “fun outing” into “anxiety provoking nightmare” if you start obsessing over whether or not you’ll be able to find a bathroom when you need one.
OAB is characterized by the frequent (and sudden) need to urinate. That urge can be difficult to control, and that can lead to leaks and incontinence. Because the exact cause of the condition is unknown, it can be hard to treat. Many times, physicians recommend taking a “multifactorial” approach, meaning one that involves changes to your lifestyle, possible medication, and potential surgical procedures. It’s always worth speaking to a doctor to find the right approach for you. (1)
Your doctor will check to make sure you don’t have an infection or any sign of a larger problem like blood in your urine. Additionally, your doctor will likely make sure that you’re completely emptying your bladder when you urinate. Not doing so means you end up with very little space to store urine, which can mimic the symptoms of OAB. If all of those possibilities are ruled out and you end up receiving an OAB diagnosis, you may wonder: what’s next? (2)
Not to fear, there are plenty of approaches that have proven effective at reducing or eliminating OAB symptoms. The first choice for dealing with an overactive bladder, as outlined by the Mayo Clinic, is to find a “behavioral therapy” that works for you. The plus side is that these strategies don’t involve medical intervention, and they won’t have negative side effects associated with some medications. From incontinence underwear to avoiding tomato juice, there is a range of things you might want to try. (1)
1. Kegel exercises
You can put your dumbbells down, they won’t help you here. Performing so-called “Kegel exercises” can help your pelvic floor muscles and your urinary sphincter get stronger. Once they are, you’ll be better able to stop the involuntary contractions of your bladder that are causing you trouble. (1)
So, how do you do Kegel exercises? They involve tightening the muscles between your genitals and anus, the same ones you would use to stop urinating mid-stream. You would do well to speak to a doctor or physical therapist to make sure you understand how to perform these correctly. Understanding the correct technique means you’ll get the most out of your efforts. (1)
2. Maintain a healthy weight
Ok, now you can pick those dumbbells back up. Or maybe just go for regular walks at moderate intensity. If you’ve got an overactive bladder and you’re also overweight, both might be worth considering. Maintaining a healthier weight could help to relieve your symptoms, and could be particularly helpful if you suffer from stress incontinence as well. (1)
The reason? Losing weight takes the pressure off your pelvic floor muscles, which can help with OAB. Plus, there are all sorts of other health benefits too. This is just one more reason why exercise, Kegels and beyond, can be worth giving a try if your aim is to be healthier.
3. Pads or incontinence underwear
If you’re particularly worried about your overactive bladder striking at an inopportune moment, but you’re still trying to figure out what behavioral changes might make the most difference, not to worry, there are some easy solutions. For instance, you could wear an absorbent pad to protect your clothing against any leaks. If that doesn’t sound appealing, and pads can be bulky, you might give incontinence underwear a try.
Designed to be absorbent, incontinence underwear can help you keep your clothes dry without advertising to any and all who see you that you’re suffering from OAB. Since many women experience incontinence more generally, especially around pregnancy and menopause, it makes some sense that there’s been growth among brands marketing discreet incontinence underwear. Given the range of options, you’re sure to be able to find something that works for you.
4. Try bladder training, and scheduled trips to the bathroom
Bladder training, and scheduling trips to the bathroom, can make a big difference for OAB sufferers.
To start with, your doctor may ask you to take note of when you go to the bathroom each day. While it might seem trivial, it can make a big difference in your treatment. Keeping a “bladder diary” will help you and your doctor figure out the frequency with which you need to urinate, as well as any events that precede that need. That way you can work together on a schedule that aims to help alter those patterns, something which usually takes between six and 12 weeks. (3)
You can help train your bladder by scheduling bathroom trips every two or four hours. The idea is to get yourself on track to urinate at the same time every day. Once that’s the case, you can plan around your new schedule instead of responding to overly frequent urges. (1)
There are other techniques to try as well, including ensuring you’ve really emptied your bladder when you urinate. You’ll want to make sure you’ve “voided” your bladder even if you don’t feel like you need to. If you have particular problems around this, you might try so-called “double voiding,” where you wait a few moments after you’ve finished urinating and try again, just to be sure. (3)
Finally, you can try some techniques to help delay the urge to urinate if it falls outside of your schedule. For instance, you can try muscle relaxation or deep breathing exercises. If those don’t work, try delaying your trip to the bathroom for five minutes, and when you do go, make sure to walk, not run to get there. (3)
5. Limit your fluid intake (but not too much)
Drinking less leads to a decreased need to urinate, so if you’re waking up frequently at night to pee, this can be a good place to start. This is both a simple and effective change, and one you can use to minimize unwelcome interruptions to your sleep, as well as a helpful tactic at times when you’re going to be unable to use the bathroom—during work, at a social event, or when you’re out shopping. (3)
At the same time, you don’t want to drink too little, which can result in overly concentrated urine. That can irritate your bladder and lead to more feelings of urgency. Make sure you still get at least six glasses of water (eight ounces each) per day. (4)
6. Avoid diuretics or things that irritate the bladder
Along with generally cutting back on fluids, you can consider cutting out your intake of drinks and foods that are “diuretic,” i.e., that promote urination or can irritate the bladder. Here are three you might cut back on:
- Caffeine—Since the substance itself is a diuretic, it makes sense to avoid food and drinks that contain it. These include chocolate, along with drinks like coffee, tea, and soda. Even some over-the-counter medications contain caffeine. You may not want to cut off your daily coffee or tea habit cold turkey, since headaches can result during withdrawal. On their blog, The National Association for Continence (NAFC) cites studies showing that people who were experiencing bladder symptoms and reduced their caffeine intake to less than 100mg a day saw improvement in their urination urges. (4)
- Alcohol—According to the NAFC, alcohol has been shown to “act as a bladder stimulant,” leading to “symptoms of urgency.” It’s also a diuretic, so that’s two strikes against it if you have OAB. That’s because alcohol inhibits the antidiuretic hormone (ADH) which helps the body stop water loss. Without it, your kidneys aren’t able to reabsorb water as easily, so your bladder fills more quickly (and your urine is more water-diluted). Through its impact on ADH, alcohol can lead you to need to urinate 20 minutes after you’ve consumed it. (4)
- Acidic and/or spicy foods—The NAFC reports that some people have experienced issues with bladder control after they consumed food or drink with high acid content or a lot of spice. This could include tomato-based food or juices, as well as citrus fruit or juices. (4)
To figure out which, if any of these, are contributing to your symptoms, you can eliminate them all for a week to see if your symptoms change. Then, add one thing back every day or so, and take note of whether or not you experience any changes in your symptoms—whether that’s urinary urgency, frequency, or loss of bladder control. (4)
If you’re considering ways to deal with your overactive bladder, be sure to speak with your doctor about what makes sense for you. If lifestyle changes don’t work, you can move on to medications, or in some cases, speak to a specialist about any surgical procedures which may be right for you. (5)
Not to worry, though, as outlined above there are a wide range of lifestyle changes you can try first, in consultation with your health care provider. Hopefully one or more of these simple solutions will have you taking a road trip or attending a social event with confidence in no time.
- “Overactive bladder,” Source: https://www.mayoclinic.org/diseases-conditions/overactive-bladder/diagnosis-treatment/drc-20355721
- “Is Urinating Often a Sign of an Overactive Bladder?” Source: https://www.verywellhealth.com/what-is-overactive-bladder-3522283
- “How Overactive Bladder Is Treated,” Source: https://www.verywellhealth.com/overactive-bladder-treatment-5116161
- Bladder Irritants and your Diet,” Source: https://www.nafc.org/bhealth-blog/bladder-irritants-and-your-diet
“Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline (2019),” Source: https://www.auanet.org/guidelines/guidelines/overactive-bladder-(oab)-guideline#x3763