Overactive bladder (OAB) is more common than you may think. It has been estimated that almost 30 million Americans age 40 and older experience OAB symptoms at least sometimes.1 OAB symptoms include urgency (having an uncontrollable urge to urinate), frequency (urinating too often, usually more than eight times a day), and leakage (urinating unintentionally after an uncontrollable and sudden urge), which can really get in the way of doing the things you enjoy, especially when you’re not near a restroom.1,2 Overactive bladder affects both men and women, but it’s more common in women.1
Recognizing how you cope with overactive bladder can help you live life on your own terms once again.
“Bladder health problems can have a significant impact on your quality of life, as well as your emotional and physical health,” says Stanford University urologist Dr. Ekene Enemchukwu.3
An online survey of American women illustrated the impact that OAB may have on personal life, with 39 percent of women reporting that it interfered with daily activities.3 Twelve percent of women even said their symptoms kept them home-bound.3
1. Talk to loved ones: An overactive bladder isn’t the easiest topic to talk about, but vocalizing your struggle to family and friends can go a long way to help you decide whether further action is necessary.
2. Speak to a doctor: If your urge to repeatedly rush to the restroom is getting in the way of your routines, it may be time to bring it up at the next appointment with your physician.2 Your doctor can help you to try to minimize OAB’s impact and determine a treatment plan that may help.2,3
“As soon as a person finds that they are scheduling their days around their bladder, or having bothersome symptoms, they should speak to their doctor,” says Dr. Enemchukwu. “There are other conditions that can mimic the symptoms of OAB, so it’s important to get evaluated.”2
3. Make easy changes: Caffeine is a known diuretic (a substance that can make urination more frequent), and you may find that limiting caffeine can help with your OAB symptoms, such as frequency.2 Enemchukwu says one of the first things she does with a new patient is examine the details of her patient’s daily schedule to find possible triggers for overactive bladder symptoms. While that extra cup of coffee might help you stay more alert at work, it may be counterproductive if you’re in the bathroom more often.
“As a physician, I go over the patient’s daily routine to see if there are any behavioral or lifestyle changes they can make to reduce symptoms,” Dr. Enemchukwu says. “Things like fluid and caffeine intake, and whether they are dehydrated or drinking too much can make a big difference.4 Caffeine in particular is a double-edged sword, because it not only pumps more urine into the bladder, but it irritates the bladder as well.”4
Changing not only what you drink, but when, can also be helpful. Limiting fluids to earlier in the day or foregoing that last glass of water after dinner can help you have a more restful evening.5
Spicy foods and citrus fruits can be irritating to the bladder, and therefore you may consider avoiding them.4,6
4. Track your bathroom visits: It’s difficult to remember how many times you’re feeling the need to use the restroom. This is where a bladder journal can help. Simply write down the times you use the bathroom, and other helpful information, such as the amount and quantity of fluids you consumed throughout the day, along with when you had them.4
5. Bladder training exercises: Exercise can be another healthy way to help manage OAB symptoms, specifically strengthening the pelvic floor muscles.2 Bladder training exercises like kegels can strengthen the muscles along the pelvic floor that support the bladder.2
“Sometimes I send my patients to do formal pelvic floor physical therapy with a physical therapist,” says Dr. Enemchukwu. “These bladder training exercises send a signal to the bladder to relax, and gives the patient more time to make it to the bathroom.”2
Sometimes, the things we do to cope with our problems actually make them worse. OAB is no different. If you’re doing any of the following, you may want to talk to your doctor about healthier ways to live with OAB.
1. Decreasing fluid intake: If drinking fluids makes you go, you may think it makes sense to just stop drinking, right? Drinking too little may lead to dehydration. Dehydration can cause many unwanted symptoms for your body, such as feeling faint or nauseated, and older adults are more at risk.7 If avoiding fluid intake becomes a regular practice in your life, not only can this increase your risk for long-term health concerns, but shows that you may be in an unhealthy cycle of coping with your OAB.5,7
“A person may be thirsty, but won’t drink out of fear of having an accident,” says Stacy Kaiser, a psychotherapist and coping expert. “Changing what you do to this extent is unhealthy and can be really detrimental, both physically and emotionally.”
2. Becoming isolated: When you’re worried about having an accident while out with friends, it can be tempting to avoid going out altogether. Unfortunately, this unhealthy way of coping only leads to isolation and possibly depression.7
“Primarily, the biggest indicator that you’re coping in an unhealthy way is that the embarrassment you feel becomes shame, and it impacts your work and family life,” says Kaiser.2,3
This method of coping can become a cycle.
“They end up alienating friends and family, and make others uncomfortable with their own discomfort,” says Kaiser. And this leads to, “missing out on the things the rest of us enjoy: concerts, work meetings, or attending a child’s choir performance, simply because they haven’t properly dealt with the issue.”
3. Skipping fun activities: Activities like going to the movies can feel impossible, if you know you’ll be spending more of the movie in the restroom than in the theater. Parties might feel like opportunities for major embarrassment — what will you do if the bathroom is full and you have an accident while waiting? It may seem easier— and less risky— to stay home, even if this is detrimental to your social life. Kaiser says reaching out to a loved one, or even a medical or mental health professional, can be helpful.
“A lot of times, people who are not coping productively feel helpless, and reaching out to someone who knows more than they do takes away the helplessness,” she says. “A doctor or therapist can help brainstorm with you about how to accommodate your lifestyle, and customize a plan to help you deal with the issue.”
The Road to Actively Managing Overactive Bladder (OAB)
Elaine, a patient with OAB, says that once she acknowledged her problem, she was on the road to a better quality of life. Elaine is sharing her story to help educate others.
“It can be really hard to deal with the problem head-on,” Elaine says.
“Sometimes you’d rather just sweep it under the carpet and not tell anyone what you are going through. But I’ve found ways to manage my bladder problems and to be more proactive. I avoid eating certain foods that can make my bladder problems worse. Caffeine can be a real problem for me. Also, spicy foods are a no because they irritate your bladder.”6
She continues, “I also began walking a bit more than I used to since exercise is important. I decided to start talking about it with people who I could trust. I discussed it with my fiancé. I told my daughter about it. Most importantly, I got up the courage to speak with my doctor about it, and we discussed a treatment plan to help manage my symptoms.”
Being proactive and assessing your coping behaviors is an important step. Coping Confessions is a new campaign sponsored by Astellas, aimed to help educate about coping— something that so many struggling with OAB experience. Coping Confessions videos share the stories of three women coping with OAB. To watch the videos and learn more about how you can assess your own coping behaviors and learn more about overactive bladder visit www.copingconfessions.com.
This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you have a medical question, please speak with your healthcare provider for more information.
This article was sponsored by Astellas.
1 Coyne KS, Sexton CC, Vats V, Thompson C, Kopp ZS, Milsom I. National community prevalence of overactive bladder in the United States stratified by sex and age. Urology 2011;77(5):1081-7.
2 Mayo Clinic. Overactive bladder: symptoms and causes (03-10-2018). https://www.mayoclinic.org/diseases-conditions/overactivebladder/symptoms-causes/syc-20355715. Accessed 05-02-2019.
3 Reynolds WS, Fowke J, Dmochowski R. The burden of overactive bladder on US public health. Curr Bladder Dysfunct Rep 2016;11(1):8-13.
4 The North American Menopause Society. What You Should Know About Overactive Bladder in Midlife Women (2017).
5 National Heart, Lung and Blood Institute. Your Guide to Healthy Sleep (2011). https://www.nhlbi.nih.gov/files/docs/public/sleep/healthy_sleep.pdf. Accessed 9-2011.
6 Interstitial Cystitis Network. 2012 ICN Food List for Interstitial Cystitis, Bladder Pain Syndrome, Overactive Bladder (2019).
7 MacDiarmid S. Maximizing the Treatment of Overactive Bladder in the Elderly. Rev Urol 2008;10(1):6-13.