Overactive Bladder

Overactive bladder can be embarrassing, and it interferes with daily activities. There are treatment options available.

What Causes Overactive Bladder?

There are many causes of frequent urination, ranging from pregnancy to diabetes, to just having a small bladder. Overactive bladders cause a “sudden and unstoppable need to urinate”, despite the amount of urine in the bladder. This disorder is a type of urinary incontinence. Sometimes incontinence is “stress incontinence”, where the bladder leaks due to “anatomic weakness in the structures” that are supposed to prevent this. Overactive bladder is more common in women and older adults. In this condition, there are spasms in the bladder muscles and a problem with the nerves. A major bladder muscle, the detrusor, is controlled by the nervous system. A certain amount of urine, about 300 cc, can signal the nerves to trigger the bladder muscles. People can normally control the sphincter muscles voluntarily, holding urine amounts up to 600 cc. Overactive bladders, however, have inappropriate detrusor contractions. Nervous system issues can cause overactive bladder. Some of these conditions include dementia, Parkinson’s disease, multiple sclerosis, diabetic neuropathy, spinal cord injury, and stroke. Some patients with overactive bladders have normal nervous systems. In these cases, bladder stones, tumors, or urinary tract infections, can be the cause. For some people, there is no known cause.¹ Symptoms of overactive bladder are frequent urination (more than 8 times in a day), urge incontinence (involuntary urine loss after an urgency to urinate), and nocturia (awakening 2+ times at night to urinate). Overactive bladder can be very disruptive to activities and sleep.²

Medical Treatments

There are various medications available for OAB; however, many patients have been found, in a study, to stop taking medications. This may be due to unrealistic expectations of the efficacy of the medicines. Medications may not eliminate OAB entirely. Also, side effects could be bothersome, such as dry eyes, constipation, and dry mouth. Some of the prescribe medications are anticholinergics or antimuscarinics (i.e., Toviaz, Ditropan, Vesicare, Detrol, Oxytrol). These work by “relaxing the smooth muscle of the bladder”. Other prescriptions include estrogen, imipramine and duloxetine (antidepressants), desmopressin (antidiuretic), or botulinum toxin. Botox may stop excessive contractions.³ Myrbetriq is another prescription medication for OAB. It, too, has potential side effects, including an increase in blood pressure.⁴

Natural Options

There are more natural options for overactive bladders. Some are herbal remedies, such as gosha-jinki-gan, Buchu, cornsilk, horsetail, cleavers, and saw palmetto. Supplements to reduce inflammation include quercetin and bromelain. Natural practitioners may also suggest antioxidants, such as vitamins E and C. Dietary changes are also important, including avoiding caffeine and alcohol. Pelvic floor exercises (Kegels) and going to the bathroom on a regular schedule are lifestyle changes that could be beneficial.⁵ Patients may also want to track their fluids, use pads to absorb and hide leaks, and lose weight to combat their OAB.⁶