Clear signs you may suffer from “overactive bladder”
What is an overactive bladder? Overactive bladder (OAB) is a very common condition that affects one in three Australians, according to the Continence Foundation of Australia. It causes a combination of symptoms related to involuntary urination. Here are the signs and symptoms you should know.
- You get sudden urges to go
“We spend our younger years learning how to have our brains control our bladder, letting us empty our bladders when it is socially acceptable,” says urologist, Dr Aisha Khalali Taylor. “As we age as women, our bladders become defiant and start to want to overrule the brain, causing bladder contractions or spasms at times when it’s not socially acceptable.”
Pregnancy and childbirth, as well as lower levels of oestrogen after menopause, can contribute to OAB in women. And although OAB is more common with age, it should not be considered a “normal” part of ageing.
- You have to go all the time
- You often go only a little bit
“Sudden urge to urinate occurs because the muscles of the bladder start to contract involuntarily, even when the amount of urine in the bladder is low,” Dr Taylor says. “This involuntary contraction makes women feel an urgent need to urinate, which signals OAB, as the bladder lining becomes ‘hypersensitive’ to the smallest volumes of urine.”
Note: this particular symptom could also be a symptom of a urinary tract infection (UTI). “The only way to truly tell the difference between a UTI and OAB is to obtain a urine culture to see if bacteria is growing in the urine,” Dr Taylor says. A urine culture is a very easy test that can be done in most labs.
- You feel like you have to go even if you’ve just gone
This constant need for the bathroom can be disruptive, but luckily, there are natural remedies for overactive bladder that can help.
“Sometimes we have to use our brains and emotions to retrain our bladder what is the right amount of urine to hold before going to the bathroom,” Dr Gregory says.
Pelvic floor exercises called Kegels can help you control those muscles, especially if they’re done with a qualified pelvic floor therapist using a device such as InTone, which offers feedback on your progress. Then you can attempt bladder training, which involves “training yourself to delay urination when you feel the urge to urinate,” Dr Taylor says.
“You start with small delays such as five to 10 minutes, and work your way up to three to four hours.”
- You wake up to go to the bathroom
“Fluid in your body has an easier time getting back to the heart because it doesn’t have to work as hard against gravity.”
High urine output at night could also indicate other conditions such as congestive heart failure, sleep apnoea, diabetes, or poor kidney function, so see a urologist if you’re constantly waking up to pee to make sure it’s not something else.
- You have accidents
“The amount of urine one leaks is not necessarily correlated with severity of OAB,” Dr Taylor says. “What counts the most is the level of bother a patient feels. Some women are comfortable wearing pads and leaking large amounts of urine, while some are very bothered by the slightest drops.”
Triggers for such accidents may be touching or hearing running water, drinking a small amount, or even briefly being in a cold environment, such as reaching into the freezer at the grocery store.
To identify your personal triggers, keep a bladder diary. “If you leak urine, marking down what you were doing and feeling can help you and your provider understand that better,” Dr Gregory says.
Retraining the bladder by scheduling bathroom trips at regular intervals can also help. “As infants we learn to control our bladder and go to the bathroom when it is socially acceptable,” Dr Gregory says, and you may need to do the same thing again now.
- It doesn’t necessarily happen when you cough, sneeze or jump
“Leaking a few drops at a time can be a sign of stress urinary incontinence, when moving, coughing, sneezing, standing up, jumping and jogging put stress on the bladder to cause the leakage,” Dr Gregory says.
But it’s possible to have both urgency incontinence, a symptom of OAB, and stress incontinence together. “Some women have a disorder called mixed incontinence when leakage occurs with both urge and coughing/straining activity,” Dr Taylor says. “It is important to discuss these concerns with a physician to tease out what is going on.”
- Certain foods and drinks trigger symptoms
“Alcohol acts as a diuretic, causing more urine to be filtered through the kidneys, increasing subsequent urine production and the feeling of OAB,” Dr Taylor explains. “Caffeine acts as both a diuretic and also makes the bladder more sensitive by lowering the threshold at which a bladder contraction will occur.”
Dr Gregory says that some people just have a lower tolerance for certain foods that irritate the bladder’s lining. “If you have that type of sensitivity, then a good strategy is to identify and avoid your trigger foods,” he says. Culprits often include hot peppers, tomato sauce, wasabi, and even cranberry juice.
- You don’t have pain, burning or blood
- You’re always scoping out bathrooms
“If you have any of the quality of life issues – knowing all the bathrooms, afraid to be in social settings – it’s time to talk with a doctor,” Dr Taylor says.
Many OAB sufferers are often embarrassed to bring up the subject, but overactive bladder treatment is available, and there are completely natural remedies such as exercises and bladder retraining. If those don’t work, there are medications and procedures as a next step.
“If you are changing the way you live – not seeing friends or family, not exercising or doing the things you like – then you should seek assistance,” Dr Gregory says. “These problems can often be addressed and improved.”
Image: Getty Images
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