A healthy bladder depends on a healthy urinary tract and communication pathways between nerves and muscles. Conditions that affect these can cause involuntary contractions, leading to overactive bladder (OAB)

If you have an overactive bladder (OAB), learning the cause can help you manage it better. Sometimes, your doctor won’t be able to find a cause.

In other cases, you and your doctor can pinpoint an underlying condition that may be treatable. Read on to learn more about what causes OAB, its risk factors, and triggers.

OAB is caused by involuntary muscle contractions in your bladder muscles, whether or not your bladder is full. The exact cause of these contractions is sometimes impossible to identify. In other cases, you and your doctor can identify the underlying cause.

  • Neurological conditions: Some neurological conditions can disrupt the signals between your nerves and bladder muscle. These include Parkinson’s disease, multiple sclerosis, and stroke.
  • Nerve damage: This includes trauma to your spine, pelvis, or abdomen caused by injuries or surgeries, complications of diabetes, brain or spinal cord infections, and neural tube defects.
  • Urinary tract infection (UTI): This can cause your bladder to become overly active, triggering the urge to urinate more. Unlike OAB, a UTI often causes pain or a burning sensation during urination.
  • Side effects from medications: Certain medications, like water pills or caffeine pills, can cause OAB-like symptoms. Taking medications with lots of fluids can also increase urine production, leading to urgency and incontinence.
  • Obstructions: Blockages or other abnormalities in your urinary tract can cause symptoms similar to OAB. These include bladder stones, enlarged prostate, and tumors. An enlarged prostate can also cause urgency.
  • Metabolic disorders: Certain metabolic disorders can co-occur with OAB and can be an underlying cause.
  • Stress incontinence: This is incontinence caused by physical overexertion from things like sneezing, coughing, or exercising.

For females assigned at birth (FAAB), OAB-like symptoms may indicate menopause or pregnancy.


Menopause causes a sudden drop in the level of estrogen in a female body. Lower estrogen levels can cause your bladder and urethra muscles to weaken. This can lead to sudden urges to urinate and urine leakage, a condition known as urge incontinence.

You may also develop stress incontinence with menopause. In this condition, laughing, sneezing, and similar movements put pressure on your bladder and lead to urine leakage.


During pregnancy, a uterus expands. This can put pressure on your bladder and cause sudden urges to urinate or incontinence. You might also experience incontinence after childbirth due to weakened pelvic floor muscles. This is a common cause of OAB-like symptoms and is treatable with Kegel exercises and other therapies designed to strengthen your muscles.

Particularly in males assigned at birth (MAAB), OAB may be caused by an enlarged prostate gland.

It’s not unusual to have an enlarged prostate, and it can be a sign of age. However, it can also be a sign of prostate cancer.

An enlarged prostate can affect the flow of urine out of the urethra, leading to frequent sensations of urgency. However, males, like females, can get OAB from a variety of non-sex-specific causes, so screening is important.

Certain risk factors affect your chances of developing OAB. Some of them, such as age and gender, are beyond your control. Others, such as obesity, are preventable through healthy lifestyle choices.

Risk factors for OAB include:

  • Age: OAB can occur at any age, but your risk increases as you get older. Age also raises your risk of other conditions that affect bladder control.
  • Sex: FAABs are more likely than MAABs to be incontinent, reports the National Institute on Aging. In part, this reflects how menstruation, pregnancy, and menopause affect female hormone levels and pelvic floor muscles.
  • Obesity: Carrying excess weight puts pressure on your bladder. Obesity may also lead to conditions affecting blood flow and nerve activity in your bladder.

If you have OAB, there are many possible triggers for your symptoms. These include:

  • eating acidic foods, such as tomatoes and citrus fruits
  • drinking too much alcohol or caffeinated drinks
  • not drinking enough fluids
  • not getting enough fiber in your diet
  • constipation

Identifying and avoiding your triggers can help reduce your OAB symptoms.

How do you calm an overactive bladder flare-up?

Treatment for overactive bladder can take time. Some lifestyle changes can support your treatment, including quitting smoking, maintaining a healthy weight, eating a balanced diet, getting enough fluids, and exercising.

In addition, it’s a good idea to limit coffee, alcohol, and acidic foods.

Does an overactive bladder come and go?

An overactive bladder tends to be a chronic condition, but triggers can make your symptoms worse. Eliminating or reducing these, where possible, can help reduce the severity. Speak with your doctor for specific recommendations to you.

Understanding the causes and risk factors for OAB may help you avoid developing it. If you have OAB, diagnosing the cause and identifying triggers can help you manage your condition.

Healthy lifestyle choices are important. Try to maintain a healthy weight, eat a well-balanced diet, and exercise regularly. Stay in touch with your doctor, who can help you manage your symptoms and treat any underlying health conditions.