What is overactive bladder?

An overactive bladder (OAB) causes a sudden urge to urinate. It can also trigger involuntary loss of urine, known as incontinence. Overactive bladder affects about 33 million Americans. Women are more often affected than men.

It can be difficult to manage symptoms because an overactive bladder may be unpredictable. This can cause some people with the condition to limit their social activities, which can affect the quality of your life. It can also trigger isolation and emotional distress.

But there are several treatments available that can help you manage your symptoms. Treating overactive bladder can also improve your outlook and reduce incidence of incontinence.

Experiencing occasional incontinence doesn’t mean you have an overactive bladder. Urine leakage can happen for other reasons, like if you’re laughing too hard. You may also experience loss of urine if you’ve been fighting the urge to urinate for an extended period of time.

An overactive bladder is determined by the frequency and urgency of urination. Symptoms include:

  • an urgent and uncontrollable need to urinate
  • frequent involuntary loss of urine
  • frequent urination (more than eight times in a 24-hour period)
  • waking up more than once a night to use the bathroom

Symptoms of overactive bladder can change. They may be different from person to person, too, which can make identifying the issue difficult without a doctor’s help. Knowing the symptoms of overactive bladder can help you find better treatments faster.

Several treatments are available to help you manage symptoms of OAB. These can include:

Pelvic floor physical therapy

There are physical therapists who specialize in the muscles of the pelvis. Through targeted muscle exercises and strengthening, they can help manage a variety of urinary problems, including urgency, frequency, and nighttime symptoms.


Medicines that treat overactive bladder focus on two effects: relieving symptoms and reducing episodes of urge and incontinence. These medicines include tolterodine (Detrol, Detrol LA), trospium (Sanctura), and mirabegron (Myrbetriq).

OAB medications may cause some side effects, including dry eyes, dry mouth, and constipation. Read about the possible side effects from overactive bladder medication and other considerations.


Small doses of Botox can temporarily paralyze or weaken bladder muscles. This stops them from contracting too often, which can reduce symptoms of overactive bladder. The effects of the injection typically last six to eight months, so you may need repeated treatments.

Nerve stimulation

This procedure changes the electrical signal of the nerves that carry impulses to the bladder. The electrical stimulation can be performed using a small wire inserted into the low back or a small needle inserted through the skin of the lower leg.

Though it hasn’t been clearly established, some research has shown this can relieve the frequency and urgency of an overactive bladder.


Your doctor may suggest surgery to increase your bladder’s capacity if your symptoms don’t improve with medication, nerve stimulation, or other therapies.

Your kidneys produce urine and that urine travels to your bladder. Then, your brain sends signals that tell your body to urinate. Your pelvic floor muscles relax and allow urine to exit your body.

An overactive bladder causes your bladder muscles to contract involuntarily. This gives the sensation of needing to urinate frequently even if your bladder isn’t full.

Different conditions and factors can cause symptoms of OAB:

  • drinking too much fluid
  • taking medications that increase urine production
  • urinary tract infections
  • consumption of caffeine, alcohol, or other bladder irritants
  • failure to completely empty the bladder
  • bladder abnormalities, such as bladder stones

The exact case of an overactive bladder is unknown. The risk of developing this condition increases with age. But an overactive bladder isn’t a normal part of aging, so you shouldn’t ignore symptoms. Seeing your doctor can help make sure you get the correct diagnosis.

Bladder function relies on good urinary tract health. The causes of overactive bladder are often the result of issues in your urinary tract.

Your doctor may complete several tests in order to diagnose the cause of your overactive bladder symptoms. Your doctor may also refer you to a specialist who treats issues with the urinary tract. These doctors are called urologists.

Tests used to diagnose overactive bladder include:

Urine sample (Urinalysis)

A sample of your urine is collected and then tested for any abnormalities, including blood. A urinalysis can help identify a urinary tract infection or other urinary tract problems.

Physical examination

This allows your doctor to feel for tenderness around your abdomen and kidneys or check for an enlarged prostate.

Bladder scan

This test uses an ultrasound to measure the amount of urine left in your bladder after you urinate.

Urodynamic testing

This assortment of tests can assess the bladder’s ability to hold and store urine.


During this test, your doctor inserts a lighted scope into your bladder while you’re sedated. A cystoscopy helps your doctor determine if your symptoms are caused by any abnormalities within your bladder, such as bladder stones or tumors. Biopsies can be taken as well.

Your doctor or urologist may use additional tests to help rule out or confirm an overactive bladder diagnosis. Read more about each of these tests and what you need to do to complete them.

OAB is more common in women, but at least 30 percent of men in the United States experience symptoms of overactive bladder regularly. That number could be higher because men may not report symptoms of OAB to their doctor.

Symptoms of overactive bladder in men include

  • an urgent need to urinate
  • urinating up to eight times per day
  • experiencing urine leakage
  • feeling an urge to urinate that’s so strong it can’t be controlled

Many cases of OAB among men are the result of an enlarged prostate. As the gland swells, it can block urine flow and make urine incontinence more common.

An enlarged prostate is more common in older men, so overactive bladder is more common in older men, too. Treating the prostate issues may ease symptoms of OAB. Learn more about the causes of overactive bladder in men and how it’s diagnosed.

Women are more likely to report symptoms of OAB to their doctor. In fact, at least 40 percent of American women experience symptoms of overactive bladder. Many more may not report the experiences to their doctor at all.

Overactive bladder consists of a series of symptoms that cause you to need to urinate more frequently. These symptoms include

  • feeling a sudden need to urinate
  • not being able to control urination
  • urinating at least two times every night
  • urinating at least eight times every day

It’s not clear what causes overactive bladder, but OAB becomes more common in women after menopause. That may be the result of estrogen deficiency. However, overactive bladder can occur at any age.

OAB in women can be treated with medicine, surgery, and some physical exercises. Read more about these exercises and alternative treatments to decide if one might be right for you.

Overactive bladder is a common childhood condition, but not every accident or soiled bed is the result of OAB. Children frequently grow out of overactive bladder symptoms, but treatment can help prevent frequent urination or complications.

Symptoms of OAB in children include:

  • an urgent or frequent need to urinate
  • accidents or leaking urine
  • urinating more than eight times in a day
  • not feeling as if they’ve emptied their bladder despite urinating

Symptoms of OAB become less common as children get older. With age, kids learn to properly control their bladder and recognize signals that they need to urinate. If symptoms of overactive bladder don’t seem to be resolving or are getting worse, talk with your child’s doctor.

Causes of OAB in children include:

Like adults, treatments for overactive bladder in children focus on treating any underlying causes and preventing symptoms. Learn more about these treatment options and when it’s a good time to seek help from your child’s doctor.

In most cases, surgery isn’t recommended until you’ve tried all the other treatment options and haven’t gotten relief.

Sacral nerve stimulation

Overactive bladder is often the result of errant nerve impulses. These urges tell your bladder you need to urinate even when you don’t. This can lead to frequent urination or urges after you’ve already urinated.

During this procedure, your doctor can place a small electrode under the skin of your buttocks or lower abdomen. This electrode will send pulses that help regulate these signals that tell your body when you need to urinate.

Urinary diversion

Rerouting your ureters (the tubes that carry urine from your kidneys to your bladder) can reduce the frequency and urge to urinate. During this procedure, your doctor will bypass the bladder and create an opening in your abdominal wall where urine can empty into an ostomy bag.


If your doctor thinks your OAB symptoms are the result of a bladder that is too small, they may suggest enlarging it during this procedure. However, cystoplasty is typically reserved for people who’ve seen no improvements from other treatment options.

Bladder removal

Rarely, your doctor may decide removing your bladder entirely is the only option to eliminate OAB symptoms and complications. When they do this, they reroute urine from your kidneys to an ostomy bag on the outside your body.

These surgeries are often highly effective, but they carry a number of risks and possible lifelong complications. Learn more about the risks of overactive bladder surgery and what you should consider before using this OAB treatment option.

What you eat may have a direct impact on your urinary health. Food and drinks can stress your bladder, increasing your risk of irritation and symptoms of OAB.

However, what affects you may not affect another person. Keeping a food log can help you figure out which foods might make your symptoms worse.

Diet-related factors that can interfere with urinary health include:

  • Carbonated beverages. The bubbly drinks can aggravate symptoms of OAB and irritate the muscles in your bladder.
  • Fluid intake. Drinking adequate water is important for your overall health, but drinking too much can increase how often you need to urinate.
  • Drinking before bed. If you drink liquid within two to three hours before bed, you may find that you wake up more frequently to urinate in the night.
  • Gluten sensitivity. People who are allergic or sensitive to gluten (a protein found in wheat-based foods like bread, pasta, and crackers) may experience more symptoms of overactive bladder.
  • Caffeine. This stimulant may increase symptoms of overactive bladder. Caffeine is found in soda, coffee, chocolate, ice cream, and some over-the-counter medications.
  • Irritating foods. Some people may find that foods like citrus fruits, tomato products, spicy foods, artificial sweeteners, alcoholic beverages, artificial flavorings, or preservatives increase symptoms of overactive bladder.

As you figure out the best diet to reduce symptoms of OAB, you may want to consider taking nutritional supplements. Learn more about which are recommended and why they may be right for you.

Natural treatments can include exercises, behavioral and physical therapy, herbs and supplements, and more.

Vitamins and supplements

Some herbs, supplements, and vitamins are used as an alternative treatment for overactive bladder. These include Chinese herbal blends, like gosha-junki-gan, mushroom extracts, like ganoderma lucidum, and plant extracts, like corn silk and capsaicin.

Supplements, such as magnesium hydroxide and L-arginine, have been more thoroughly studied in people with overactive bladder or incontinence and have shown promise as a way to relieve symptoms.

Before you take any of these supplements or vitamins, check with your doctor. Some supplements can interfere with prescription medicines.


Acupuncture involves placing fine-tipped needles in specific areas of the body. Activating these points is thought to restore the flow of energy (“qi”), and this may ease symptoms. Some research shows that there’s promise for the use of acupuncture for OAB symptom relief. However, the evidence that it works is insufficient at this time.

Essential oils

Overactive bladder is often the result of nerves firing and causing muscles to contract unexpectedly. Essential oils that can help calm these nerves and muscles may help you find symptoms relief.

Essential oils that are commonly used for OAB treatment include:

  • ylang-ylang oil
  • lavender oil
  • clary sage oil
  • pumpkin seed oil

Homeopathic remedies

This type of OAB treatment relies on listening to your body and finding treatments that can address your whole body, not just the symptoms of overactive bladder. Common homeopathic remedies include cutting out foods that are irritating and cause urinary urgency.

Likewise, bladder training and muscle training can be considered homeopathic. These can help you learn to increase the length of time you can go between feeling an urge to urinate and actually urinating.

Home and natural remedies may reduce symptoms of overactive bladder and help you control your urination more easily. Learn more about how they work and when it’s right to use them.

The muscles around your urinary tract help you hold urine when you have an urge. They also help you fully empty your bladder when you do urinate. Like muscles in your arms and legs, strengthening those muscles with exercise can be beneficial.

Pelvic floor exercises

These exercises, also known as Kegels, can help you strengthen the muscles in and around your pelvis. The increased strength can help you stop and start urination more successfully, which can reduce unwanted or unintended urination.

A basic Kegel requires you to squeeze the muscles in your pelvic floor and hold for several seconds. If you’re unsure what muscles to isolate, imagine trying to stop the flow of urine. Do this several times each day.

Vaginal cones

If imagining using those muscles seems too abstract or difficult, you can use a device called a vaginal cone to help you isolate your pelvic floor muscles. Place a cone inside your vagina and attempt to hold it in place with your pelvic floor muscles. With practice, you can use your muscles to lift heavier cones. Do this at least once per day.

Bladder training

Bladder training helps you hold your urine longer so you can reteach the muscles and nerves in your urinary tract. In other words, this exercise helps you lengthen the time between an urge to urinate and when you actually urinate.

You can try this each time you need to urinate. Start with a short period of time, such as three minutes. Slowly build up.

If you’re curious how much of an impact muscle strengthening can have, get started with these five exercises for women with an overactive bladder.

If you find that you wake up to urinate more than one time per night, you may have a condition called nocturia, or overactive bladder at night. Nocturia isn’t the same as overactive bladder. In fact, some people who experience no OAB symptoms during the day can still have nocturia.

Nocturia is more common in people over age 60, but one in three adults over 30 need two or more trips to the bathroom each night. Most adults can sleep six to eight hours without waking up. Others may only need to wake up once.

If you require more bathrooms breaks during your slumber, you may be experiencing overactive bladder at night.

If you believe you have nocturia, learn more about the symptoms and how it can be treated so you can talk with your doctor.

Botox may be best known as a great wrinkle reducer for the face. But this injection has actually shown great promise as a treatment for many medical conditions.

Most overactive bladder medications aim to calm muscles and nerves in the urinary tract. If these medicines aren’t effective, your doctor may consider injecting Botox into your bladder muscles. This can help calm the muscles and reduce symptoms of OAB.

Botox injections for overactive bladder are well-tolerated with few side effects. The injection’s effects typically last six to eight months. After that time, your doctor may want to use another round of injections to control symptoms.

Botox injections aren’t without possible complications or concerns, so read more about how they work before you talk with your doctor about this possible OAB treatment.

An overactive bladder can present challenges in everyday life. But doctor-prescribed treatments and lifestyle changes can help you reduce the frequency of urges.

The most important thing you can do if you have symptoms of overactive bladder or difficulty controlling your urine is talk to your doctor. OAB is often underreported.

Research and treatments have come a long way in helping doctors understand potential causes and treatments for this condition. You and your doctor can work together to develop a treatment plan that will be ideal for you and address any concerns you may have.