How to Manage an Overactive Bladder

Overactive bladder (OAB) is a chronic condition affecting approximately 50 million American adults1,2, with a higher incidence in women than men. It is typically characterized by frequent and sudden urges to urinate, even if the bladder is not full. The condition can affect a patient's sleep quality and daily functioning.

Though frequent urination or incontinence (leaks) – common symptoms of OAB – can occur with the natural changes that come with aging, OAB is not normal for healthy adults. Certain symptoms can even indicate a serious underlying health condition, which is why doctors use a careful diagnostic process to determine whether a patient's symptoms are due to OAB or something else, such as a neurological disease or an infection.

First-line treatments for OAB revolve around modifying a patient’s daily habits to reduce OAB symptoms, the most common of which are:

Frequent urination – Frequent urination is defined as urinating so often that it disrupts your daily life – typically 8 or more times in a single day
Incontinence- Partial or full loss of control of the bladder that results in leaks
Nocturia – Also known as nighttime urination, or getting up to urinate more than once per night

Overactive Bladder Can Be Managed

Though OAB is a chronic condition that has no cure, it can potentially be managed naturally with lifestyle interventions ranging from dietary changes to physical exercises. If you’re diagnosed with OAB, your doctor will typically start by recommending these treatment approaches before considering advanced therapies. Keep reading to learn more about how behavioral and dietary interventions can help reduce OAB symptoms.

Overactive Bladder Remedies: Lifestyle Interventions

Behavioral Approaches

Below, we’ll cover two of the most common behavioral overactive bladder remedies: bladder training and pelvic floor exercises.

Bladder Training

Bladder training is a behavioral therapy aimed at helping a patient regain control of their bladder. It consists of retraining the patient’s bladder to hold urine for longer and longer periods of time. Bladder training is one of the most common first-line treatments for incontinence and bladder leaks.

How Bladder Training Works

First, your doctor will have you keep a bladder diary to record how often you’re urinating, including when and how much urine you release. From there, doctors will typically recommend the following practices as part of a bladder training regimen:

Delaying urination: This is the practice of holding urine for a certain amount of time once the urge to urinate sets in. For example, a patient might start by holding it for 5 minutes, then gradually increase the time by 10 or so minutes until you can go two, three, or even four hours without urinating.
Schedule restroom visits: This technique works by first using a bladder diary to determine how often you’re currently visiting the restroom to urinate. Start by delaying the trip by 15 or so minutes, then gradually increasing the delay time in a similar fashion to the delayed urination technique. For example, if you’re currently using the restroom every hour, Healthline recommends scheduling a bathroom visit every 1 hour and 15 minutes. With this technique, using the restroom at every scheduled visit is important, even if you don’t feel the urge to urinate.
Double voiding: Another bladder training technique is to start urinating, pause and “hold it” for a few minutes, then finish emptying the bladder in order to exercise and strengthen the muscles that control the release of urine.

Pelvic Floor Exercises

Pelvic floor or Kegel exercises may or may not be recommended as part of your bladder training regimen. These exercises are designed to strengthen the muscles that control the start and stoppage of urinating, similar to the practice of double voiding, and are especially effective in women, especially combined with the bladder training techniques mentioned above.

To perform pelvic floor or Kegel exercises, squeeze the muscles you use to start or stop urinating for 10 seconds. Release for 10-seconds to complete the exercise, then repeat. It is generally recommended to do 3 sets of 10 repetitions every day. (Your doctor may recommend that you start with 5-second contractions before working up to 10 seconds.)

Diet Changes

If you’re keeping a bladder diary, you’re likely tracking what you drink or eat throughout the day to determine potential triggers for your OAB symptoms. This can help you figure out what to reduce or eliminate from your diet.

Though there is some individual variation, some of the most common trigger foods and fluids to avoid or limit include caffeinated drinks such as coffee, tea, and soda; alcohol; foods containing caffeine (such as chocolate); and spicy foods (which can irritate the lining of the bladder and increase feelings of urgency).

Reduce the amount of caffeine, alcohol, or other diuretic fluids you drink throughout the day. It’s also recommended to limit all fluid intake close to bedtime, including water.

General Tips for Managing OAB Naturally

The following are general best practices for managing OAB symptoms without medication or advanced therapies:

Always urinate right before bed and right upon waking up.
Maintain good sleep hygiene to encourage uninterrupted sleep, regular bedtimes, and regular wake-up times.
Avoid or quit smoking, as cigarette smoking can exacerbate OAB.

When Behavioral Overactive Bladder Remedies Aren’t Enough

Bladder training techniques (delayed urination, scheduled bathroom trips, double voiding), Kegel exercises, and dietary changes can be highly effective for managing OAB symptoms. However, for many people behavioral interventions aren’t enough. Doctors may look next to pharmaceutical treatments.

Medications are available to help improve bladder control and reduce leaks if incontinence is a factor. Your doctor will consider your unique symptoms, your overall medical history, and any other medications you’re taking to determine the best drug for you. To ensure that you find a medication that works for your symptoms without too many detrimental side effects, some trial and error may be required before you find the right drug.

Finally, advanced therapies for OAB are available for patients whose symptoms are not resolved by behavioral therapies or medication. These overactive bladder solutions include Botox and sacral neuromodulation. Sacral neuromodulation can be delivered using The Axonics System.

Is Sacral Neuromodulation right for me?

If you’ve been unable to resolve your OAB symptoms with behavioral therapies or medication, the Axonics System may be able to help. This is an effective therapy that works by using a small, minimally invasive implant to deliver electrical stimulation to the sacral (pelvic) nerves to help normalize bladder function. Learn more about the system today to find out if it’s right for you.

Disclaimer: Axonics does not provide medical advice, diagnosis or treatment. The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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Coyne KS, Sexton CC, Thompson CL, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK, and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int. 2009;104(3):352-360.
Census Reporter website. https://censusreporter.org/profiles/01000us-united-states/. Accessed July 19, 2019.