Overactive bladder treatment: Finding the best options

Overactive bladder can have a major impact on just about every aspect of your life. It can force you to avoid holidays, meals out, and other social situations. You can even miss out on valuable time with family and friends because you’re afraid your overactive bladder (OAB) will trigger at the wrong time and embarrass you. 

Fortunately, there are ways to combat the problem. Overactive bladder treatment has many approaches, from medication, to behavioural changes, to a combination of both. Visiting your GP for a thorough evaluation and following his or her instructions carefully can help you get the OAB treatment you need to get back into your routine. 

Bladder training and pelvic floor exercises are just two natural treatments for overactive bladder. Research suggests that these non-drug remedies can cut overactive bladder episodes by about half, and they have almost no side effects. 

Before starting any OAB treatment, however, it’s important to understand bladder function and what factors may cause overactive bladder. Then you can learn to control your fluid intake and manage constipation (which is a common side effect of medication for overactive bladder). 

• Bladder training. This is the most common OAB treatment that doesn’t involve medication. Bladder training helps change the way you use the toilet. Instead of going whenever you feel the urge, you urinate at set times of the day, called scheduled voiding. You learn to control the urge to go by waiting, for a few minutes at first, then gradually increasing to an hour or more between toilet visits.
• Pelvic floor exercises. Just as you exercise to strengthen your arms, abs, and other parts of your body, you can exercise to strengthen the muscles that control urination. During these pelvic floor exercises, called Kegels, you tighten, hold, and then relax the muscles that you use to start and stop the flow of urination. Using a special form of training can help you locate the right muscles to squeeze. Start with just a few Kegel exercises at a time, and gradually work your way up to three sets of 10. Another method for strengthening pelvic floor muscles is with electrical stimulation, which sends a small electrical pulse to the area via electrodes placed in the vagina or rectum.

Until you get your overactive bladder under control, wearing absorbent pads can help hide any leakage that occurs.

Medications for overactive bladder

In people with overactive bladder, nerves misfire, signalling muscles in the bladder wall to contract and release urine at the wrong time. A group of drugs called anticholinergics combat this problem by blocking the nerve signals and reducing bladder muscle contractions. Research suggests that these drugs also might increase bladder capacity and decrease the urge to go.