Published: July 5, 2024

7 Steps to Regain Control of Your Overactive Bladder

By: Melissa Fischer, M.D.

How do you know if you have overactive bladder? How about when nature stops calling and starts shouting. A lot, and especially at night.

Overactive bladder is the immediate, hard-to-control need to urinate. If you feel like you’re holding all of Lake Michigan in your bladder, yet squeeze out just a puddle, you could be among the 40% of women and 30% of men who experience symptoms of OAB. Other signs include waking up more than twice in the night to go and sometimes not making it to the bathroom in time (leakage).

Why Your Bladder is Overactive

The bladder is a funnel-like organ that stores your urine. Typically, a healthy adult bladder can hold two cups of urine for as long as five hours.

As the bladder fills, your brain signals the sacral nerves in your lower spine, which control the bladder. When all goes as planned, the bladder will compress and you can urinate when you’re ready. If you have OAB, however, the bladder muscles may start squeezing before your bladder is full.

Often, OAB is the symptom of another condition, such as a bladder obstruction (stones or an enlarged prostate), infection, diabetes, hormonal changes from menopause, or nerve damage. It also could be misfired communications from your sacral nerves, signaling your bladder to empty before it’s full and prompting the sudden need to go.

How to Manage Overactive Bladder Symptoms

If you recognize any of the above symptoms, it might be time to see a urologist. But first, here are seven modifications you can try.

  1. Rethink what you drink – Even with OAB, you need to drink at least eight glasses of fluid daily, but limit caffeine, alcohol, and artificial sweeteners. Avoid drinking anything in the two hours before sleep.
  2. Reduce spicy and acidic foods – Certain foods can irritate the bladder and aggravate OAB. These foods include hot peppers, tomatoes, and citrus fruits like oranges and lemons (as well as their juices). Low-acid substitutes include pears, watermelon, and apricots.
  3. Stay active – Keeping moving and strive to have good general fitness. Extra weight can put pressure on the bladder, especially when standing up or getting out of bed. Even modest weight loss can be very helpful!
  4. Keep a bathroom log – Jot down how much and when you drink, the times you go, and how much came out (generally). If a leak occurs, include that. These details can help you pin down triggers.
  5. Embrace Kegel exercises – Strong pelvic floor muscles help you better control urination, so strengthening them should improve your ability to keep it in. Squeeze like you’re trying not to pee, hold for a few seconds, and release. Try to perform five sets of 10 daily.
  6. Take a breath – When an OAB attack occurs, resist the impulse to rush to the bathroom. Calm your body for a few seconds; breathing exercises and Kegels can help.
  7. Set a “go” schedule – Once you’ve gained confidence, practice bladder training: going only at designated times – say every hour or two – then gradually add time.

When Nature Calls Too Frequently, Call Your Doctor

If these steps don’t make a difference after two months, contact your urologist for more advanced medical care.

Typically, your initial approach will involve a medication that can calm the bladder muscles. If drugs don’t do the trick, your doctor might advise Botox bladder injections, which relax the bladder muscles, or nerve stimulation treatments to modulate the nerves that control the urge to pee.

You have the power to subdue the call of nature. And you have a voice. Talk about your OAB symptoms with a professional, and you can regain control.

You can download our free OAB educational booklet for more specifics, including a log to track your trips to the bathroom. Or visit our OAB website, which explains what to expect during diagnosis and treatment.

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