Are you skipping excursions with friends because you’re worried a bathroom won’t be in arm’s length? You’re not alone. Overactive bladder (OAB) doesn’t have to cramp your style or your social life. Find out 12 natural ways to manage that frequent urge to urinate.
Do you have the path to the mall restroom mapped? Are you afraid to leave home because there won’t be a bathroom nearby when you need one?
That’s the reality for the millions of women who suffer from overactive bladder (OAB).
In fact, 17% of all women over age 18 have OAB, according to the National Association for Incontinence (NAFI), an education and advocacy association.
So why does OAB have you living in the ladies’ room? And what exactly are the underlying causes of the urge to urinate?
The condition occurs when your brain sends signals to the bladder at the wrong time, telling the organ that you need to urinate. Your bladder responds by contracting and you feel the urge to go – frequently, sometimes urgently and certainly more than “normal.”
While its causes are unknown and the condition isn’t dangerous, OAB’s symptoms are annoying and embarrassing, forcing women to plan their lives around it.
But here’s good news: OAB is very treatable and a range of medical and surgical options are available. However, changing daily habits is the first course of treatment – simple steps, such as watching fluid intake and doing Kegel exercises. Here are 6 do’s and 6 don’ts to get you started:
The Don’ts
1. Don’t squat when you pee.
It’s important to really empty your bladder every time you go, says Elizabeth Kavaler, a New York urologist and author of A Seat on the Aisle, Please! When you hover over the toilet, you can’t empty your bladder well.
“[Women] squat and don’t take the time they need,” Kavaler says.
Her tips? Don’t squeeze your legs and don’t restrain and hurry.
“You need to take the extra 30 seconds,” she says.
What if you’re using a public restroom?
“Put paper on the toilet seat and sit.”
2. Don’t drink 8 glasses of water a day.
The adage that 8 glasses of water is good for your health doesn’t apply if you have OAB. In fact, it may be the cause of it, says Sandra Valaitis, M.D., chief of Gynecology/Reconstructive Surgery at University of Chicago Medical Center.
As part of OAB treatment, Valaitis asks her patients to keep a diary of everything they drink and when they urinate.
“I’m amazed so many times what patients are drinking without even realizing it,” she says. “I had one 25-year-old woman [who] was drinking 120 ounces of Pepsi a day and hadn’t even thought about how that would impact her bladder control.”
What’s the right amount? Four to six glasses of water a day is enough for most people – a little more if you exercise vigorously and sweat, says Ariana Smith, urologist and assistant professor at the University of Pennsylvania in Philadelphia.
3. Don’t drink too little.
You want to decrease your fluid intake but not too much: Too little can irritate the bladder, so you still may feel that constant urge to urinate.It can also lead to urinary tract infections (UTIs), because the urine becomes concentrated (and turns dark yellow and smells) due to dehydration. That leaves bacteria behind.
How do you know if you’re drinking the right amount? Your urine should be clear and odor-free.
4. Don’t go for the cranberry cure.
Even though cranberry juice is a UTI folk remedy, it’s not good for your bladder, says Kavaler. It doesn't hydrate well or flush out toxins. In fact, it’s a sugary diuretic and OAB sufferers should steer clear.
“Drink water when you’re thirsty and eat a well-balanced diet as part of a healthy lifestyle,” she says.
5. Don’t give up sex.
Sex doesn’t cause OAB or make it worse, so there’s no reason to give it up, says Smith.
Sure, the condition can make women uncomfortable during sex because they feel the urge to urinate and worry they might have an accident. But these conditions go away when OAB is treated, she says.
Limiting fluid intake before having sex also may relieve discomfort, suggests Kavaler.
6. Don’t obsess about peeing.
“There's no such thing as ‘normal’ urination,” Kavaler says. “Whatever makes you functional is normal.”
Obsessing when, where and how you go, she says, only leads to stress. And that can make many women experience even more frequent urination because when they're stressed, they tend to drink more liquid – creating an endless cycle.
If you’re urinating more than is practical and it’s bothersome, see your doctor, Kavaler says.
The Do’s
1. Do Kegel exercises.
Kegel exercises strengthen pelvic-floor muscles and short-circuit the urge to urinate, Smith says.
“If you have good pelvic floor muscles, you can suppress your urge to go,” she says.
Kegel exercises are simple squeezes you can do at home, contracting your pelvic-floor muscles as if you’re trying not to pee. (Don't do these if you have a full or partially empty bladder, says Edward Geehr, M.D., Lifescript Chief Medical Officer. It can lead to UTIs.)
Even better: You can do them anywhere without anyone noticing – at your desk at work or while watching TV.
2. Do cut back on the mocha lattes.
Caffeine in coffee, tea, soda – even chocolate – has a diuretic effect: It makes your bladder fill quicker so you have to urinate. It may also irritate it.
“Eight ounces of coffee seems to be harder on the bladder than 8 ounces of water,” Smith says. “So go with water.”
The good news: “A lot of women come back after they’ve eliminated caffeine and their OAB symptoms are significantly better,” she says.
3. Do set a pee schedule.
The brain can tell your body that you have to go, even if you don’t.
“Your bladder might get used to holding a smaller amount and it doesn’t want to stretch [to hold more urine],” Valaitis says. So you need to "train" it to go when you want to go, she says.
“One treatment is to teach patients how to gradually increase intervals between voidings,” she says.
To do this, you have to keep a diary of when you urinate to find a pattern. You may also be asked to measure your output in provided containers to determine when you really need to go and when you don’t.
A recommended interval between bathroom breaks is 2-1/2 hours, Valaitis says.
If you’re going more often, longer intervals between bathroom breaks will gradually be introduced, Kavaler says. But finding your own rhythm is what’s most important for overactive bladders, she says.
“Everyone has their issues and you have to know your body and its requirements.”
4. Do manage your medications.
Drugs you take for other conditions may trigger OAB, including blood-pressure drugs, diuretics, muscle relaxants, sedatives and antidepressants, Valaitis says. Others cause dry mouth, which may make you drink more water, causing OAB symptoms.
“It’s good to take a look and maybe change the time of day when you take your medication.”
You may be able to make simple adjustments, such as not taking the medication at night or when you’re going out.
5. Do maintain a healthy weight.
Being overweight puts extra pressure on the bladder and increases the risk of developing bladder problems.
Even if you lose a little weight – as little as 5% in overweight or obese women – you can regain bladder control, according to a study of 338 heavy-set women conducted by a University of California, San Francisco researcher, which was published in 2009 in the New England Journal of Medicine.
6. Do seek further treatment.
If a change in habits doesn’t work, anticholinergic medications, such as Detrol and Ditropan, may alleviate the urge to urinate by blocking the nerve signals to the bladder.
Minimally evasive surgery is also an option – either the insertion of a bladder pacemaker or Botox injected into the organ to relax the muscle and minimize the sensation that you need to urinate all the time.
Are You Having Bladder Problems?
Leak when you laugh? Have a constant urge to pee? Incontinence is a problem that can be managed. Knowing the causes and common triggers can help you stay dry and out of the bathroom. Do you know how to make your bladder behave?
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