Bladder Problem? Top 10 Myths About Overactive Bladder Get the Truth Behind Your Urge to Pee

Nature is calling way too much. You may even leak occasionally. It can’t be overactive bladder. That's for old people, right? Wrong. Learn the symptoms and discover 10 myths about this condition that affects millions of women. Plus, get doctor-recommended tips for overactive bladder treatment... Will drinking more liquid help manage overactive bladder? Can you get OAB from sex? You’ve probably heard tons of theories about why you have OAB and how to relieve it. Guess what? Many aren’t true. We asked OAB specialists to identify the top myths about this misunderstood and misdiagnosed condition. First, the basics: Overactive bladder is the frequent, sudden urge to pee and difficulty holding it in. Next, get the truth about OAB and how to manage your urge to pee: 1. Myth or Fact? Only older women get OAB. Myth: “That’s the biggest misconception in women – that ‘I’m too young for this,’” says Ariana Smith, M.D., urologist and assistant professor at the University of Pennsylvania in Philadelphia. While OAB is more common in post-menopausal women, about 17% of women over age 18 (and 16% of men) have OAB, according to the National Association for Continence (NAFC). After 40, that number increases to 20% for both men and women. Women can experience OAB before menopause, agrees Arthur Mourtzinos, M.D., a urologist with the Lahey Clinic Continence Center in Boston, who has treated female OAB patients ranging in age from 28-98. In younger women, OAB can be a sign of a more serious condition, such as a neurologic disease (MS, spinal cord injuries), kidney stones, bladder infection or even a bladder tumor. If you have overactive bladder symptoms at any age, get evaluated by a physician, say all the doctors we interviewed. 2. Myth or Fact? “Urge incontinence” and “stress incontinence” are the same as OAB. Myth: With OAB, nerves surrounding the bladder send abnormal signals to urinate, even if your bladder isn’t full. If you have the urge to pee more than eight times a day (or two or more times at night), you could have OAB and should see your doctor. You may leak, but that’s not what defines the condition. Urge incontinence, in which you leak after a strong feeling you need to go, can be a symptom of OAB. But it can also be caused by other medical conditions, such as diabetes, infection or stroke. Stress incontinence – leaking when you cough, sneeze or do strenuous exercise like running – is another condition entirely. It’s usually caused by an anatomical problem (such as weakness in the sphincter or pelvic muscles) rather than a nerve issue. You can have both OAB and stress incontinence at the same time. “Many things can cause leakage that are not OAB, and many women with OAB don’t leak,” says Sandra Valaitis, M.D., chief of gynecology/reconstructive surgery at University of Chicago Medical Center. 3. Myth or Fact? Urinary tract infections (UTIs) and OAB go hand in hand. Myth: “People think OAB causes UT infections. That’s not true,” Mourtzinos says. UTIs are among the most common infections in the body. Bacteria (often E. coli) enters the urinary tract through the urethra, the tube that carries urine out of your body, and can multiply in the bladder. Like OAB, a UTI can cause leaks and the need to pee. So it’s easy to mix up the two, Mourtzinos says. UTIs, however, are treated with antibiotics. Once the infection is gone, the overactive bladder-like symptoms should go away, Smith says. 4. Myth or Fact? Drinking more liquid will help manage OAB. Myth: Consuming liquid will not help manage OAB, Mourtzinos says. When assessing bladder problems in women, the first thing doctors check is the amount of liquid consumed. “My own mother used to have six cups of coffee a day and lived in the bathroom. When she cut her coffee intake by 75%, her OAB went away,” Mourtzinos says. Too much liquid can even lead to OAB, especially caffeinated drinks, which work as a diuretic (meaning they increase your urge to pee), Smith says. “You have to pee out what you take in.” Switching from coffee to cranberry juice won’t help either, says Elizabeth Kavaler, M.D., a New York-based urologist and author of A Seat on the Aisle, Please! (Springer). Often touted as an aid against urinary tract infections, cranberry juice will actually make OAB worse. It's also a diuretic, says Kavaler. “Plus, it’s all sugar and not healthy.” 5. Myth or Fact? Kegel exercises help with OAB. Myth: Kegel exercises, in which you squeeze together the muscles of your pelvic wall, won’t cure overactive bladder symptoms. But they can help manage the condition and are usually recommended as part of treatment. “Kegel exercises are effective in short-circuiting an urge to urinate,” Kavaler says. By strengthening the pelvic floor muscles, you can suppress the urge. In addition to Kegels, a doctor probably will recommend watching your liquid intake, Mourtzinos says. “It’s important to note that [Kegels] are part of therapy, but not the sole one,” he adds. With other treatment, “it will make a difference.” 6. Myth or Fact? Too much sex is one of the top overactive bladder causes. Myth: An abundance of hanky-panky does not bring on leaks, according to Mourtzinos. “Sex is not the cause of OAB,” Smith agrees. But if you do have OAB, you may accidentally urinate during sex or not enjoy it because you feel the urge to pee. Don’t worry; both issues should go away when your OAB is treated. “Not having sex is not the solution,” Smith says. 7. Myth or Fact? You can get OAB if you have a small bladder. Myth: “People with small bladders go frequently in small amounts,” Mourtzinos says. “If you go frequently in large amounts, you don’t have a small bladder; you just drink too much.” The real issue with OAB is not the size of your bladder – what’s “normal” varies anyway – but that you’re contracting your bladder more than you should, a result of abnormal nerve signals to your bladder. 8. Myth or Fact? OAB is something you must live with. Myth: This is the most important myth to be debunked, say doctors. A lot of women think OAB is a condition you get when you’re older – that it’s just a fact of life. “They're either embarrassed, feel like social outcasts, or feel they have to live with it. They don’t,” Mourtzinos says. “And don’t assume you’re alone,” he adds. That attitude prevents women from seeking treatment earlier. If you feel you’re urinating too much or something is not normal, see your doctor, Mourtzinos says. 9. Myth or Fact? The pubovaginal sling (also known as “the hammock”) treatment helps curb overactive bladder symptoms. Myth: The pubovaginal sling is becoming increasingly popular in managing urinary incontinence in women. In this surgical procedure, a urologist places a stretchy band in the area of the urethra to provide support against leaks. However, it’s not helpful with OAB, according to the doctors we interviewed. It can even make OAB worse, Valaitis says. The hammock doesn’t alleviate the actual urge to pee, and it can “sometimes lead to voiding difficulties, which can aggravate OAB symptoms,” she says. Mourtzinos points out that the hammock is designed for patients with anatomic abnormalities and is mostly used to treat stress incontinence (leaking while coughing, sneezing or exercising). 10. Myth or Fact? Surgery is the only way to “fix” OAB. Myth: Surgery should only be used as a last resort, the doctors agree. There are several steps doctors recommend before “the knife.” They include: 1. Behavior modification, such as reducing bladder irritants like caffeinated beverages. “A lot of people come back [after] eliminating caffeine, and their symptoms are significantly better,” Smith says. 2. Kegel exercises to strengthen bladder control. 3. “Bladder retraining.” This treatment will help you discover your urination pattern and help you extend the amount of time between bathroom breaks. As part of this, you’ll probably keep a urination diary, and be taught to clench and wait between scheduled bathroom visits. 4. Medication. There are nine anticholinergic medications (such as Detrol) for overactive bladder treatment. They work by blocking abnormal bladder signals that give you the urge to urinate. However, there’s some debate among physicians and scientists about how exactly these medications really work (studies have been inconclusive). Only if all that fails does surgery become an option. Two minimally invasive, FDA-approved procedures have been shown to be effective. One is a bladder pacemaker, a small pulse generator implanted in the bladder to stimulate the nerves properly. The second takes a page from Hollywood celebrities: Botox. It's approved for women who experience leaky bladders due to damage to the nervous system, through conditions such as multiple sclerosis or spinal cord injury. While not yet FDA-approved for broader population of patients, it has proven effective in relaxing bladder muscles and stopping your urge to pee. “Urge seems to improve dramatically with Botox injected into the bladder,” Smith says.