Overactive Bladder Causes, Treatment and Remedies - Dr. Axe

Fact Checked

This Dr. Axe content is medically reviewed or fact checked to ensure factually accurate information.

With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Note that the numbers in parentheses (1, 2, etc.) are clickable links to these studies.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Note that the numbers in parentheses (1, 2, etc.) are clickable links to medically peer-reviewed studies.

Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. Our team aims to be not only thorough with its research, but also objective and unbiased.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

Overactive Bladder Causes and Natural Remedies


Overactive bladder

Have you ever thought about your bladder control or how often you urinate each day? Probably not, unless you’ve experienced a bladder control problem like overactive bladder.

Overactive bladder is a condition in which the bladder cannot hold urine normally. One of the most common symptoms of this pee health problem is urinary incontinence or leaking urine. Many people suffer in silence, but if you are currently experiencing a bladder-related difficulty you are truly not alone. It’s estimated that at least 30 percent of men and 40 percent of women in the U.S. have overactive bladder.

Sometimes a person experiencing overactive bladder doesn’t have any underlying health problem. Other times, an overactive bladder can be the result of medications or other more serious health issues, such as diabetes, kidney disease, multiple sclerosis or Parkinson’s disease.

Overactive bladder can also occur after surgery or childbirth. How much is too much when it comes to urination? People with overactive bladder typically have to urinate more than 8 times per day or more than once at night.

It’s crucial to address overactive bladder symptoms right away. Early treatment can reduce, or even completely get rid of, the highly unwanted symptoms. With some time and effort, there are several very doable and natural ways you can overcome an overactive bladder.

What Is an Overactive Bladder?

Overactive bladder (OAB) is a syndrome, or a set of symptoms, that is believed to be due to sudden contractions of the muscles in the wall of the bladder. When you have overactive bladder syndrome, the muscles controlling bladder function start acting involuntarily. This often leads to urinary incontinence or loss of bladder control.

The urine leakage experienced by someone with overactive bladder can be as little as several drops to up to several ounces. Sometimes, incontinence can be a sign of something simple like drinking way too many caffeinated beverages on a daily basis. Other times the underlying cause can be something more serious.

An overactive bladder is said to account for 40 to 70 percent of incontinence. What is incontinence? Incontinence is a lack of voluntary control over urination or defecation. When you have overactive bladder, you can experience urinary incontinence or loss of control over urination.

There are actually two different types of overactive bladder. “Dry” is when you have a sudden, urgent need to urinate many times during the day. “Wet” means you have the sudden, urgent need to urinate and you experience bladder leakage, which is also referred to as urge incontinence.

Both “dry” and “wet” can occur without any underlying health condition. An estimated 67 percent of overactive bladder patients have dry overactive bladder (no leakage) while others have wet overactive bladder (urine leakage).


Overactive bladder symptoms can differ on an individual case basis. Common symptoms of an overactive bladder include:

  • an urgent need to urinate
  • urine leakage
  • frequent trips to the bathroom

These symptoms can be serious life disruptors during the waking and sleeping hours of a person’s life. Having to constantly go to the bathroom, and not knowing when you might have urine leakage, can cause a lot of stress. If you already have overactive bladder, then you know how important it is to be near a bathroom at all times.

You’re probably wondering just how many trips to the bathroom per day is considered normal. An overactive bladder sufferer typically feels the need to urinate eight or more times in a full day or 24 hour period. This urgent need to relieve oneself might even exist when fluid intake is low.


Overactive bladder occurs in both men and women. It’s possible to have overactive bladder at any point in your life. Here are the most common causes and risk factors.

1. Aging

OAB is especially common in older adults. The prevalence of overactive bladder in people younger than 50 years of age is less than 10 percent. But after the age of 75, it affects up to 40 percent of men and 30 percent of women ages 75 years and older.

2. Nerve Damage

A healthy, normal functioning bladder holds urine until it gets full and is prompted to empty by nerve signals. However, when nerve damage occurs in the body, the muscles surrounding the urethra (the tube that takes urine out of your bladder) can be too loose. This undesirable looseness can cause someone to become incontinent.

What can cause nerve damage that can then lead to bladder leakage? Some possibilities include:

  • Back or pelvis surgery
  • Diabetes
  • Herniated disc
  • Multiple sclerosis
  • Parkinson’s disease
  • Radiation
  • Stroke

3. Weak Pelvic Muscles

When a man or woman’s pelvic floor muscles are weak, bladder control issues can happen. The pelvic floor muscles are like a sling that holds up the uterus and bladder. For women, a pregnancy and childbirth can often lead to a stretching and weakening of the vital pelvic floor muscles.

When pelvic floor muscles are compromised for this reason or another, the bladder can then sag out of place. The opening of the urethra also stretches and urine easily leaks out.

4. Menopause

For women, the bladder often changes after the body goes through menopause and makes overactive bladder more likely. One theory is that there is a loss of estrogen that makes up bladder tissue. Or, it’s just due to aging or a combination of both. Overall, in the U.S. the prevalence of OAB is 43 percent in women and 27 percent in men.

5. Extra Weight or Obesity

Need another reason to aim for a healthy waistline? Carrying around extra pounds is linked to overactive bladder and urine leaks. This makes a lot of sense since excess weight puts more pressure on the bladder.

6. Diuretic Medications

Diuretics or water pills are very commonly prescribed for high blood pressure. These medications cause your body to get rid of water and salt faster through the urine. As a result, this can cause the bladder to fill up faster and possibly leak.

Other causes behind some overactive bladder symptoms include bladder stones, urinary tract infection (UTI), urethral strictures, benign prostatic enlargement (BPH) or bladder tumors. Often, no apparent cause of overactive bladder can be determined. This is called idiopathic overactive bladder.

Overactive Bladder vs. Urinary Incontinence

Overactive Bladder

  • Condition in which the bladder can no longer hold urine normally.
  • Often feel a sudden urge to urinate or experience an accident.
  • Defining symptom is urgency, or the inability to postpone urination.
  • Overactive bladder is typically a chronic problem
  • Often requires strengthening of pelvic floor muscles to get rid of symptoms like urinary incontinence.
  • Symptoms including urinary incontinence are ongoing.
  • Bladder muscle problems at the root of it.
  • Can result from regularly consuming alcohol and caffeine in large quantities.
  • Serious health conditions can lead to overactive bladder including a stroke, diabetes, kidney disease, multiple sclerosis (MS), or Parkinson’s disease.

Urinary Incontinence

  • Is when you lose control of your bladder.
  • Isn’t a condition; it’s a symptom.
  • Is a symptom of overactive bladder.
  • Can be caused by a loss or weakening of control over the urinary sphincter.
  • Can be a sign of something simple like a singular occasion of too much fluid consumption, a temporary problem.
  • Is a common symptom of a UTI along with a burning sensation during urination and/or blood in the urine.

Conventional Treatment

Conventional treatment typically involves prescription medications, specifically antimuscarinic drugs, that aim to calm the bladder.  The seven common drugs for overactive bladder include: darifenacin (Enablex); fesoterodine (Toviaz); mirabegron (Myrbetriq); oxybutynin (Ditropan XL, a skin patch called Oxytrol, a topical gel called Gelnique, and generic); solifenacin (Vesicare); tolterodine (Detrol and generic, Detrol LA) and trospium (Sanctura, Sanctura XR and generic).

An analysis of these drugs demonstrated that none of these medications are obviously better than the others. What difference did they find? In addition to cost variations, there were also different side effects including constipation, dry mouth, drowsiness, blurry vision and dizziness. Most healthcare professionals will recommend lifestyle modifications before turning to medications.

In more serious cases, a doctor may inject botulinum toxin (BOTOX®) to calm the bladder muscles. Again, this treatment is not without possible and often serious side effects including urinary tract infection, urinary retention (not being able to empty the bladder completely), hematuria (blood in the urine), fatigue and insomnia.

Overactive bladder

Natural Remedies

1. Kegel Exercises

If a weak pelvic floor is at the root of your overactive bladder then kegel exercises can help a lot. These pelvic floor exercises can be done anywhere at anytime and they benefit both men and women.  When done regularly, they can really help an overactive bladder.

Studies have demonstrated that by exercising these specific muscles, meaning practicing series of contracting and then relaxing them, they become stronger and better able to control unwanted symptoms. Most people are able to see results from kegel exercises within four to eight weeks of regularly practicing them, although for some people it takes up to several months to see real improvement in pelvic strength.

2. Avoid Dietary Triggers

Significantly reduce the following foods and drinks that are known to contribute to overactive bladder:

  • Alcohol
  • Caffeinated beverages and foods
  • Citrus juices and fruits
  • Soda and other carbonated beverages
  • Spicy foods
  • Artificial sweeteners
  • Milk and milk products
  • Sugar and high sugar foods (also don’t overdo it on honey and choose a high quality honey to use)

Caffeine, alcohol and certain medications like diuretics are known to be major causes of acute incontinence, especially in the elderly population. Cranberry juice is surprisingly another thing to avoid if you have overactive bladder. Although cranberry juice is often recommend for bladder health, it actually acts as an irritant if you have overactive bladder.

3. Watch Fluid Intake

It’s essential to drink enough water each day to avoid dehydration. However, if you are drinking too many liquids right before bed, you are more likely to need to empty your bladder.

Many overactive bladder sufferers have nocturia, which is the need to urinate several times a night. This is obviously very disruptive to a good night’s sleep. Additionally, a really sound sleeper may not get out of bed fast and can end up unintentionally wetting the bed.

To reduce this risk and overactive bladder symptoms at night, it’s recommended to limit fluid intake before bedtime. One suggestions is to not drink any liquids after 5 or 6 p.m.

4.  Double-Void

Another natural way to help with overactive bladder symptoms, especially at night, is to double-void. This means that you urinate not once, but twice before going to bed.

5.  Schedule Bathroom Trips

To help retrain your bladder, you can try keeping a daily dairy of urinary urges and trips to the bathroom, as well as any urine leakage. After you figure out how many times you’re going to the bathroom daily, you can start scheduling your trips, adding on about 15 minutes to the normally expected time.

Even if you don’t have to go to the bathroom, stick with the scheduled times. As time passes, you can increase the amount of time that passes between urinations. This is meant to improve bladder control.

6.  Delay Urination

Delaying urination is another part of a typical bladder retraining technique. It may not sound pleasant, but if you can hold out another few minutes after feeling the urge to urinate, you can help retrain your bladder. By gradually increasing the holding time, you can eventually and ideally go at least three to four hours without having to go to the bathroom.

At some points, if you find that you really just can’t hold it any longer, use the bathroom, but stick to your next scheduled urination time. Using relaxation techniques, such as deep breathing, can help make the delay time more bearable.

7. Try Acupuncture

A study published in the British Journal of Urology demonstrates another natural treatment option for overactive bladder: acupuncture. The study’s 20 subjects received acupuncture treatment once per week for a total of 10 weeks. Each treatment session was 30 minutes long and targeted acupuncture points SP6, CV4 (RN4) and KI3.

The results of this study were excellent: 77 percent of patients with idiopathic detrusor instability were symptomatically cured. Idiopathic detrusor instability (IDI) plays a role in overactive bladder because it a common cause of lower urinary tract storage symptoms including urgency, frequency and urge incontinence.

8. Stop Smoking

The reasons to stop smoking cigarettes are basically endless. Here is another. Smoking not only irritates the bladder, it also increases the risk of bladder cancer.

Smoking cigarettes can also lead to coughing spasms that increase problems with stress incontinence. Stress urinary incontinence occurs when the bladder leaks urine during physical activity or exertion including coughing or lifting something heavy. Anyone who smokes and is dealing with overactive bladder should quit smoking right away.

Precautions and Proper Diagnosis

The main symptoms of overactive bladder can also occur in other health conditions like bladder cancer, urinary tract infection (UTI) and enlarged prostate. Seeing cloudy urine or blood in your urine is not a symptom of overactive bladder.

A sudden and frequent need to urinate is common in both overactive bladder and a UTI. How can you tell the difference between these two urinary health issues? Unlike overactive bladder, a UTI also comes with other symptoms such as discomfort while urinating. In addition, overactive bladder symptoms are continuous while UTI symptoms are sudden and may also include a fever.

Overflow incontinence is characterized by the involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate. This condition is not associated with overactive bladder. It typically occurs in people who have a blockage of the bladder outlet, which can occur with benign prostatic hyperplasia, prostate cancer or a narrowing of the urethra. Overflow incontinence can also occur when the muscle responsible for removing urine from the bladder is too weak to empty the bladder in a normal way.

It is very important to see a healthcare professional to ensure a proper diagnosis if you experience any changes in your urine and/or urination habits.

More Health