The bladder is the hollow organ located in the lower front of the pelvis that is responsible for holding urine produced by the kidneys until we can find an appropriate time to urinate. In order to accommodate more urine as time passes, the bladder actually expands and stretches a little like a balloon. Unfortunately, as we age, our bladder can become overactive. 

The average person’s bladder can hold anywhere from 350 to 550ml of urine at any time, although the urge to urinate tends to occur at around 200ml of fluid. Normal urination occurs at around every 3-4 hours in people with an average fluid intake.

Overactive Bladder - Urge Incontinence

There are two major muscles involved in urination; the sphincter at the external end of the urethra must relax to allow the urine to pass, and an internal muscle is then responsible for squeezing the bladder to force out the urine. When these muscles contract or relax at the wrong times, it can result in frequent strong urges to urinate and even cause urine to leak out at unintended times. This is a condition known as urge incontinence, or more commonly known as overactive bladder. It is important to distinguish the urgency of overactive bladder from Urinary Incontinence, where urine leakage occurs due to activities that increase abdominal pressure like sneezing or laughing.

What Causes An Overactive Bladder?

There are many potential causes of overactive bladder, some more serious and some that are very simple to treat. Common causes are: bladder inflammation, bladder stones, and bladder infection. Anything that blocks proper draining of the bladder can also cause an overactive bladder, such as an enlarged prostate or urethral obstruction. More serious conditions are bladder cancer and nervous system diseases (like Multiple Sclerosis) or nerve injuries (like a stroke). Unfortunately, many cases of urge incontinence are of unknown cause, making this a difficult condition to treat.

Conventional Treatment Options

Medical doctors will most commonly treat an overactive bladder with medications to help relax the bladder muscles to prevent the spasms that trigger urgency and leakage. Side effects of these medications include dry mouth, constipation, and glaucoma. Some doctors may instead prescribe tricyclic antidepressants to prevent stimulation of the bladder walls. Side effects of these medications include: blurred vision, dizziness, dry mouth, fatigue, insomnia, and nausea. In severe cases, surgery may also be presented as an option.

Natural Treatment Options For Overactive Bladder

Diet 

Monitoring and managing your consumption of liquids can help reduce some symptoms. If your bladder is infected or irritated, drinking more water can help ease your bladder. Even if your bladder isn’t infected, drinking more water can help reduce urine odour in the case of leaking. Ensure that your water consumption is steady rather than all at once. Drinks that contain caffeine, like coffee, tea, and energy drinks, will only further irritate your bladder. Some foods, namely acidic foods like citrus, as well as spicy foods, would be beneficial to avoid. By maintaining a healthy weight and diet, urination frequency should be reduced.

Lifestyle

A healthcare practitioner should diagnose bladder symptoms and rule out infections or bladder stones. A simple urinalysis can identify underlying issues and guide treatment. Staying active helps maintain a healthy weight and supports pelvic floor strength. Avoid urethral irritation from harsh soaps, bubble baths, and tight clothing. Choose breathable cotton underwear and sanitary pads to reduce bacterial growth. Urinate after sex to help flush bacteria from the urethra. Sit fully on the toilet to empty the bladder completely. Avoid squatting, which may prevent complete bladder emptying. Review medications for diruetic effects and discuss alternatives with your doctor. Acupuncture may also help reduce symptoms of an overactive bladder.

Kegel Exercises

Kegel exercises and other means of strengthening the muscles of the pelvic floor can significantly improve the symptoms of an overactive bladder. These exercises simply involve squeezing and lifting the vaginal and rectal muscles as though you are holding in urgent urine and/or stool. Hold this squeeze for 5-10 seconds each time without clenching your buttocks; Repeat 5 or more times daily. You can do them anywhere, and no one will have to know! Other options include vaginal weight training, where a small weight is held in the vagina for 15 minutes a few times a day to help tighten the pelvic floor. When these muscles become stronger, they help to prevent bladder leakage.

Sanitary Products

Often, the use of sanitary pads or adult diapers is our biggest fear of aging, and people will avoid them at all costs. There’s a feeling of loss of dignity with loss of continence. This doesn’t have to be the case. Interestingly, we can use these devices as stop-gap measures while we deal with the underlying problem to get life back on track. One example of these measures is bladder retraining.

Bladder Retraining

We are born without control over bladder function. Infants release urine automatically when the bladder fills. This explains why toddlers require potty training. Similar techniques can retrain bladder control later in life. Bladder muscles can gradually learn to hold urine longer. Start by tracking your urination habits in a journal for one week. Use this information to create a realistic bathroom schedule. Begin with manageable intervals, such as 1-1.5 hours. Practice holding urine between scheduled bathroom visits. Sanitary products can help manage urgency or leakage during training. Over time, bladder control improves. Gradually increase the time between bathroom trips by 30 minutes. The goal is to urinate every 3-4 hours.

Supplements

The proper treatment of an overactive bladder will always rely on an understanding of the underlying cause of the problem. There are a number of things that can help to reduce the symptoms, but the ultimate goal is always to fix the root of the problem, so the symptoms resolve naturally. There are a number of anti-spasmodic herbs that can help to reduce the smooth muscle spasms associated with an overactive bladder. Butterbur, in particular, can help to reduce spasms in the urinary tract, and thus reduce the urgency and leaking associated with this condition. Supplementing Magnesium can also help to relax the smooth muscles of the bladder and prevent spasms. There are a number of herbs that can soothe bladder irritation, such as marshmallow, and in men, Saw Palmetto can help prevent BPH associated problems.