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Women & Overactive Bladder

Overactive bladder (OAB) is a medical condition that affects over 17 million people. Men and women of all ages suffer from OAB, though it is more prevalent in women and older adults, writes certified nurse practitioner Diane K. Newman. It is often called the "closet disorder" because OAB sufferers are too embarrassed to consult their health-care provider about it or because they are unaware that OAB is a medical problem that can be managed successfully.

  1. Urinary Incontinence

    • A person suffering from urinary incontinence (UI) loses urine involuntarily, according to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). UI refers to five types of disorders: stress incontinence, urge incontinence, overactive bladder, functional incontinence and overflow incontinence. Most women with UI have a combination of types of incontinence.

    Why Women?

    • Women have UI two times as often as men, according to NKUDIC. Factors such as pregnancy, giving birth, menopause and the structure of a woman's urinary tract make women more susceptible to incontinence than men. Physical stresses such as childbirth can weaken bladder structures, causing incontinence. Changes in estrogen levels during menstruation or menopause may affect incontinence, as a decrease in estrogen may lead to lower muscular pressure and therefore a possible increase in incontinence.

    Overactive Bladder

    • OAB is a form of UI where nerves send messages to the bladder at the wrong time. These unexpected messages make the muscles in the bladder spasm suddenly, resulting in the need to urinate. Thus, having OAB could be limiting and even debilitating for sufferers, as the unexpected need to urinate greatly disrupts their daily activities. OAB symptoms include urinary frequency and urgency; urge continence, or leaking or gushing of urine; and nocturia, or waking up at night to urinate.

    Causes and Risks

    • Nervous-system problems that can cause OAB to develop include spinal-cord injuries, strokes, Parkinson's disease, dementia, multiple sclerosis and diabetic neuropathy, according to internist Siamak Nabili, M.D. People with healthy nervous systems can also develop OAB; Dr. Nabili cites infections as well as bladder stones and tumors as causes. Others get OAB with no known cause.

      Older adults, women (especially those who had multiple pregnancies), people with nervous-system disorders and men with prostate problems are at a greater risk of getting OAB.

    Diagnosis

    • Diagnosing OAB begins with a review of your symptoms and medical history, and a pelvic exam. You may be asked to start a diary recording your voiding patterns. A urine analysis and cytology may be performed; these test for infections and cancer cells in the bladder that may be causing your symptoms. An ultrasound may also be used to determine the cause of incontinence.

    Treatments

    • Treatments start with pelvic-muscle rehabilitation (to regain muscle strength in the bladder) and behavioral therapies (where patients are taught to resist the urge to urinate). The doctor may also prescribe anticholinergics to relax bladder muscles or decrease overactivity. Estrogen therapy is sometimes used for postmenopausal women who are experiencing UI. Surgery is rarely required to treat OAB, and is only considered as a last resort when other treatments do not work for the patient.

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