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What Causes Overactive Bladder In Women

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What causes the bladder to be overactive? (Michael Guralnick, MD, FRCSC)

Increased age is a common risk factor for pelvic floor disorders, including OAB and urinary incontinence. Some life phases can also affect your bladder. For example, pregnancy and childbirth can change the tone of your vagina, your pelvic floor muscles, and the ligaments that support your bladder.

Nerve damage from diseases and trauma can also cause mixed signals between the brain and the bladder. Medications, alcohol, and caffeine can also affect signals to the brain and cause the bladder to overflow.

What Are The Causes Overactive Bladder

Youve reached an age where you feel like youve got it all figured out. Youre enjoying life spending time with family, friends, traveling, enjoying good food and weather, and no longer sweating the small stuff.

Until you start rushing to the bathroom. Its not just once it is over and over and over. You finally make a doctor’s appointment to find out what exactly is going on with your body.

Overactive bladder. your physician tells you. He or she gives you a short spiel about how to treat overactive bladder maybe they suggest various overactive bladder medications, bladder training programs or a natural treatment approach and leaves you bewildered in the exam room.

What? you think. Why now? What caused me to have an overactive bladder all of a sudden?

Well, friends, I am here to help. First, lets take a look at what happens to the bladder when you have overactive bladder and what causes overactive bladder.

Overactive Bladder Causes Treatments And Home Remedies

Written byDr. Victor MarchionePublished onApril 30, 2016

Overactive bladder, or OAB, affects about 15 percent of the North American population. People who have OAB find themselves using the bathroom eight or more times a day and can even have urge incontinence involuntary loss of urine. Although it may appear that the older we get, the odds of us developing OAB increase, it really is not age-related. OAB occurs when contractions of the detrusor muscle within the wall of the bladder occur involuntarily. This, in turn, leads to more frequent trips to the bathroom.

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Symptoms Of Overactive Bladder And Diagnosis

The most common symptoms of overactive bladder are urinary frequency and the sudden urge to urinate. If a woman is urinating more than eight times a day, this might be a symptom of OAB. Waking up in the middle of the night to urinate often indicates OAB, as well.

A urologist or urogynecologist may perform a number of tests to diagnosis OAB. These may include:

  • Physical exam, medical history review and symptom questionnaire.
  • Bladder stress test, performed by filling up the bladder and having the patient cough to ascertain how much urine leaks.
  • Postvoid residual volume test checks if the bladder is actually fully emptying by inserting a catheter through the urethra and into the bladder after urination. The catheter measures any remaining urine.
  • Urodynamic testing is a series of tests typically reserved for unusual cases and primarily measures urine flow to test for obstruction as well as evaluating urge sensation.
  • Urinalysis screens for the presence of bacteria and may rule out other similar conditions such as a UTI.
  • Cystoscopy examines the inside of the bladder by placing a long thin tube with a magnifying glass up the urethra.

What Do We Mean By Small Bladder

What causes an overactive bladder and what you can do to ...

Firstly, lets clear up the confusion between having a small bladder and an overactive bladder. Anatomically, its highly unlikely anyone has a small bladder. Our internal organs dont tend to differ from one person to the next.

However, it is possible to have a functionally small bladder, which means your bladder, for any number of reasons, cant hold a lot of urine. Bladder muscles and/or the bladder sphincter muscles become overactive and as a result there is a constant need to void.

Thats why when some people say they have a small bladder, what theyre really suggesting is they have an overactive bladder.

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The Pattern Of Incontinence Is Often Mixed

Symptoms of overactive bladder include frequency and nocturia . Some women also feel they need to pass urine, having only just done so due to over activity of the bladder muscle.

Recurrent urinary tract infections

UTIs can affect women of all ages, but this problem increases with age as a result of estrogen deficiency.

Management of urinary problems

Local estrogen

Local estrogen replacement therapy has been shown to alleviate urgency, urge incontinence, frequency, nocturia, dysuria and also to reduce urine infections.

Genuine Stress Incontinence would not appear to be helped by estrogen alone, but it does seem to improve the action of other treatments currently used.

The newer treatments including Ospemifene, DHEA and laser therapy may all have a beneficial effect on bladder problems.

Pelvic floor exercises

These can strengthen the pelvic floor reducing the risk of uterovaginal prolapse. Many women have learnt these techniques from childbirth, but it is well worth revisiting them.

Pelvic-floor physiotherapists are specialists in this field and are able to fully assess and monitor a womans pelvic floor function and teach appropriate techniques to strengthen it and retrain the bladder. They often use devices to help women perform appropriate exercises, such as weighted vaginal cones, or vaginal trainers. Your practice nurse or GP should be able to refer you to a specialist pelvic floor physiotherapist.

Surgery

What Causes Irritable Bladder

Irritable bladder can happen to anyone, but research shows that it is prominent in women. What can cause bladder irritation for one person who has the condition may not be what causes irritation for another person who is dealing with it. There are many different potential irritable bladder causes, as outlined below.

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Causes Of Urge Incontinence

The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder.

The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.

Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder.

The reason your detrusor muscles contract too often may not be clear, but possible causes include:

  • drinking too much alcohol or caffeine
  • not drinking enough fluids this can cause strong, concentrated urine to collect in your bladder, which can irritate the bladder and cause symptoms of overactivity

Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder does not completely empty when you urinate. As a result, the bladder becomes stretched.

Your detrusor muscles may not fully contract if:

  • there’s damage to your nerves for example, as a result of surgery to part of your bowel or a spinal cord injury
  • you’re taking certain medicines

What Are The Causes Of Overactive Bladder

Frequent Urination In Men And Women – Causes And Symptoms Of Overactive Bladder Syndrome

In many cases, the cause of OAB is not easily identifiable. OAB symptoms are more common as one gets older, but should not be considered an untreatable consequence of aging. Also, OAB can occur in young women as well. Some women will experience OAB after childbirth or pelvic surgery. Certain neurological conditions can cause OAB symptoms including multiple sclerosis, Parkinson’s disease, stroke, and spinal cord injury.

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Causes Of Stress Incontinence

Stress incontinence is when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed. Your urethra is the tube that urine passes through to leave the body.

Any sudden extra pressure on your bladder, such as laughing or sneezing, can cause urine to leak out of your urethra if you have stress incontinence.

Your urethra may not be able to stay closed if the muscles in your pelvis are weak or damaged, or if your urethral sphincter the ring of muscle that keeps the urethra closed is damaged.

Problems with these muscles may be caused by:

  • damage during childbirth particularly if your baby was born vaginally, rather than by caesarean section
  • increased pressure on your tummy for example, because you are pregnant or obese
  • damage to the bladder or nearby area during surgery such as the removal of the womb , or removal of the prostate gland
  • neurological conditions that affect the brain and spinal cord, such as Parkinson’s disease or multiple sclerosis
  • certain connective tissue disorders such as Ehlers-Danlos syndrome
  • certain medicines

Signs And Symptoms Of Overactive Bladder

Having to go to the restroom with every turn is not only downright annoying, but also disrupting in one’s everyday routine. Although having an overactive bladder and incontinence – when you lose control of your bladder – is common during the menopausal transition, don’t it control your life.

Continue reading to learn more about the signs and symptoms over overactive bladder as well as what you can do to stop making frequent pit stops throughout your busy day.

Women who suffer from an overactive bladder may have the following symptoms:

  • Sudden need to urinate that’s hard to control
  • Frequent urination of 8 or more times in a period of 24 hours
  • Having to urinate two or more times throughout the night
  • Experiencing uncontrollable loss of urine right after an urgent need to urinate

Usually, symptoms of an overactive bladder allow a woman to be able to diagnose herself with the condition.

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Sexual Differences In Incidence

In the NOBLE study, the prevalence of OAB was similar in women and men . However, the prevalence of incontinence associated with OAB differed. Among women, 9.3% reported having OAB with incontinence 7.6% reported having OAB without incontinence. In contrast, more men reported having OAB without incontinence than with incontinence . In women, the prevalence of OAB with urgency urinary incontinence increased with increasing body mass index , whereas in men, no difference was found.

Milsom et al, in a population-based survey of 16,776 men and women aged 40 years or older from the general population in Europe, found the overall prevalence of OAB symptoms to be 16.6%. The main outcome measures included the prevalence of urinary frequency , urinary urgency, and urgency incontinence.

Frequency was the most common symptom , followed by urgency and urgency incontinence . The prevalence of OAB increased with age, and rates in men and women were similar. Symptoms of urinary urgency and frequency were similar between both sexes, but urgency incontinence was more prevalent in women than in men.

OAB in men is often related to obstruction therefore, it may be important to differentiate between obstruction and irritative symptoms before the initiation of treatment.

Overactive Bladder Vs Urinary Incontinence

Women

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.
  • OAB 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 OAB including a stroke, diabetes, kidney disease, multiple sclerosis , or Parkinsons disease.

Urinary Incontinence

  • Is when you lose control of your bladder.
  • Isnt a condition its a symptom.
  • Is a symptom of OAB.
  • 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.

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Effects Of Caffeine And Alcohol

Tea, coffee, cola, and some painkiller tablets contain caffeine. Caffeine has a diuretic effect and will make urine form more often. Caffeine may also directly stimulate the bladder to make urgency symptoms worse. It may be worth trying without caffeine for a week or so to see if symptoms improve. If symptoms do improve, you may not want to give up caffeine completely. However, you may wish to limit the times that you have a caffeine-containing drink. Also, you will know to be near to a toilet whenever you have caffeine.

In some people, alcohol may make symptoms worse. The same advice applies as with caffeine drinks.

Hormones And Your Pelvic Floor

As you may already know, the pelvic floor is essentially an area of muscles that stretch over your pelvic bone. Its role is to support your uterus, ovaries, bowel, and the infamous bladder just to name a few. During the menstrual cycle, pregnancy, perimenopause, and menopause, our pelvic floor changes A LOT. And guess whos partially responsible? Our hormones! Specifically estrogen, progesterone, and testosterone.

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Is Frequent Urination A Sign Of Pregnancy

Women who are pregnant also tend to need to urinate more often. This is because the babies they are carrying cause the uterus to expand and put extra pressure on the bladder. Frequent urination during pregnancy is very common and typically not a cause for concern unless accompanied by other unexplained symptoms. Even after a baby is born, frequent urinate symptoms may continue. Women who have given birth vaginally in the past are at a greater risk of frequent urination. Giving birth in this way is known to make the pelvic floor weaker, and the pelvic floor is the body part that holds the bladder up and in place. This affects some women with children more than others.

Therefore, to conclude, frequent urination has numerous causes. Depending on how serious the cause is, fix your appointment with the doctor and take adequate care of yourself.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749018/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695664/

Hope this article was of help to you! Please share your comments/queries/tips with us and help us create a world full of Happy, Healthy and Empowered Women!!

Overactive Bladder At A Glance

What is Overactive Bladder Syndrome?
  • Overactive bladder is a group of urinary symptoms that produces the feeling that one has to go to the bathroom urgently and often.
  • Women also may have accidental leakage of urine with urgency and leak urine because they cant get to the bathroom in time . Some women also wake up many times in the middle of the night to urinate .
  • Overactive bladder is common in both men and women, with 40% of women experiencing OAB symptoms.
  • OAB can be caused by nerve damage from another medical condition or have no apparent cause. Factors increasing ones risk for OAB include age, childbirth, obesity and urinary tract infections.
  • This condition causes emotional stress and can disrupt a persons normal lifestyle. Yet many women, and men, are too embarrassed to talk about it, so they suffer needlessly.
  • Women do not have to suffer with symptoms of OAB and urge incontinence! We have several types of treatments to address these including lifestyle changes, medications, pelvic floor muscle therapy, Botox injections and nerve stimulation treatments.

Also Check: Men’s Overactive Bladder Treatment

What Causes Bladder Pain After Hysterectomy

The most common cause of pain after hysterectomy is vaginal or bladder prolapse. When they remove the uterus, the vagina is attached to supporting ligaments but these tissues can weaken over time. Roughly 10% of women will experience a vaginal vault prolapse in the years following their hysterectomy.

Read Also: Can Tubal Ligation Cause Early Menopause

Urinary Incontinence: More Common Than You Think

How to Stop Urinary Incontinence

Urinary incontinence is the involuntary and unintentional leaking of urine. Urinary incontinence can also be an embarrassing problem. As with many potentially embarrassing or uncomfortable symptoms, those affected may be hesitant to speak up or ask questions about their condition, even at the doctor’s office. Urinary incontinence occurs more often in women than in men, and it is a lot more common than you might expect. In fact, chances are that you know other people who have been affected by urinary incontinence.

Incontinence must not be a source of embarrassment when you speak with your physician. The fact is that this common condition is treatable by a variety of approaches, and not speaking up about the problem means that you won’t have access to effective treatments:

  • dietary changes, /li>

Millions of women experience involuntary loss of urine called urinary incontinence . Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress.

Stress Incontinence

Urge Incontinence

Overactive Bladder

  • at night to urinate

Functional Incontinence

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What Are The Treatments For An Overactive Bladder

Once tests have been done to determine the cause your overactive bladder, your doctor will suggest a solution that will alleviate your symptoms and minimise any side effects. And while the goal is obviously to find a simple, effective solution, it could be one or a combination of treatments including lifestyle changes, medications and/or surgery.

Lifestyle changes

  • Bladder Training and Scheduled Voiding This method teaches the bladder to steadily hold urine over time, which can help build a tolerance to the urgency that comes with an overactive bladder.
  • Double Voiding This involves urinating twice within a few minutes in between to void any residual urine in the bladder.
  • Kegel exercises These are pelvic exercises to help manage urge incontinence in an overactive bladder by helping strengthen the muscles of the pelvic floor and urinary sphincter.
  • Fluid and Diet Management including:
  • maintaining a schedule of the timing and amount of daily fluid intake
  • limiting caffeine and acidic drinks such as coffee, cranberry and citrus juices
  • limiting alcohol
  • eating foods high in fibre, such as flaxseed, or taking fibre supplements.
  • maintaining a healthy weight and a healthy body mass index
  • Intermittent Catheterisation This can be done at home and involves inserting a thin tube into the urethra each time you need to urinate. This procedure is quite invasive, so we recommend you speak with your doctor first to see if this procedure right for you.
  • Medications

    • Anticholinergics

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