How We Made Our Recommendation
Our evaluation is primarily based on an independent scientific review of the evidence on the effectiveness, safety, and side effects of overactive bladder medications. A team of physicians and researchers at the Pacific Northwest Evidence-Based Practice Center conducted the analysis.
A synopsis of that forms the basis for this report. A consultant to Consumer Reports Best Buy Drugs is also a member of the Pacific Northwest EPC research team, which has no financial interest in any pharmaceutical company or product. The full Pacific Northwest EPC review of overactive bladder drugs is available here. . We also relied on research conducted by the Agency for Healthcare Research and Quality and the Cochrane Collaboration.
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Natural Supplements You Can Take At Home
While there have been very few scientific studies on herbal remedies as an option for overactive bladder treatment, some remedies have shown promising results for some people.
Studies from Japan have shown improvements in urgency, leakage and a reduction in night-time urination using a herbal remedy known as Gosha-jinki-gan. Also, the buchu plant from South Africa is thought to nourish the bladder tissue and fights inflammation which can lead to infections and incontinence.
There are also plenty of common herbs that may help with symptoms, including:
- Ganoderma lucidum
Remember to consult your doctor first before adding any of these herbal remedies into your overactive bladder management plan.
Are Claims For Newer Drugs For Overactive Bladder Warranted
Two previous Therapeutics Letters on drugs for overactive bladder concluded that the antimuscarinic drugs had limited short-term potential symptomatic benefit and significant risk of adverse effects .1, 2 This Letter compares drugs to one another, including newer drugs introduced since 2007, when our most recent Letter on this topic was published.2
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Buchu And Your Bladder
A flowering plant native to the mountainous areas of South Africa, buchu has a long history of traditional use. Legend has it that buchu helps heal everything from fevers to coughs to urinary tract infections.
Buchu tea has no caffeine, so swapping your morning coffee or black tea for buchu will cut your caffeine consumption. That may be helpful in easing OAB symptoms, but dont expect a cure-all. No studies measure buchus effect on OAB.
Rationale For Anticholinergic Use
Detrusor muscle contractions are essential for normal micturition, but involuntary contractions produce the symptoms of overactive bladder. Contractions depend on the activation of muscarinic receptors in the bladder by acetylcholine. The M3 muscarinic receptor-subtype is thought to be the most important in regulating detrusor contractions.
Anticholinergic drugs block muscarinic receptor activation and inhibit the spontaneous detrusor contractions found in overactive bladder. Drug efficacy is dose-dependent, but effectiveness is often limited by unwanted antimuscarinic effects in distant organs where other acetylcholine receptor-subtypes predominate . These adverse effects are also dose-dependent. They commonly include dry mouth, dry eyes, confusion, constipation, somnolence, blurred vision and increased heart rate.
There are no currently available drugs with pure selectivity for the muscarinic receptors in the detrusor. To try to improve the benefit:harm ratio a number of anticholinergics have been developed with greater selectivity for the detrusor or the M3 receptor, or with extended release properties.
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Seven Effective Treatments For Overactive Bladder
Overactive bladder occurs when sudden or frequent urges to urinate become hard to control, and can often lead to leakage .
In order to best treat overactive bladder, a urologist must pinpoint the underlying cause. Treatment will depend on symptom severity and the degree to which they impact someone’s quality of life. In general, there are three approaches to treatment: medication, behavioral interventions, and surgery.
What Exactly Is Overactive Bladder
Overactive bladder, also referred to as OAB, causes a sudden and frequent urge to urinate that can be hard to control. You may experience involuntary loss of urine or you may feel like you need to pee many times throughout the day and night.
- A sudden urge to pee thats difficult to control
- Frequent urination
- Waking up more than twice in the night to relieve yourself
- Urinate unintentionally or immediately after an urgent need to pee
For many people, getting to the toilet on time may not be an issue, but the frequency and urgency of urination can seriously disrupt your life.
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Using Nerve Stimulation For An Overactive Bladder
If youre finding lifestyle changes and medication cant control your overactive bladder symptoms, your doctor may recommend a slightly more invasive approach for long-term relief.
There is a procedure known as nerve stimulation which involves implanting a small electronic device into the body, almost like a pacemaker, which sits under your skin and sends electrical impulses to the sacral nerve, which plays a significant role in bladder emptying.
The aim of this treatment is to strengthen the supporting muscles of the bladder and leads to better control. At the moment, however, theres no guarantee that this procedure will eradicate all of your overactive bladder symptoms.
Pelvic Floor Exercises Can Help Immensely
You cant see your pelvic floor muscles however, just like other muscles in your body they lose their strength if they are not put to use.
Pelvic floor exercises help strengthen the pelvic floor when done consistently at least twice a day. How are they done?
- Imagine you are holding back gas or urine.
- Squeeze and lift the rectal area without tightening your buttocks or belly. Try and hold it for a count of three before relaxing. Repeat this cycle 10 times. Do 10 sets of Kegel exercises, at least 3 times a day.
- Increase your contractions as your doctor recommends.
- Do not hold your breath when you do Kegel exercises. Keep your stomach, back, and leg muscles relaxed.
- Don’t use Kegel exercises to start and stop your urine stream which can lead to incomplete emptying of the bladder and an increased risk of a urinary tract infection.
Review our information about Kegel exercises for both women and men to learn more about the techniques.
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What Are The Causes Of Overactive Bladder
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.
Medical Treatments For Nocturia
Your doctor may prescribe medications when preventive measures and lifestyle changes fail to reduce the frequency of your nighttime urination. Doctors prescribe a class of drugs called anticholinergics to treat symptoms of OAB, if thats the cause of your nocturia. They reduce bladder spasms that create the urge to go.
Your doctor may suggest you take a diuretic for regular urine production. A diuretic can itself cause nocturia. But if you take it early enough in the day, it may help you get rid of excess fluid while youre awake. This should decrease your urine production at night.
Other drugs that may help are:
- desmopression in cases of diabetes insipidus to cause the kidneys to produce less urine
- tamsulosin , finasteride , or dutasteride to treat prostate enlargement
- antibiotics if you have a urinary tract infection
Your doctor may also adjust your diabetic medications to lower your blood sugar if theyre causing nocturia.
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Supplements For Adequate Nutrition
Developing a diet free of irritants can take some trial and error. During this time, its important to get the recommended amount of daily nutrients.
Be sure to talk with your doctor about your individual nutritional needs. They can help determine the appropriate supplements for you.
You may find it beneficial to supplement your diet with a daily multivitamin or nutrition drinks. Popular nutrition drinks include shakes, such as Boost or Ensure, and formulas, such as ProNourish.
Check in with your doctor before adding a supplement or nutrition drink to your regimen. Certain ingredients may interfere with your medications or otherwise negatively impact your overall health.
Treatment Options For Overactive Bladder
- Behavioral therapies to help you regain control of their bladder
- Watch the type, quantity and timing of food and drink that you take in
- Avoiding foods and beverages that are likely to cause OAB symptoms
- Regular toileting to prevent the bladder from getting too full
- Weight Loss: Being overweight puts extra pressure on your bladder. Weight loss may help relieve some of the symptoms of OAB.
- Urinate on a Schedule: Sometimes, the message that the bladder is full comes without warning and often too late. In these cases, women find that they lose urine on the way to the bathroom. There isn’t enough time between the message and their ability to get to the bathroom before they start to leak. Voiding on a schedule, also referred to as “Timed Voids” may help prevent urgency and urgency incontinence.
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Natural Remedies For An Overactive Bladder
1. Kegel Exercises
If a weak pelvic floor is at the root of your OAB 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.
Melody Denson, MD, a board-certified urologist with the Urology Team in Austin, TX, recommends these exercises for OAB. She says, They will trigger a reflex mechanism to relax the bladder. If you feel a tremendous urge to urinate, doing a kegel before you run to the bathroom will help settle down the bladder spasm and help you hold it until you get there.
2. Avoid Dietary Triggers
Significantly reduce the following foods and drinks that are known to contribute to overactive bladder:
- Soda and other carbonated beverages
- Artificial sweeteners
- Milk and milk products
- Sugar and high sugar foods
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 OAB. Although cranberry juice is often recommend for bladder health, it actually acts as an irritant if you have OAB.
3. Watch Fluid Intake
5. Schedule bathroom trips
6. Delay Urination
7. Try Acupuncture
8. Stop Smoking
What Is An Overactive Bladder Symptoms To Look For
Overactive bladder 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 OAB 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 60 percent of OAB patients have dry OAB while 40 percent have wet OAB .
OAB symptoms can differ on an individual case basis. Common symptoms of an overactive bladder include:
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Causes Of Overactive Bladder
To understand the cause of Overactive Bladder, a basic understanding of how the urinary system operates is needed.
The kidneys produce the urine and send it to the bladder. The bladder expands to holds the urine while the sphincter muscle acts as a spiget and controls the flow of urine. Basically on or off. As soon as your bladder gets approximately half fullmost people can handle about 2 cups of urineyour brain is signaled that you need to empty it. The bladder muscles contract while the sphincter relaxes. When there is a coordination problem along this system, incontinence occurs.
With Overactive Bladder, a person may be suddenly aware of the urgency sensation but is unable to get to the toilet before losing control of his or her urine. Urine loss can be in large amounts that soak underwear and even outer clothing.
Common triggers like hearing running water or simply the anticipation of urinating can cause a bladder spasm. In some cases, people who have physical limitations may not be able to reach the toilet in time, causing an accident.
Natural Treatment For Overactive Bladder
Bladder training and pelvic floor exercises are just two natural treatments for overactive bladder. Research suggests that these nondrug remedies can be very effective for many women, and they have almost no side effects.
But before starting any OAB treatment, itâs important to understand bladder function and what things may cause overactive bladder.
Another way to strengthen pelvic floor muscles is electrical stimulation, which sends a small electrical pulse to the area via electrodes placed in the or rectum.
Until you get your overactive bladder under control, wearing absorbent pads can help hide any leakage.
Other lifestyle tips for preventing incontinence include:
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Weight Loss & Health Improvements To Reduce Your Symptoms
Studies suggest that losing excess weight can reduce the symptoms of stress incontinence and an overactive bladder.
What does this mean exactly? If you can lose about 8 percent of your body weight thats typically around 15 to 20 pounds you will likely see remarkable results. In fact, even just a few pounds of weight loss can reduce incontinence episodes by over 25%.
Aside from all the other health benefits, by losing weight the abdomen will alleviate pressure on all the organs in the area, including the bladder.
As well as weight loss, getting regular exercise can reduce overactive bowel symptoms. Exercise can help to reduce the strain on your bladder which ultimately means less urine leaks.
Stopping smoking can also help with OAB problems since the smoke from cigarettes can irritate your bladder. Smoking can also lead to hacking cough a loud, dry cough which can cause further leaks.
Surgery Is A Last Resort For Restoring Proper Bladder Function
If lifestyle measures, drug treatments, Botox, and neuromodulation therapy are all ineffective at relieving your symptoms, your doctor may consider more drastic surgical treatments for overactive bladder.
These surgical treatments are usually reserved for people with severe symptoms. At this point, two main surgical options are available:
Surgery to Increase Bladder Capacity Surgically increasing the size of your bladder may help relieve pressure and improve its ability to store urine.
In this procedure, your doctor removes pieces of your bowel and uses them to replace a portion of your bladder.
If you have this surgery, you may need to use a catheter intermittently to urinate for the rest of your life.
Bladder Removal As a last resort, your doctor may remove your bladder. A replacement bladder, called a neobladder, may be surgically constructed, or your urine may be routed to the outside of your body through a hole in your skin called a stoma.
If you have a stoma following this surgery, youll wear a bag or pouch on your skin to collect your urine.
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What Medications Can I Use For Overactive Bladder
Your doctor may suggest trying behavioral techniques before having you use a medication to treat overactive bladder. However, medications can work very well to return normal function to the bladder. Ask your doctor about the risks and benefits of using the following commonly prescribed medications:
These medications control muscle spasms in the bladder:
- Oxybutynin , oxybutynin XL , oxybutynin TDDS .
Getting Help For Overactive Bladder
The first step in treatment is to ask for help. It may feel funny talking to your doctor about something as private as urinary issues, but rest assured that your doctor is a professional and is here to help. Be prepared before your appointment by keeping a bladder diary for a few days. This will help your doctor see the extent of your problem, and may help him or her to see any triggers that may be causing your urinary urgency issues.
Be prepared to have a thorough discussion with your doctor about your overactive bladder symptoms, as well as any other symptoms you may be experiencing. You should also let you doctor know if you suffer from any other conditions, such as diabetes, and provide a list of medications youre currently taking, which may be contributing to your symptoms.
Making a list of questions beforehand is also a great idea to ensure that you dont forget anything during your appointment. You may want to ask your doctor about different treatment options that he thinks may be a good fit for you, or about any options youve read about that youre interested in trying. Make sure you find out about the potential side effects for any treatment your doctor proposes, as well as what you can expect in terms of a success rate.
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