There’s nothing that spoils your fun faster than leaving home and having bladder spasms strike immediately after. Racing to the nearest bathroom while worrying about the risk of a potential bladder leak is more than just stressful — it can be downright embarrassing. Still, you can rest assured you’re far from the only one dealing with this.
“It’s estimated that 9.6 million women 50 and younger experience bothersome stress leakage and/or urinary urge incontinence,” says R. Mark Ellerkmann, MD, Director of the Urogynecology Center at Mercy Medical in Baltimore, Maryland. “For women age 60 years and older, prevalence rates of over 50% to 70% have been reported.” The good news: There are easy ways to outsmart urge incontinence, also known as an overactive bladder (OAB).
What is overactive bladder?
“Overactive bladder is exactly what it sounds like — a bladder that’s working overtime,” says Aleece Fosnight, PA-C, a certified physician assistant specializing in women’s sexual health, women’s medicine and urology. “A person with an overactive bladder feels the need to void, or urinate, more frequently or urgently than someone who doesn’t.”
A good indication you have OAB is needing to urinate more than eight times in 24 hours, assuming your fluid intake is not excessive, says Karyn S. Eilber, MD, a urologist at Cedars-Sinai Hospital in Los Angeles. While some women with OAB also experience urinary leakage, others don’t.
Regardless, “patients describe a sense that they must rush to the bathroom and may or may not make it on time,” says Kathleen Kobashi, MD, MBA, FACS, Chair of the Department of Urology at Houston Methodist Hospital. “This can have a tremendous negative impact on quality of life.”
The link between OAB and bladder spasms
That urgent need to urinate occurs because of sudden, unexpected contractions or spasms of the detrusors, muscles in the walls of the bladder.
“Normally, the bladder stretches out slowly as it fills with urine,” explains Alexandra Berger, MD, a urologist at Brigham and Women’s Hospital and an assistant professor of surgery at Harvard Medical School. “When the bladder is nearly full, the bladder nerves send signals to the brain that it is time to go to the bathroom. In a normal bladder, these signals are not urgent until the bladder is very full. But in some patients with OAB, when the bladder is filling but not completely full, the bladder muscles can suddenly spasm or shake, causing a strong urge to urinate.”
Dr. Berger says that in most cases, the causes of these bladder spasms are idiopathic, meaning the source is unknown. However, she adds that sometimes they’re “caused by a neurologic problem such as multiple sclerosis, Parkinson’s disease or conditions such as diabetes.”
The bottom line: “OAB is just a diagnosis and not the cause of bladder spasms,” Dr. Eilber says. “It’s actually the reverse — bladder spasms cause the symptoms of urgency and urge incontinence.” (Click through to learn more about female bladder problems — and their solutions.)
The top causes of an overactive bladder
Many people think an overactive bladder is a natural side effect of aging, but Fosnight says that isn’t the case. While older adults are more likely to experience OAB, it usually points to one or more underlying medical issues. Jason Kim, MD, Director of the Women’s Pelvic Health and Continence Center at Stony Brook Medicine in New York, says some of the most common factors (aside from age) that cause OAB include:
- Muscle or nerve issues, which can disrupt signaling between the bladder and brain
- Infections, which can irritate the bladder
- Bladder obstruction, such as bladder stones, pelvic organ prolapse or tumors
- Hormonal changes, especially during menopause
- Neurological disorders
- Medications such as diuretics (click through for meds that cause bladder leakage)
- Constipation, which puts pressure on the bladder
- Psychological factors, like stress and anxiety
“Sometimes the exact cause of OAB may not be clear, and multiple factors could contribute to its development,” Dr. Kim adds.
Symptoms of an overactive bladder
OAB affects everyone differently, but Dr. Ellerkman says there are several telltale signs to look out for, including:
- Urinary urgency (the need to urinate urgently)
- Urinary frequency (urinating more frequently than normal)
- Urinating more than twice per night (nocturia)
- Leakage of urine (urge-related urinary incontinence)
Sometimes, outside factors make these symptoms worse. You might notice you need to urinate more after drinking certain beverages (more on that below) or when you’re stressed. Fortunately, there are a few easy ways to calm bladder spasms and quell that urgent “gotta go” feeling.
6 easy ways to soothe bladder spasms
When it comes to treating an overactive bladder, “behavioral modification is considered the first-line treatment,” Dr. Eilber says. So before reaching for meds that can be pricy or come with side effects, consider trying these lifestyle tweaks first.
1. Drink with dinner
It’s important to stay hydrated, which is key for good bladder health, but that doesn’t mean you have to chug water all day long. That’s especially true if you suffer from nocturia, or the urge to pee several times a night. “If you’re getting up several times at night to urinate, stop drinking fluids at least four hours before going to bed,” Dr. Berger says. “This can reduce the number of times you need to get up and use the toilet.”
An easy way to remind yourself of “last call”? Have your last drink with dinner, which typically is about four hours before most folks turn in for the night. Or simply set a nightly reminder on your phone to help you remember when to stop drinking fluids.
2. Jot down triggers
Some foods and drinks are diuretics, meaning they help remove fluid from your body. Others are bladder irritants, which increase the urge to urinate. While you don’t have to give up your favorites completely, scaling back on those that spur bladder spasms can help eliminate bladder urgency. The easiest way to tell which ones are giving you trouble is by jotting down when you eat or drink a potentially bladder-irritating food, then noting how you feel after. Common items that increase the risk of bladder spasms include:
- Black tea
- Caffeinated energy drinks and sodas
- Citrus juices
- Alcohol (beer, wine, etc.)
- Artificial sweeteners
- Spicy foods
- Acidic foods
- Dairy products
If one (or more) of the above triggers overactive bladder symptoms, try enjoying it in smaller portions or less often and see how you feel.
3. Schedule bathroom breaks
Simply pre-planning trips to the toilet can help calm overactive bladder spasms and reduce urinary frequency. “Urinating on a schedule can be extremely helpful,” Dr. Ellerkmann says. “This might include setting your smartphone to make a sound every two hours or so during the day to remind yourself to urinate.” It helps reinforce the mind-body connection, letting your bladder know that you’re in control of bathroom breaks.
Heading out and about but are unsure if there will be bathrooms nearby? Don’t stress! “My patients with OAB often relay that when they go out, they map out bathrooms along the way to mitigate symptoms and prevent leakage,” says gynecologist Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer of Bonafide Health. A free smartphone app like Flush Toilet Finder & Map (for Apple) or Flush Public Toilets/Restrooms (for Androids) makes finding nearby restrooms a cinch.
4. Train your bladder
Scheduling trips to the toilet is a great first step to help ease bladder spasms. What can also help? Training your bladder to “hold it” for longer. “This involves gradually increasing the time between bathroom visits to help stretch the bladder and reduce the urgency to urinate,” Dr. Kim explains.
Here’s how it works: When you feel the need to urinate, “delay your bathroom trips by a few minutes and gradually increase the intervals,” Dr. Kim says. “This can help retrain the bladder to hold more urine” and minimize the urge to go.
5. Think about your shoes
What do your shoes have to do with your bladder? They serve as a form of technique known as urgency suppression. Dr. Kobashi says that urgency suppression typically focuses on “thinking thoughts unrelated to the bladder, for example, what you will be cooking for dinner or what your foot feels like in your shoe.”
The goal isn’t to avoid urinating, but instead to ease the urge to go so you don’t have to rush to the toilet. Taking deep breaths and focusing on something other than using the toilet calms bladder spasms in the moment. After the urge subsides, go ahead and urinate if you still need to. Gradually, this technique can help you avoid “false alarm” trips to the toilet altogether.
6. Try Kegels
Pelvic floor exercises known as Kegels is one of the most popular ways to quell bladder spasms. “These exercises can strengthen the muscles that support the bladder and help improve bladder control,” Dr. Kim explains. His advice: Contract your pelvic floor muscles, as if trying to stop the flow of urine, and hold for a few seconds before releasing. Repeat 10 to 12 times.
Dr. Kim says you’ll get the best results if you repeat these contractions several times a day, such as while lying on the couch watching TV or waiting in line at the grocery store. Need a little extra guidance? Check out the video below. And if you still need extra help, Fosnight advises seeing a pelvic floor physical therapist. (Click through to learn how pelvic floor massage stopped one woman’s bladder leaks for good.)
When to visit a doctor for bladder spasms
Conservative treatments like those above are often effective in managing overactive bladder. But in some cases, they aren’t enough. If your symptoms continue, Dr. Berger advises visiting an incontinence specialist. “Often, a minor office-based procedure, such as a bladder Botox injection, offers almost life-changing improvement,” she says. “And there is nothing more satisfying than seeing these patients be able to enjoy life again!”
For more ways to outsmart bladders bothers:
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.