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What is Overactive Bladder?

Overactive Bladder (OAB) is a very common condition amongst women around the world. It refers to a group of urinary symptoms that are experienced by approximately 16% of women1. That's a huge number – one in seven – so you are not alone!

What are the symptoms of OAB?

The main symptom of OAB is urinary urgency2. This is a strong, sudden feeling of needing to urinate, which can sometimes be difficult to control (i.e. the “I really gotta go now!” feeling).  

Sometimes this urgency is accompanied by another symptom known as urge incontinence, which is when you are no longer able to hold in urine and experience accidental leakage of urine.  

Women with OAB may also experience urinary frequency, a need to urinate more often than normal (e.g. more than 7 times in a 24-hour period), and nocturia, waking up throughout the night with a need to urinate (e.g. more than twice per night).  

The symptoms associated with OAB are varied and can affect each woman differently.  Whether you experience one or all of the symptoms above, OAB can seriously impact your day-to-day routines and have a negative impact on overall quality of life.  

What causes OAB?

Although OAB is very common, the specific causes remain somewhat of a mystery! Scientific research has shown that OAB results from a breakdown in communication between the brain and bladder3:

Brain-bladder connection

When the bladder works properly, it fills with urine from the kidneys and a nerve signal is sent to the brain to let it know when the bladder is full. This signal tells us that we need to urinate, which causes the bladder muscles to tighten and the pelvic floor and urethra muscles (i.e. tube that urine exits the body through) to relax, allowing urine to flow out.

In the case of an overactive bladder, there are issues with this signalling process between the brain and bladder. This breakdown in communication can result in the bladder muscles contracting (tightening) which creates the feelings of urgency, even when the bladder is not actually full.  

Lifestyle Factors

The exact cause of this brain-bladder communication error is not yet fully understood, however there are a number of factors that can impact symptom severity. Lifestyle factors such as smoking, what you eat, body weight and intake of artificial sweeteners, caffeine and carbonated drinks for example, have all been shown to worsen OAB symptoms4. The good news is, that even if the specific cause of your OAB remains unknown, it is still possible to effectively manage your symptoms by making healthy lifestyle and behavioral changes.  

Of course it is also possible that you might frequently need to urinate without it bothering you or affecting your quality of life. It is always important to seek advice from a healthcare provider if you experience any symptoms or have health concerns.  

References

1. Reynolds WS, Fowke J, Dmochowski R. The Burden of Overactive Bladder on US Public Health. Curr Bladder Dysfunct Rep. 2016;11(1):8-13. doi:10.1007/s11884-016-0344-9

2. Haylen BT, de Ridder D, Freeman RM, et al. An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and Urodynamics. 2010;29(1):4-20. doi:10.1002/nau.20798

3. Griffiths D, Tadic SD. Bladder control, urgency, and urge incontinence: Evidence from functional brain imaging. Neurourol Urodyn. 2008;27(6):466-474. doi:10.1002/nau.20549

4. Wyman JF, Burgio KL, Newman DK. Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. International Journal of Clinical Practice. 2009;63(8):1177-1191. doi:10.1111/j.1742-1241.2009.02078.x

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