Overactive bladder is a condition where the bladder is unable to hold urine normally.

The Urology Care Foundation estimate that at least 33 million people in the United States have overactive bladder.

Overactive bladder (OAB) may be caused by an underlying disorder such as Parkinson’s disease, diabetes, multiple sclerosis, or kidney disease. Other times it can be linked to medications, surgery, or childbirth. However, for some people, there appears to be no underlying cause.

Guidelines recommend that lifestyle and behavioral changes are the first-line treatment for OAB. For many people, a combination of these options is necessary to control symptoms.

Natural remedies for overactive bladder include the following:

Dietary changes and fluid management

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Red wine and chocolate may cause or worsen the symptoms of an overactive bladder.

One of the most straightforward methods in the treatment of OAB involves making dietary changes. This involves cutting out several known food irritants from the diet and limiting fluid intake.

Foods to avoid

Foods and drinks, which are known to cause or worsen the symptoms of OAB include:

  • alcohol
  • artificial sweeteners
  • caffeine
  • chocolate
  • citrus fruits and juices
  • corn syrup
  • cranberry juice
  • dairy
  • sodas and fizzy drinks
  • spicy foods
  • sugar and honey
  • tomatoes
  • vinegar

As triggers from food vary from person to person, it can be helpful for people to keep a diary detailing food intake and bladder symptoms. A diary can help people work out which foods are causing the greatest problems.

Manage fluid intake

Drinking enough water is essential for health. Too little water can lead to concentrated urine, which can irritate the bladder lining, increasing urgency. Too many liquids may worsen frequency symptoms. Fluid intake before bed can contribute to urinating during the night.

A 2016 paper, published in Research and Reports in Urology, recommends limiting fluid intake to 6 to 8 glasses of water daily, and avoiding liquids for 2 to 3 hours before bedtime.

Bladder control techniques

Retraining the bladder is often recommended to reduce bladder leaking. There are several ways to do this:

Scheduled urination

A person with OAB can keep a diary of urinary habits, including bathroom trips, leakage, and symptoms of urgency. Based on the patterns noticed from the diary, they can begin to schedule trips by adding on 15 minutes to the usual urination times.

For example, if urination takes place every 60 minutes, they should schedule bathroom breaks for every 75 minutes.

It is important to use the bathroom at the scheduled times, regardless of whether urination is needed. The person can then gradually increase the length of time between bathroom visits.

Delayed urination

Each time the urge to urinate occurs, the person should try to delay urination for 5 minutes if possible. Relaxation techniques, such as deep breathing, may help.

People should gradually increase the holding time until there are 3 to 4 hour gaps between bathroom visits.

Double-void technique

This technique is helpful for those who feel like their bladder does not empty fully. It is also a good idea to double-void before bedtime.

Anyone wishing to double-void should follow these steps:

  1. sit on the toilet, leaning slightly forward
  2. rest the hands on the knees or thighs
  3. urinate as normal
  4. remain on the toilet and wait 30 seconds
  5. lean slightly further forward and urinate once more

Kegel contractions

Kegel contractions involve strengthening the pelvic floor muscles, which are used to control urinary flow.

To discover the location of the pelvic floor muscles, a person can try to stop urinating midstream. If successful, this means the correct muscles have been located.

A person should practice squeezing these muscles for 10 seconds, and then relax for 3 seconds. This pattern should be repeated 10 times. A person should try to do three sets of 10 repetitions daily. Deep breathing techniques may make this process easier.

Lifestyle changes

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Quitting smoking is recommended as smoking may make symptoms of overactive bladder worse.

There is a wide range of lifestyle changes that people can make to improve OAB symptoms. These include:

Quitting smoking

Smoking may make symptoms of OAB worse. Coughing fits that occur in some smokers may also increase episodes of leaking.

Discussing medications with a doctor

Certain medications can lead to bladder leaking. People with OAB who are taking the following medications should discuss the possibility of alternatives with a doctor:

  • alpha-adrenergic antagonists
  • antihistamines
  • diuretics
  • muscle relaxants and sedatives
  • narcotics, such as oxycodone and morphine

Maintaining a healthy weight

Excess weight can put pressure on the bladder and pelvic muscles. Staying within a healthy weight range may help with bladder control.

Managing medical conditions

It is important for people to manage the symptoms of chronic conditions that may contribute to OAB. These include Parkinson’s disease, diabetes, multiple sclerosis, and kidney disease.

Herbs and supplements

Several herbs and natural supplements have been recommended for the treatment of OAB, although the research on these is limited:

  • Gosha-jinki-gan: Some research has shown that this blend of 10 traditional Chinese herbs can positively affect bladder contraction.
  • Ganoderma lucidum: This herbal extract from East Asia was shown in one study on men with urinary tract issues to improve symptoms.
  • Corn silk: A traditional medicine used for centuries for conditions, such as bladder irritation and nighttime incontinence.
  • Capsaicin: This natural remedy comes from chili peppers. Some research recommends it as an efficient and inexpensive treatment for overactive and highly sensitive bladders.
  • Pumpkin seed extract: Research suggests this is beneficial for both nighttime urination and OAB.
  • Magnesium hydroxide: These supplements were shown in one small study to improve symptoms of urinary incontinence and nocturia in over 50 percent of female participants.
  • Vitamin D: A 2010 study found that higher vitamin D levels were associated with a lower risk of pelvic floor disorders, such as bladder leaking, in women. Another study suggests a link between low vitamin D levels and episodes of bladder leaking in older adults.

Alternative therapies

Although research is limited, the following complementary or alternative treatments may prove useful remedies for OAB.

Acupuncture

Some research suggests that acupuncture provides benefits for those with OAB symptoms. These benefits include reducing urgency and frequency of urination, and improving quality of life.

Biofeedback

Biofeedback uses electrical sensors to monitor muscles. This therapy is sometimes used to treat bladder leaking. Research suggests it is a beneficial first-line treatment for children.

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Urinating more frequently than six to eight times a day and a sudden urgency to urinate may be symptoms of OAB.

The symptoms of overactive bladder vary from person to person. Common symptoms include:

  • Urgency: A strong and sudden need to urinate with an inability to delay it. This is a defining symptom of OAB.
  • Frequency: Many people with OAB need to urinate more frequently than average. The average person urinates 6-8 times a day, and once at night. Those with OAB tend to urinate more than 8 times daily, and two or more times at night.
  • Incontinence: This is defined as the involuntary loss of bladder control, leading to leakage.

OAB does not tend to affect lifespan, but it can impact quality of life. The condition may affect work, relationships, and sleep. Treating symptoms early is advisable to successfully manage, or even cure, the condition.

Those who experience changes in their urine or urination habits should consult a doctor. Urinary urgency and frequency are associated with other medical conditions, including urinary tract infections. As a result, a proper diagnosis is important to inform treatment plans.

It is also recommended that people speak with a doctor before trying alternative remedies for overactive bladder.

If first-line treatments do not help symptoms to improve, doctors may then suggest second-line treatments. These can include medication.

If this is unsuccessful, third-line treatment in the form of neuromodulation, a method of altering nerve activity, or surgery may be considered.