Conservative treatment and lifestyle changes
General lifestyle measures:
- Caffeine. This is in tea, coffee, coca-cola and can be found in some over-the-counter pain medications and cold remedies. As well as causing the kidneys to produce more urine, caffeine can also irritate the bladder and make urgency symptoms worse. It may be worth cutting out caffeine for a couple of weeks to see if your symptoms improve.
- Alcohol. For some people, alcohol makes their symptoms worse. The same advice applies as with caffeine drinks.
- Drink normal quantities of fluids. It may seem sensible to reduce the amount that you drink so the bladder does not fill so quickly. However, this can make symptoms worse as the urine becomes more concentrated which may irritate the bladder more. In general, it is better to drink a normal amount of fluid: for most people, this is about 1.5 to 2 litres per day – or about 6-8 cups of fluid. In hot weather, this may need to be more.
- Go to the toilet only when you need to. It is important not to get into the habit of going to the toilet more often than necessary. Some patients go when their bladder only has a small amount of urine "just in case". Again, this may seem a sensible idea as people may want to avoid letting their bladder get too full. Unfortunately, this often makes symptoms worse in the long-run because the bladder becomes used to holding less urine and may become even more sensitive. So, you may find that when you have to hold on (for example, if you go out), symptoms are worse than ever.
The aim is to slowly stretch the bladder so that it can hold larger and larger volumes of urine. In time, the bladder muscle should become less overactive and you should become more in control of your bladder. This means that more time can elapse between feeling the desire to pass urine, and having to get to a toilet. Leaks of urine are then less likely. A doctor, nurse, or continence advisor will explain how to do bladder training.
Bladder training can be difficult, but becomes easier with time and perseverance. It works best if combined with advice and support from a continence advisor, nurse, or doctor. Make sure you drink a normal amount of fluids when you do bladder training (see above).
Pelvic floor exercises
Pelvic floor exercises help to strengthen the muscles that lie at the bottom of the pelvis. These muscles are responsible for supporting the internal organs, including the womb, bladder and rectum. If these muscles become weak or damaged during childbirth, then the support for the internal organs is reduced. This can lead to urinary problems including incontinence. It can also cause vaginal prolapse, bowel trouble and sexual problems.
Follow this link for further details about Pelvic Floor Exercises.
Many women develop overactive bladders after going through the menopause. The bladder is very sensitive to hormone levels, and this may affect you even if you are using HRT treatments. Using an oestrogen cream or pessary, which is inserted into the vagina, can help replenish the oestrogen levels and improve OAB symptoms.
This type of oestrogen treatment is very safe as only minimal amounts are absorbed into the rest of the body, and it does not have the risks associated with many other types of oestrogen treatments.