What to Know About Overactive Bladder

Medically Reviewed By Matt Coward, MD, FACS

An overactive bladder causes you to pass urine too often. You may experience uncontrollable, sudden, or intense urges to urinate. This can lead to urine leaks, or urinary incontinence. Many treatment options can help. Many underlying conditions and factors can cause an overactive bladder. In some cases, the underlying cause is unknown. Still, treating causes or improving bladder function can help you manage an overactive bladder.

This article discusses overactive bladder, including its symptoms, causes, and treatments.

Key facts about overactive bladder

  • Overactive bladder is the need to pass urine too often or difficulty controlling the urge to urinate.
  • Sometimes, the cause is unknown, but underlying health conditions may contribute.
  • Symptoms of overactive bladder include strong or sudden urges to urinate, frequent urination, and urinary incontinence.
  • Treatment options include bladder training, medications, and nerve therapies.

What is an overactive bladder?

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Overactive bladder is the need to urinate more than usual.

According to the National Institutes of Health (NIH), doctors may diagnose an overactive bladder if you experience at least two of the following symptoms:

  • urinating eight or more times per day, or two or more times during sleep
  • having strong, sudden urges to urinate
  • leaking urine after a strong, sudden urge to urinate

Bladder function requires the organs, muscles, and nerve signals to work together.

Typically, while the bladder fills with urine, the bladder muscles stay relaxed, and the sphincter muscles stay closed around the urethra. This prevents urine from passing.

When the bladder is full, it prompts the brain to send signals to trigger the bladder muscles to squeeze and the sphincter muscles to relax. This causes urine to pass.

However, with an overactive bladder, there may be difficulty with the nerve signals or muscle coordination.

What are the symptoms of an overactive bladder?

The main symptom of an overactive bladder is urgency, a strong, sudden need to urinate that is hard to control.

Other overactive bladder symptoms include:

  • frequent urination
  • needing to urinate during sleep, or having to wake from sleep to urinate
  • sleep problems or fatigue as a result of sleep time urges
  • urinary incontinence, leaking urine
  • urge incontinence, whereby urine leaks after having a sudden need to urinate
  • stress incontinence, whereby pressure in the abdomen may lead to urine leaks, such as from sneezing, bending, lifting, or laughing
  • emotional or social effects, such as withdrawal from social settings, anxiety, or depression

Sometimes Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , symptoms worsen over time.

Talk with a doctor if you experience any symptoms of overactive bladder or other urinary symptoms.

Learn more about urinary incontinence, including its types, causes, and treatment.

What causes an overactive bladder?

Overactive bladder occurs when something interferes with typical bladder function and control. This can include problems with the parts of the urinary system, including different organs and the nerves.

Conditions that may affect the urinary system and lead to an overactive bladder or incontinence include:

The following may also cause muscle or nerve damage or weaken the pelvic floor muscles, leading to an overactive bladder:

According to the National Health Service (NHS), some people may be born with a higher likelihood of developing an overactive bladder. In some cases, doctors do not know the cause.

Exposure to water, hearing running water, or being in a cold environment may trigger some people’s symptoms.

What are the risk factors for an overactive bladder?

Factors that may contribute to incontinence or an overactive bladder include:

How do doctors diagnose an overactive bladder?

To diagnose an overactive bladder, your doctor will ask about your symptoms and medical history. They may perform a pelvic exam or digital rectal exam to feel the prostate gland.

Doctors may order more tests to identify or rule out possible causes. Tests may include:

  • urinary stress test, which requires you to cough and see if urine leakage occurs
  • urine samples
  • blood samples
  • cystoscopy, in which a doctor inserts a thin tool through the urethra into the bladder to see inside
  • urodynamic testing, which uses a catheter to measure how well the urinary system is working
  • imaging tests, such as ultrasound scans

Read more about how doctors diagnose an overactive bladder.

Keeping a bladder diary may help with diagnosis. A bladder diary involves keeping a record of:

  • fluid intake
  • when you urinate and the amount of urine you produce
  • how often you experience urine leaks
  • whether you feel strong urges to urinate before urine leaks occur
  • what you were doing when you had urine leaks

What are the treatment options for an overactive bladder?

Medical options for treating overactive bladder symptoms include:

  • Bladder training: Exercises train the bladder to hold more urine and empty less often.
  • Pelvic floor training: Methods such as Kegel exercises and biofeedback with electrical stimulation train the pelvic floor and improve incontinence.
  • Medications: Anticholinergics, beta-3 agonists, and tricyclic antidepressants may help relax the bladder.
  • Injections: Botulinum toxin (Botox) may help improve nerve function and coordination.
  • Nerve stimulation: Electrical nerve stimulation uses mild electric pulses to improve nerve and muscle reflexes.
  • Medical devices: Pessaries and other medical devices inserted into the vagina may help with stress incontinence symptoms. External catheters drain urine into a wearable bag, preventing leaks.
  • Surgery: Surgery, such as bladder enlargement, addresses structural problems that are contributing to an overactive bladder.
  • Psychotherapy: Psychotherapy or counseling helps you manage emotional effects of an overactive bladder, such as anxiety.

Read more about bladder training and biofeedback.

Your medical team also may recommend treatment to address other causes of an overactive bladder. Insulin medication for diabetes is an example.

Lifestyle approaches can also be a key part of treatment, which are explained in the following.

What self-care approaches help with an overactive bladder?

The following approaches may help improve or manage symptoms of an overactive bladder or incontinence:

  • not drinking as much close to sleep time
  • limiting caffeine, alcohol, and other triggers
  • stopping smoking or tobacco use
  • getting regular physical activity
  • maintaining a moderate body mass
  • eating enough fiber to avoid constipation
  • wearing incontinence underwear or pads
  • asking your doctor or a pharmacist about:
    • urine deodorizing tablets to reduce the smell of urine
    • ointments to relieve skin irritation from leaks

Can you prevent an overactive bladder?

Many overactive bladder cases or incontinence episodes cannot be prevented.

However, to reduce episodes you can try:

  • avoiding known triggers, such as drinking alcohol or being in cold environments
  • not drinking close to sleep time
  • stopping tobacco use
  • treating underlying conditions according to your doctor’s recommendations

Follow your doctor’s advice for an overactive bladder. Talk with your doctor if you experience new or persistent symptoms.


Overactive bladder causes the need to pass urine too often or difficulty controlling the urge to urinate. This may cause strong or sudden urges to urinate, frequent urination, or urine leaks.

Sometimes, the cause of an overactive bladder is unknown. However, conditions that affect the urinary organs, muscles, and nerves may play a role.

Treatment options to improve symptoms include medication, bladder training, and lifestyle adjustments.

Contact your doctor if you have urinary symptoms.

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Medical Reviewer: Matt Coward, MD, FACS
Last Review Date: 2024 Jan 19
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