The physical effects of an overactive bladder are obvious. But the emotional impact is not often talked about. You might avoid going on road trips with friends, playing sports, or visiting your grandchildren because you’re ashamed of leakage or have to stop often to use the bathroom.
“People start living their lives around their bladder management,” says Dr. Aksa Khan, MD, a urologist at the Mayo Clinic in Phoenix, Arizona.
Even at home, OAB can make even the simplest of social interactions stressful. Khan says one of her patients, a 50-year-old woman, described having a sweet conversation with her yard neighbor when she suddenly started peeing in the middle of her talk. To cover it, she turned the garden hose on itself.
Khan says losing control can be devastating. “Losing something really defines you as a social being,” she says. “It makes you feel like a baby in a way. It puts you back in diapers.”
OAB can also affect intimacy. You may avoid sexual activity because you are worried about leaking. This can lead to bigger problems in the relationship. If your partner doesn’t know what’s wrong, he may think it has something to do with it. Do your best to open up and trust that your partner will be supportive.
The challenges of intimacy are tough enough for couples who have been together for decades. It can be even more confusing when you’re in the dating game. “[OAB] It can be a huge elephant in the room when those more intimate relationships start,” says A. Lenore Ackerman, MD, PhD. She is director of research in the UCLA Department of Pelvic Medicine and Reconstructive Surgery.
Sleep disorders and depression
You may wake up four times a night, but go back to sleep each time. Others may only wake up twice a night. But they have so much difficulty getting back to sleep each time that it has such a huge impact on their quality of life. “It’s torture,” says Khan.
This is because when you don’t get enough rest, your body doesn’t get a chance to recover. This may lead to other problems, including problems with brain function. There is a strong link between OAB and depression, Ackerman says, and lack of sleep is a major factor. “Sleep is really important to all of this,” she says.
stress and tension
The anxiety surrounding OAB can also worsen physical symptoms. Just as you might tighten your jaw without realizing it, people with OAB often tighten their pelvic floor muscles, says Veronica Asence, DPT. She is a physical therapist at Lahey Hospital and Medical Center in Burlington, Massachusetts, and she specializes in pelvic health.
“Your pelvic floor is always active: it supports your pelvis, it holds your organs,” she says. “If we contract our pelvic floor muscles in relation to need [to pee] And the anxiety surrounding this craving, it’s as if we’re constantly sticking our tails up.”
This constant pressure can corrode them. So much so that they lose control when you need them most. You can see a significant change in your symptoms just by working on ways to relieve anxiety and the associated pelvic floor tension.
If you are older, you may think that urinary problems are a normal part of aging. (They are not.) But if you’re young, OAB can carry an extra level of shame and self-blame. You may be wondering how this could have happened or what was “wrong” with you.
Shame can be a major obstacle to seeking help, but OAB is more common than you think. “Talk to your friends,” Ackermann says. “Odds are that some of them have it, too.” In fact, Ackermann says the first thing you do when meeting a new patient is to tell them about your urinary tract problems.
Talking about it more, other OAB sufferers will likely feel more comfortable looking for long-term treatments rather than simply managing symptoms with pads, spare underwear, catheters, and other items. It can be a great way to take back control. For example, new products are often designed with light, attractive fabrics that secretly contain a lot of fluid. Sometimes they prevent people from getting professional help, Ackermann says.
“You don’t have to deal with this alone,” Ackermann says. “It happens to a lot of us, and there’s a cure, and we want to give you the cure.”
Talk to your doctor
“Physicians get into this kind of work because they want to help patients,” says Sivan Hilo, MD, a urologist at the Mayo Clinic in Rochester, Minnesota. “We can’t improve something we don’t know is a problem.”
If your doctor doesn’t know how to treat OAB, they should refer you to someone who can. With help, you can take control. “It doesn’t matter if you’re 28 or 88,” Asence says. “Your bladder can be retrained at any time in your life.” The key, she adds, is to be persistent and take full care of yourself. “Bladder personality is a lot like a toddler: It works best with structure, discipline, and a healthy environment.”