Overactive Bladder (OAB) is a frustrating, embarrassing, and even exhausting condition. If you feel like you have been living in your bathroom, or you are constantly scouting out the nearest bathroom, “just in case”, you may suffer from OAB.  Millions of people are impacted by OAB, but what causes it and is OAB different for women than men?  This post will walk you through what OAB is, how it affects women, and how it compares to mens' experiences.

What is Overactive Bladder, Anyway?

More than a single disease, OAB refers to a group of bladder symptoms that result from poor communication between your brain and your bladder.  The most important symptom for OAB is Urgency.  Urgency is the feeling that if you don’t get to the toilet immediately, your bladder is going to start emptying on its own. In fact, for some people with OAB they really can’t hold their bladder and leak when they get the symptom of urgency. Others manage to get to the toilet before they actually start to empty.  

Even if you don’t leak, urgency can be a very debilitating symptom that keeps you from doing the things you like to do. Besides urgency, and incontinence due to urgency, OAB also often causes frequent urination (typically 8+ times per day)and the need to get up to urinate multiple times during the night. You don’t have to have all of these symptoms to have OAB. Some people have urgency and frequency without leakage, while others leak almost every time they get urgency.

Is OAB More Common in Women than Men?

It turns out that OAB is just as frequent in men as it is in women, affecting about 1 out of 6 men and women.  OAB symptoms are the result of poor communication between the bladder and the brain.  You might think of it as the bladder going rogue and trying to empty without checking in with the brain first.  This might be because of neurologic issues in the brain, such as a prior stroke or Parkinsons Disease, or it can be due to issues in the spinal cord such as arthritis or disk disease. But it can also be due to a bladder that has a hard time emptying.

Older men are prone to difficulty emptying from bladder obstruction due to prostrate disease, and this is the most common cause of OAB in men.  They experience urgency as the bladder tries to empty against the enlarged prostrate.

Is OAB More Severe in Women Than Men?

Only about a third of men with OAB have leakage when they experience urgency, while two-thirds of women with OAB have leakage associated with the symptom of urgency. The symptom of urgency can be a big stressor even if you don’t leak, but the associated leakage can cause even more anxiety not to mention embarrassment with leakage. So in general, women do have more severe OAB than men just because they have twice the chance of having leakage.  

They also tend to get the symptoms at a younger age.  Because prostrate disease begins to effect men after age 50, they usually develop OAB at an older age, especially after age 60.  OAB is more common in women over 60 years old too, but also affects many younger women, including those between the ages of 20 and 40 years.  This means that women with OAB have to suffer the burden of disease longer than men.

How Does OAB Affect Women?

We have already reviewed the typical symptoms of OAB; urgency, the uncontrolled feeling that your bladder is going to empty, urgency incontinence, when it actually does leak, urinary frequency, when you have to empty your bladder more than 8 times per day, and nocturia, the need to empty your bladder multiple times through the night. To really understand the burden of OAB on the quality of life, you need to understand how these symptoms impact daily life.  

OAB symptoms tend to tether women to a toilet, which either keeps them at home or limits where they can go that has reliable easy access to a toilet. Unfortunately, there are consequences for social engagement as well as work performance. The fear of leakage also results in anxiety that further limits mobility and social engagement.  Leakage can feed embarrassment that only deepens the isolation.  OAB has also been shown to negatively impact the quality of your sleep as well.  It is easy to see how a woman experiencing these limitations would also be prone to depression, which is more common in women with OAB. So, in short, OAB has a negative impact on many aspects of daily life and tends to isolate women.

You Don’t Have to Be Silent About It

Talking about bladder issues can feel vulnerable, but sharing your experience—with a friend, a partner, or a healthcare provider—is often the first step toward relief. OAB is incredibly common, especially among women, who tend to suffer more severe symptoms and over a longer time frame than men. But having OAB says nothing negative about your hygiene, your worth, or your strength.  Your bladder should not be running your life. With the right support, you can regain control—at any age, and at any stage.

When Should You Seek Help?

If you are a woman that suffers from the symptoms of OAB, you should put your embarrassment aside and seek help.  There are effective treatments that you can now access from your home through a virtual visit at Dry Days Health.

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