Some risk factors for an overactive bladder can't be changed, such as some chronic health conditions, but you can control others. Here's what you need to know.
By Beth W. Orenstein
Medically reviewed by Cynthia Haines, MDPrintE-mailVery often, your doctor can’t tell you why you have an overactive bladder. But certain risk factors can increase your chances of developing the condition. Some risk factors are beyond your control. Learning about the risk factors you can control can help you maintain bladder health and reduce your risk of developing overactive bladder, which can lead to urinary incontinence (involuntary loss of urine).

Overactive Bladder: The Gender Factor

Although women are far more likely than men to experience some form of urinary incontinence, some studies have shown that overactive bladder — which can cause a form of incontinence called urge incontinence — occurs about equally in men and women. Others have found that overactive bladder — or at least certain forms of it — is more common in men.

But regardless of one's gender and regardless of the type of overactive bladder (with or without incontinence), the condition is linked to poorer quality of sleep, poorer quality of life, and higher incidence of depression.

As with urinary incontinence in women, some cases of overactive bladder may be related to menopause. Estrogen helps maintain the health of the bladder walls and the urethra, as well as nerves that control the bladder. As estrogen is depleted during menopause, the bladder walls can thin and become irritated, and bladder nerves can become more sensitive. This could lead to or aggravate overactive bladder symptoms. The urethra also has estrogen receptors and, without estrogen, it can weaken, too, says Yvonne Koch, MD, assistant professor of urology at the University of Miami Miller School of Medicine.

Men may experience symptoms of overactive bladder if they have an enlarged prostate or prostate cancer, says Anne Pelletier-Cameron, MD, assistant professor of urology at the University of Michigan in Ann Arbor. And men may be more susceptible to an overactive bladder and urinary incontinence if their prostate cancer is treated with surgery that damages the detrusor muscle, which surrounds the bladder.

Risk Factors That Threaten Bladder Health

Risk factors for overactive bladder and urinary incontinence that can affect both sexes include:

Chronic medical conditions. People with certain neurological disorders, such as Parkinson’s disease, multiple sclerosis, stroke, or dementia, are at higher risk of symptoms of overactive bladder and urinary incontinence. People who have spinal cord injuries, diabetes, or kidney disease are at higher risk as well. “Having sugar in the urine is not good for bladder health and, over time, will damage it irreversibly,” says Dr. Pelletier-Cameron — one more reason it’s important to keep diabetes in particular under control.
Bladder cancer and other bladder abnormalities. Bladder cancer can cause symptoms of overactive bladder, especially if the cancer spreads to the bladder wall. Nerve damage from various treatments for bladder cancer can also result in overactive bladder symptoms. Other causes of nerve damage that can affect the bladder include accidents, diabetes, vaginal childbirth, heavy metal poisoning, and infections of the brain and spinal cord. Bladder abnormalities, such as bladder stones, can also cause symptoms of overactive bladder; however, once the stones pass from the urinary tract, the urges — and any associated urge incontinence — should pass, too.
Medications. Some drugs, such as diuretics, can cause symptoms of overactive bladder and can even lead to urinary incontinence. You should talk to your doctor if you think your medication could be causing bladder issues. Your doctor may be able to switch you to a medication that doesn’t affect your bladder health, Dr. Koch says.
Obesity. One recent study found that premenopausal women who are obese have nearly twice the risk of overactive bladder than their non-obese counterparts, although this obesity link was not seen in women older than 55 or in men. Being severely overweight increases the pressure on your bladder and surrounding muscles. Maintaining a healthy weight can improve your overall bladder health and reduce the risks of overactive bladder symptoms, including incontinence, says Pelletier-Cameron.
Smoking. Smoking increases the risk of bladder cancer, which can cause or contribute to symptoms of overactive bladder and urinary incontinence. If you smoke, this is another reason to quit, Pelletier-Cameron says. However, while use of tobacco could irritate the bladder, any other definite links between smoking and overactive bladder have not been well defined, according to at least one recent review.
Poor bladder habits. “There have not been significant studies on this, but people who have poor bladder voiding habits are more likely to develop an overactive bladder,” Pelletier-Cameron says. It’s best not to hold in your urine until it’s too late to get to the toilet, she adds. And make sure you void completely, so that no urine is left in the bladder when you are done urinating.

While you can’t control all risk factors for overactive bladder, you can control some, such as quitting smoking and working with your doctor to switch a problematic medication. You also have power over your bladder habits. Working on a better bladder routine — and better health in general — can improve bladder health and help you avoid overactive bladder and urinary incontinence through the years.
Hi there,

That's a very helpful post.

Suffered with overactive bladder for many years. Last November, I had surgery to insert a pelvic sling which has really helped and I am on medical patches for a year, which have signigicantly helped with the urges.
I'm posting to say that if this condition becomes unmanageable, there is help available. Since the op I haven't looked back and hopefully this might give sufferers some hope.

New member since yesterday. :D