Doctors use medications like anticholinergics and beta-3 agonists to treat an overactive bladder (OAB). Other OAB treatment options may include Botox injections.

Overactive bladder is not curable, but symptoms respond well to treatment. Many people find relief through medications, lifestyle changes, or procedures like nerve stimulation.

A doctor may tailor OAB treatment based on your symptoms and how much they affect your daily life. The goal is to help reduce urgency, frequency, and leakage so you can improve your quality of life.

Changing certain habits is usually the first step in OAB treatment. These options are safe, low cost, and often effective.

Healthcare professionals may recommend:

  • Bladder training: This involves scheduled toileting and gradually increasing the time between voiding to help the bladder hold more urine. Research from 2023 found that it may work better than medication with fewer side effects.
  • Pelvic floor exercises: These Kegel exercises strengthen the muscles that control urination, helping to reduce leaks. A 2022 study found that doing them 3 times a week for 12 weeks can improve symptoms.
  • Fluid and dietary changes: Reducing or eliminating bladder-irritating foods, such as caffeine and alcohol, can reduce bladder irritation and improve symptoms. However, don’t limit your fluid intake, as dehydration can worsen OAB symptoms.
  • Weight management: If you have overweight or obesity, even slight weight loss can ease OAB symptoms. A 2020 study review found that lifestyle changes like diet and exercise, may reduce OAB symptoms, although more research is needed.
  • Stress reduction: Stress reduction techniques such as deep breathing, yoga, or meditation may also help with OAB. Some research found that older women practicing daily mindfulness reported fewer urinary incontinence episodes.

Consider talking with a healthcare professional before making lifestyle changes to manage your OAB symptoms. They can guide you depending on the severity of your symptoms.

If lifestyle changes do not help relieve your symptoms, doctors may add OAB medications to your treatment plan.

Common medications include:

  • Anticholinergics: These help reduce bladder spasms, which may ease urgency and frequent trips to the bathroom. Common examples include oxybutynin (Ditropan XL), solifenacin (Vesicare), and tolterodine (Detrol).
  • Beta-3 adrenergic agonists: Drugs like mirabegron (Myrbetriq) relax the bladder muscle, allowing it to hold more urine. These medications may cause fewer side effects than anticholinergics, but they can raise blood pressure.
  • Antidepressants: If other medications don’t work for you, doctors may prescribe antidepressants, like duloxetine (Cymbalta), even if the drug is initially approved for other purposes. This is known as “off-label” use.
  • Topical estrogen: For postmenopausal women, applying a low dose estrogen cream around the urethra and vagina may help relieve OAB symptoms, primarily when used with other treatments.

When you discuss OAB medications with a healthcare professional, it’s important to discuss potential side effects and risks. You may also want to add about potential interactions with supplements and other drugs, and the best times of the day to take them.

If lifestyle changes and medications don’t work well, doctors may suggest other OAB treatment options, such as:

  • Peripheral​ tibial nerve stimulation (PTNS): This procedure uses a small needle placed under the skin to apply a low electrical current. The electrical stimulation targets the tibial nerve near the ankle to help control bladder function.
  • Botox injections: A doctor injects Botox (onabotulinumtoxinA) into the bladder muscle to help it relax. This increases the bladder’s capacity to hold fluid and reduces leaks. The effect usually lasts 6 to 9 months.
  • Sacral neuromodulation (SNS): This treatment uses a small device placed under the skin. It sends mild electrical signals to the nerves that control the bladder, helping to regulate bladder activity. ​
  • Surgery: In rare cases, doctors may consider surgical interventions to increase bladder capacity or divert urine flow. These are typically reserved for severe OAB cases where other treatments have not worked.

The best OAB treatment for you depends on your symptoms, personal preferences, and other health conditions. Here are a few things to consider and that you may want to discuss with a healthcare professional:

  • Severity of symptoms: Treatments vary depending on the frequency and intensity of your symptoms, so your options may align with your specific needs.
  • Underlying health conditions: Some treatments may not be indicated if you have certain underlying conditions like glaucoma or heart disease. In this case, a doctor may need to suggest a different approach to manage OAB.
  • Side effects: You may not be able to tolerate some of the medication side effects, or you may prefer avoiding them altogether. If you use other medications, you may also need to adjust your treatment to avoid interactions. That’s why giving your health team a complete list of medications and treatments you currently use is essential.
  • Cost and access: Asking about long-term costs and insurance coverage may help you identify treatments that better suit your finances and needs.
  • Ease of use: You may want to choose treatments that fit your routine. Some medications might require multiple doses daily, others need to be taken once or applied on the skin, and others require you to go to a doctor’s office.

OAB responds well to treatment and different approaches, which often involve a combination of lifestyle changes, medications, and sometimes medical procedures.

While there’s no permanent cure, treatment can relieve symptoms and improve the quality of life. Consider talking with a healthcare professional to find the appropriate treatment plan.