Overactive Bladder in Women

Overactive Bladder in Women: How Acupuncture and Eastern Medicine can Help Treat Urinary Incontinence In older women, signs of urinary incontinence are surprisingly common. According to the National Institutes of Health, around 45 percent of women experience the condition to some extent. And for many, an overactive bladder can be distressing to live with. There are numerous treatment options available for women with an overactive bladder (OAB), including acupuncture and other forms of eastern medicine. Acupuncture in particular is gaining a lot of attention for its potential with OAB, as western forms of treatment – including drug therapy and surgery – come with risks of their own. What Are the Symptoms and Underlying Causes of an Overactive Bladder in Women? An OAB is not a disease, though it may indicate the presence of disease. Diabetes, kidney disease, neurological conditions, certain cancers, and urinary tract infections can all cause OAB. However, the majority of OAB cases are related to muscle dysfunction in the bladder. Signs of an overactive bladder include: A sudden and frequent need to urinate. This feeling may come on in seconds and strike many times a day. Unintentional urine leakage from the bladder (urinary incontinence). Waking up at night with an urge to urinate. The detrusor muscle, in particular, is implicated in many OAB patients. The detrusor muscle rings the inside of the bladder and is responsible for contracting and relaxing to regulate urine flow. If the detrusor muscle has trouble relaxing, it may fire too often, resulting in the above symptoms. Treatments are generally targeted at restoring proper muscle function in the bladder. How Do Doctors Typically Treat an Overactive Bladder? Doctors typically prefer conservative treatment options first when managing OAB in their female patients. If those conservative options don’t respond, doctors may scale up treatment for severe cases. Treatment modalities include: Exercise – The first line of OAB treatment involves exercise recommendations. The goal is to retrain the bladder muscles so they spasm less often and are easier for the patient to control. These are pelvic floor exercises – alternatively termed Kegels. They’re difficult to explain, but imagine trying to pick a marble off the floor by bending down and picking it up using those pelvic muscles. Kegel exercises require long-term engagement to work. The standard recommendation is 3-4 sets of 10 repetitions a day, for 4-6 months. Medication – If the patient’s OAB doesn’t respond to exercise, medication is the next step. There are a couple medication classes used for OAB, including beta-3 adrenergic agonists and antimuscarinics. Among beta-3 adrenergic agonists, the most popular choice is mirabegron. Physicians prefer mirabegron to other medications, but affordability is a concern, as many insurance plans do not cover it. Side effects include headaches, nausea, diarrhea, constipation, and runny nose. Some drugs in this class may also increase blood pressure. The other drug class used for OAB is antimuscarinics. Oxybutynin is a common option and works by relaxing the bladder muscles. And while it’s usually more affordable (and therefore prescribed more often), it has a significant side effect profile. Adverse effects include dry mouth, constipation, drowsiness, which are relatively mild. However, antimuscarinics may also be associated with an increased risk of dementia, though it’s not clear yet whether there is a link or if the medication has been prescribed in patients who are mor