10 Ways to Live Normally With a Leaky Bladder

Retrain your brain, your muscles, and your habits to control an overactive bladder.
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Nervous about going out because your bladder sometimes leaks? Or constantly worried about getting to a bathroom on time? About one in five adults over age 40 has problems with urinary urgency and frequency, according to the National Association for Continence. But an overactive bladder (OAB), also called urge incontinence or irritable bladder, doesn't have to cramp your lifestyle.

Overactive bladder is often caused by a disruption in nerve signals from the brain to the muscles involved in urination. Symptoms include the need to go often or suddenly. It's the second-leading kind of incontinence, as well as part of the most common kind, "mixed incontinence" -- having both OAB and stress incontinence, a muscle weakness causing leaks when you cough or sneeze.

Here are ten ways to live a normal life despite bladder worries:

1. Be sure you're not drinking too much -- or too little.

Too much liquid, of course, will send you running to the bathroom too often, no matter what the condition of your nerves and muscles. A smart rule of thumb from ob-gyn Jill Rabin, coauthor of Mind Over Bladder, or I Never Met a Bathroom I Didn't Like and chief of ambulatory care and urogynecology at the Albert Einstein College of Medicine in Hyde Park, New York: Divide your body weight in half, and that's roughly the number of ounces of liquid a day that should be your maximum. So if you weigh 150 pounds, aim for 60 to 80 ounces of liquid a day. (That's about 10 cups total, including water, tea, juices, milk, soup, and so on.)

Drinking too little, on the other hand, sets you up for constipation, which can lead to urinary tract infections. UTIs irritate the bladder, triggering the need to go. Not drinking enough also creates concentrated urine, which is itself a bladder irritant and smells even worse if there's an accident.

The very best beverage for the bladder: plain water. Try drinking it flavored with a slice of lemon or lime, or drop an herbal tea bag into a sport bottle, glass, or thermos of cool water.

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2. Identify and avoid your trigger food(s).

For most people with overactive bladder, one or two kinds of food exacerbate the problem. Ob-gyn Jill Rabin's list of the top offenders: artificial sweeteners (especially Nutrasweet), coffee (and caffeine generally, including tea), alcohol, chocolate, tomatoes, red peppers, and spicy foods. Energy supplements can also contain ingredients that annoy the bladder. Other triggers in some people: acidic foods (citrus) or high-sugar foods.

Eliminate one food for two weeks and see if there's any difference, Rabin suggests. If not, pick a different substance to eliminate. Most people have just one primary trigger, not all of these.

3. Get the knack.

The muscles that help hold back urine until it's convenient to go are both involuntary and voluntary. There's a moment before coughing, sneezing, lifting a box, swinging a tennis racquet, or dealing with other physical stressors when you can consciously tighten the urethra to help hold back the urine. Doctors call this maneuver "the knack."

Because the knack maneuver is a voluntary movement, with practice you can teach yourself to do it at the moment you'll need it. Right before you cough or lift something (or whatever move you know creates your urinary leakage), consciously contract your pelvic floor.

Do this often enough, and the habit will become a reflex, Rabin says. The extra contracting of the knack movement can be enough to prevent any leaks.

4. Keep on Kegeling.

A therapy used to treat overactive bladder should be an everyday feature, doctors say. Most women know pelvic-floor exercises by the name "Kegel," after Arnold Kegel, the physician who popularized them. Kegels build the muscles used to control urine flow.

Because their effect is cumulative, the more you do them, the better you can resist an ill-timed urge to urinate. To remember to do the exercises often, build associations: Do them every time you're sitting at a red light, for example. Or leave yourself reminder notes in front of the bathroom mirror or on the dashboard of your car.

You can identify the muscles involved by stopping urine flow midstream. Do regular Kegel exercises when you're not urinating, however, to avoid the risk of urinary tract infections or other damage. Rabin recommends holding the contraction for a slow count of five ("one Mississippi, two Mississippi . . . "), then relaxing for a count of ten. Repeat five times for one set. Gradually work up to ten sets per day. "It takes up to six weeks to see results," she says.

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5. Visualize a delay.

Since OAB is partly a signaling problem between the brain and the body, try using your mind to forestall an urgent need to urinate. Decide on a powerful mental image that you can turn to whenever you desire a distraction from urinating. Some people imagine a dam at a rushing river, or a drain plug, although for others the water in these images is too tempting. If that's the case, picture another form of blockage: a fence, a railroad gate, a stop sign on a desert highway. A picture that simply makes you calm and happy might also work, such as a child's or lover's face, a sunset, flowers.

When the urge strikes, return to your mental image and take deep breaths.

6. Quit smoking.

Reason number 5,999,999 to drop a cigarette habit once and for all: The chronic cough it causes isn't doing your bladder any favors. Nicotine irritates the bladder lining. Even worse, smoking produces chronic coughing, which triggers leakage.

7. Treat your bladder the same, seven days a week.

Doctors often see a phenomenon called "schoolteacher's bladder," ob-gyn Jill Rabin says. Overactive bladder symptoms worsen at night because during the day, the person simply doesn't use the restroom often enough, sometimes because of work constraints. The result: up all night with what seems like an overactive bladder.

Ideally, aim for using the bathroom every two to four hours (under age 50) or every two to three hours (over age 50).

More ways to live normally with a leaky bladder

8. Make sure all of your doctors know about a new prescription.

More than 300 different medications can cause incontinence symptoms, ob-gyn Jill Rabin says. A drug can either be the cause of your overactive bladder, or it can exacerbate the problem. Often a related alternative medication proves less irritating. Be sure that the doctor treating your urinary symptoms knows about any new drugs you're given by a physician for an unrelated issue.

9. Wear tampons or pads for extra security.

Reducing the odds of leaking in the first place (by changing diet, medications, muscle strength, and so on) provides the best freedom. In the meantime, given the range of discreet, absorbent personal products out there, it's easier to live your usual life wearing added protection than to hide at home.

Some women swear by a tampon worn during heavy exercise. (Many female athletes with stress incontinence know this trick.) Be sure to change them out often. Disposable underwear is another solution. Forget the "adult diapers" imagery of the past; current products, styled for either men or women, look more like classic undergarments.

Carry a change of clothing in your car, as well as a dark plastic bag to transport soiled clothes until you can wash them.

10. Get the right diagnosis.

The best way to live normally with an overactive bladder is to be sure of the source of the problem, so you get to the right treatment. Only 17 percent of baby-boomer women say they're likely to immediately contact their doctor when they experience an embarrassing health condition or symptom, such as incontinence, according to a 2011 Harris Poll. And more than half (55 percent) wouldn't contact their doctor at all, even if the symptoms got worse!

This is changing, doctors say, as more people become aware of the options surrounding incontinence. "Thank goodness, in 2011 overactive bladder is finally coming out of the water closet," Rabin says.

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

over 4 years, said...

What about overflow incontinence?

almost 5 years, said...

I had never heard of using imagery to hold off my urges. I'm going to try that next time I feel the urge to urinate.

almost 6 years, said...

Kegeling and Knacking

about 6 years, said...

Thanks a lot for the article, very interesting.

over 6 years, said...

It is a good reminder of how to do the Kegels and how many.

over 6 years, said...

Very helpful for understanding & controlling bladder accidents.

over 6 years, said...

The further I read through the list the harder the sacrifices seemed, I think I will have to be weak and put up with that extra trip to the bathroom :)

over 6 years, said...

I can and am relating to a condition that is desperately trying to hinder my active lifestyle. Now I am not a doctor and do not know the long term effects of what I have found to avoid and and almost eliminate my leakage problem, which is what I consider severe. I have found that if I use a "super Plus size Tampon" I notice a at least a 75% or more decrease in leakage. Now I don't know for a fact why this is so, or what the long term side effects might be but for now it has made my life much less stressful. Note, I do not wear them to bed or nor do I use them out at the lake or when i'm at home feeling it is not necessary. I believe it is the pressure it puts on some part of my idk what part of my insides. I don't reccomend this for anyone. I just thought I might get some helpful feedback. Thank you,

over 6 years, said...

Ask your Doctor about a pessiary. I wear one all the time. Its like the outer springy ring of a diaphram used for contraception but has a bulb shape on one end. Its made a huge difference and hardly anyone talks about using them anymore. Don't know why because they work for some women.

over 6 years, said...

I left it another day....

over 6 years, said...

I didn't know the imitation sugars could affect me like that. I hadn't thought of exercises. Good suggestion. I recently started taking a medicine for it (via my Dr.). It is oxybutynin CL ER 5 mg tablet. I think it is helping.

almost 7 years, said...

Helpful for me, I hope, will be the Kegel training and the 2-3 hours disciplined interval. Thank you.

almost 7 years, said...

Hi pokerplayer, Thanks for your question. Many of the suggestions in this article can absolutely apply to males as well. I hope that helps to answer you question! Take care -- Emily | Community Manager

almost 7 years, said...

I am a 65 year old male with this problem. Most of your remarks seems to be geared towards woman. Does your ideas apply towards men also?

almost 7 years, said...

Hi Beckworth, Great question! You are absolutely correct, a tampon wouldn't absorb the leakage. However, the tampon is used to put pressure on the urethra, which helps prevent leaking from occurring. @manubrob, you also ask a great question. If you'd like, you can post your question in our Ask & Answer section, located here: ( http://www.caring.com/ask ). I hope that helps. Take care! -- Emily | Community Manager

almost 7 years, said...

The one concerning blader problems is really useful

almost 7 years, said...

I would like to know how is the surgery for a fallen bladder : lamparospy or intra vaginal or urethra?

almost 7 years, said...

I have a prolapse bladder and the leaking happens when there is a change of temperature,the urgensy is terrible,this article is very helpful,thank you(I'm 67 years old)

almost 7 years, said...

How to do Kegels.

almost 7 years, said...

I understand how wearing a pad can help, but a tampon? Urine passes through the urethra, not the vagina. Pleas explain how a tampon helps with a leaky bladder.

almost 7 years, said...

Hi Doberman, Thanks for your question. If you'd like, you can post your question in our Ask & Answer section here: (http://www.caring.com/ask). You also may want to explore alternatives with your husband's doctor, or another medical professional. Good luck -- Emily | Community Manager

almost 7 years, said...

I knew most of the tips but my husband's cardiologist insists he take Lasix which excerbates the problem. Is there any alternative to rid the body of fluid?

almost 7 years, said...

Great article. Anything that does not involve surgery.

almost 7 years, said...

Hi hunnybunny, Yikes that doesn't sound fun at all! Maybe you're having some kind of drug interaction? In any case, you can ask your question in our Ask & Answer section here: http://www.caring.com/questions/new. I also recommend that you speak with your doctor, they may have some ideas as to why this is happening as well. I hope that helps -- Emily

almost 7 years, said...

I started taking Lyrica. At first it was a lower dose, then it was upped to 75 mg. I have noticed that I am running much more to the bathroom. The other night, after taking my evening pills (lyrica included) I literally soaked the bed. Could the Lyrica be the cause of this problem? Thank you for any help!!

almost 7 years, said...

Thanks for the feedback! We appreciate you both taking the time to share your thoughts about our offering. @carolemajor We keep a strict separation between advertising and content, and advertising is clearly labeled. Here is the section of our site where we explain how we earn revenue in order to be able to deliver free information, resources and services for family caregivers: (http://www.caring.com/about/how-we-make-money.html) @DOT DIO Ask & Answer is a free resource on Caring.com that you can use to get questions answered by caregivers and experts across a range of topics: (http://www.caring.com/ask) Also, here are an assortment of articles on the website that cover bladder-related topics: (http://www.caring.com/search?query=bladder) Thanks for asking!

almost 7 years, said...

I found it interesting and sad that on the same where bladder exercises and tips are so too are ads for bladder medication. Isn't that a contradiction or are you really a format for the drug companies?

about 7 years, said...