Exercises for overactive bladder (and when you need meds)

In this article:

• What is OAB?
• Exercises
• Bladder training
• Other treatments
• When to call a provider
• Medication
• FAQs
• Bottom line

In this article

• What is OAB?
• Exercises
• Bladder training
• Other treatments
• When to call a provider
• Medication
• FAQs
• Bottom line

Overactive bladder (OAB) affects more than 33 million Americans, according to the Urology Care Foundation. If you’re one of them, you may have been told to start with exercises. But that often raises two important questions: Do overactive bladder exercises really work, and how do you know when it’s time to consider something more?

Here’s what you need to know about overactive bladder exercises, including what kind of timeline to expect and signs it may be time to talk with a healthcare provider about medication. Plus, learn how to save on your OAB medications.

What is an overactive bladder, and can exercises really help?

“An overactive bladder (OAB) is a condition in which the bladder signals the need to empty too early or too often,” says Aleece Fosnight, PA-C, a board-certified physician assistant specializing in sexual medicine, pelvic health, and urology, and a medical advisor for Aeroflow Urology.

The condition can lead to multiple symptoms, including:

• A sudden urge to pee
• Difficulty holding urine until you reach the toilet
• Going to the bathroom more often than usual
• Waking up at night to urinate
• Leaking urine before you make it to the bathroom (urinary incontinence).

Bladder training is recommended for every patient with OAB, according to the American Urological Association (AUA) and Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) guidelines on idiopathic OAB. These exercises can help manage symptoms, but they aren’t considered a cure.

Kegel exercises for an overactive bladder

Kegel exercises, a type of pelvic floor exercise, can help manage your OAB symptoms. When done correctly, Fosnight says, a quick pelvic floor squeeze during a sudden urge may help calm the bladder and give you more time to get to the bathroom.

How to do a Kegel correctly

A good Kegel starts with knowing how to relax your pelvic floor, says Caroline Packard, DPT, a pelvic floor physical therapist and the founder of Connect Pelvic Floor Fitness. If your pelvic floor muscles are already tight, they may not be able to squeeze effectively.

Here are her step-by-step instructions for doing Kegel exercises:

1. Get comfortable. Sit or lie down with your ribs stacked over your pelvis.
2. Breathe in and relax your pelvic floor. As you inhale, let your ribs expand in the front, sides, and back. Let your pelvic floor gently relax and move downward.
3. Breathe out and lift your pelvic floor. As you exhale, tighten the muscles around your urethra and anus, as if you are trying to stop the flow of urine and hold in gas at the same time.
4. Hold briefly. Keep the muscles lifted for a few seconds, or as long as you can without straining.
5. Release completely. Let the muscles fully relax before doing your next Kegel.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends holding each squeeze for about three seconds, then releasing completely. Over time, work up to 10 to 15 repetitions at least three times a day.

Packard says a few common mistakes can make Kegels less effective. These include:

• Holding your breath
• Squeezing your glutes or inner thighs
• Pushing down instead of lifting
• Not fully relaxing between reps

How long before Kegels help

The NIDDK states that most people don’t notice better bladder control for the first three to six weeks. Packard says some people may notice small improvements sooner, but building strength and coordination takes time and consistency.

Bladder training for an overactive bladder

Bladder training helps teach your bladder muscle to hold urine for longer periods. It involves following a bathroom schedule and slowly increasing the time between bathroom trips.

Packard recommends starting with a three-day bladder diary to better understand your bladder habits. Track what you drink, each time you go to the bathroom, how strong the urge feels, and any bladder leakage.

Then, use that information to create a timed bathroom schedule. For example, if you usually urinate every 45 minutes, Packard suggests trying to wait 50 minutes. Once that feels manageable, increase the time by another five minutes, she adds.

If you have a sudden urge to pee before your scheduled bathroom break, Packard advises that you:

• Stop moving. Rushing to the bathroom can make urgency worse.
• Take a slow, deep breath. This may help the urge pass.
• Try five quick pelvic floor squeezes or five heel raises, if the urge continues.

These quick muscle contractions can help signal to the bladder that it is not time to empty yet. The NIDDK also recommends fast, firm pelvic floor squeezes as one way to calm urgency.

Avoid limiting fluid intake too much as a way to control urgency. Drinking too little can make urine more concentrated, which can irritate the bladder and make urgency worse, Packard says.

Other lifestyle changes that support bladder control

In addition to bladder training, these daily habits and exercises may help support better bladder control:

• Breathing exercises: Your breathing muscle, called the diaphragm, and your pelvic floor work together. When you breathe in, your pelvic floor should relax. When you breathe out, it can gently lift. Practicing slow, full breaths can help you learn this pattern before doing strengthening exercises.
• Hip and glute exercises: The muscles around your hips and buttocks help support your pelvis and pelvic floor. Simple exercises, such as side-lying leg lifts, may be a good place to start.
• Core muscle exercises: Try to breathe out when you lift, push, or strain. Avoid holding your stomach in all day, as this can put pressure on your bladder and pelvic floor.
• Low-impact cardiovascular activities: Walking, swimming, and biking are all recommended by the NIDDK. However, walking alone is usually not enough to treat OAB, Packard says.

Bathroom habits can also affect OAB symptoms. Constipation can leave less room for the bladder to expand, which may trigger sudden urges to pee. If you have OAB and frequent constipation, ask your healthcare provider about prevention options.

Certain foods and drinks can also worsen urgency. Common bladder irritants include caffeine, alcohol, carbonated drinks, coffee, tea, artificial sweeteners, chocolate, citrus, tomatoes, and spicy or acidic foods, according to the National Association for Continence. You may not need to avoid all of them. A bladder diary can help you track symptoms to see which foods may affect you.

Extra body weight can put more pressure on your pelvic floor. While it may be beneficial to lose excess weight, Packard suggests focusing on incorporating the above exercises and lifestyle changes rather than on weight loss alone.

Signs your overactive bladder needs more than exercises

Exercises and other behavioral strategies are often the first step for OAB. If they are helping, you may notice improvement within six to eight weeks, Fosnight says.

But exercises may not be enough for everyone. Talk with a healthcare provider if:

• You notice that urgency, frequent bathroom trips, or urine leakage is still interfering with work, sleep, travel, or exercise.
• You have practiced consistently for six to eight weeks without much improvement.
• Your bladder leaks are getting worse.
• You’re not sure whether you’re lifting your pelvic floor or pushing down. A pelvic floor physical therapist can help you learn the right technique.

Overactive bladder medications

If exercises and bladder training aren’t enough, your healthcare provider may recommend medication. The AUA/SUFU guidelines recommend two main types of medication for OAB:

1. Antimuscarinics, such as oxybutynin and Vesicare (solifenacin), have been used to treat OAB for many years. They may help calm bladder contractions, but side effects like dry mouth and constipation are common.
2. Beta-3 agonists, such as Myrbetriq (mirabegron) and Gemtesa (vibegron), work differently. They help relax the bladder as it fills, which may reduce urgency and the need for frequent bathroom trips. They also tend to cause less dry mouth than antimuscarinics.

Fosnight says many people keep doing bladder training and other behavior changes while adding medication.

How to save on OAB medications

Your out-of-pocket cost may also affect which medication you choose. The average retail price of oxybutynin is about $30 for 30, 5 mg tablets, but it can cost as little as $5 with a free SingleCare discount card. Brand-name options are typically more expensive. For example, Gemtesa averages about $687 for 30, 75 mg tablets, or as little as $442 with SingleCare.

Frequently asked questions

Can exercise make overactive bladder worse?

Yes. Kegels may worsen urgency if you have a tight pelvic floor because your muscles may need to learn to relax before they can get stronger. You should see a pelvic floor physical therapist if your symptoms worsen after incorporating Kegels or other bladder-training exercises.

How long does it take for bladder training to work?

Bladder training usually takes at least six weeks of consistent practice. Your timeline may depend on how long you’ve had symptoms, how often you practice, and whether things like caffeine, constipation, or other bladder irritants are still making symptoms worse.

Do Kegels work for men with overactive bladder?

Yes. Men have pelvic floor muscles, too, so Kegels, bladder training, urge suppression techniques, and constipation management can all help. Men with prostate problems or those recovering after prostate surgery should work with a urologist or a pelvic floor physical therapist who specializes in men’s health.

What foods or drinks make overactive bladder worse?

Common bladder irritants include caffeine, alcohol, carbonated drinks, coffee, tea, artificial sweeteners, chocolate, citrus, tomatoes, and spicy and acidic foods, according to the National Association for Continence.

Can overactive bladder go away on its own?

Sometimes. If symptoms are caused by a temporary issue, such as a urinary tract infection, constipation, or a high caffeine intake, treating that trigger may help symptoms go away. However, Fosnight says OAB is often a chronic condition that can improve with ongoing treatment and daily management.

Bottom line

Overactive bladder exercises may help improve your symptoms, but it takes several weeks of consistency to see results. For the best chance of improvement, practice both parts of Kegel exercises: gently tightening the muscles and fully relaxing them. If you’re doing bladder training, gradually increase the time between bathroom trips, for example, by five minutes at a time.

If you’re still experiencing OAB symptoms after six to eight weeks, medication may be an option. With a SingleCare coupon, generic oxybutynin can cost as little as $5 for 30, 5 mg tablets.