5 Chronic Conditions That Can Worsen Overactive Bladder

1. Cardiovascular disease

Cardiovascular diseases, including high blood pressure, heart failure and stroke, can contribute to or worsen OAB. Reduced blood flow to the bladder (bladder ischemia) can lead to low oxygen levels in bladder tissues, which may damage nerves and cause oversensitive muscles.

Medications that treat these conditions can also play a role. Diuretics (“water pills”), which are commonly prescribed to manage high blood pressure and heart failure, can increase urine production, possibly leading to frequency and urgency that can mimic OAB or worsen already-existing overactive bladder. Other medications, such as calcium channel blockers, beta-blockers and ACE inhibitors, may also contribute to frequent urination.

2. Kidney disease

Chronic kidney disease (CKD) can be associated with changes in urination, including urinating more or less than usual, especially as kidney function changes.

Medications for CKD or conditions like high blood pressure and diabetes, such as diuretics and SGLT2 inhibitors, can increase how much urine your body makes and possibly worsen OAB symptoms.

3. Diabetes

Diabetes can significantly increase the risk of OAB. High blood sugar levels can cause diabetic neuropathy, affecting nerves that control the bladder. Over time, nerve damage can lead to a weak bladder that cannot store or empty urine properly.

Excess glucose in the bloodstream can also cause the kidneys to overproduce urine, increasing urinary urgency and frequency.

Some diabetes medications, such as SGLT2 inhibitors and, in some cases, metformin, can also contribute to OAB symptoms. SGLT2 inhibitors, for example, can help flush excess glucose (sugar) and water into the urine, leading to more frequent urination.

5. Neurological disorders

Neurological conditions — including Parkinson’s disease, multiple sclerosis (MS), stroke, dementia and spinal cord injuries — can cause OAB-like symptoms through neurogenic bladder, a condition in your bladder caused by damaged nerves.

Neurogenic bladder occurs when an injury or disease disrupts the electrical signals between the nervous system and bladder. The interruption can affect how the bladder stores or empties urine.

Depending on the specific condition, symptoms may include urinary urgency, frequency, incontinence or difficulty emptying the bladder.

Here’s how neurological conditions can affect bladder function:

• Parkinson’s disease can increase urinary urgency, frequency and nocturia (waking up two or more times at night to urinate).
• Multiple sclerosis (MS) can damage the brain and spinal cord nerves, potentially causing bladder muscle spasms (detrusor overactivity).
• Stroke can reduce bladder control.
• Dementia can interrupt the brain-bladder connection, affecting the awareness of the need to urinate.
• Spinal cord injuries can disrupt bladder signaling completely.

Some medications used to treat symptoms of neurological disorders — including anticholinergic drugs, opiates, narcotics, antihistamines and alpha-adrenergic agonists — may also contribute to or worsen bladder symptoms by affecting bladder emptying.

When to seek help for overactive bladder

If you think a medical condition or medication might be contributing to overactive bladder symptoms, reach out to your clinician. They may be able to adjust your treatment plan or recommend additional medication to help manage symptoms.

Besides medication, several lifestyle changes may help, such as:

• Doing Kegel exercises to strengthen pelvic floor muscles
• Limiting foods and drinks that may irritate your bladder, like caffeinated or carbonated beverages
• Managing fluid intake
• Maintaining a healthy weight
• Quitting smoking
• Wearing absorbent pads or protective underwear if needed