What is an overactive bladder?

Normally, the bladder uses a feeling of pressure to politely request that you empty it at your earliest convenience. Once you’ve done this, it takes around two hours for it to fill up and send you to the loo again. If, however, the bladder starts demanding that it be emptied every half hour or even more than that, we’re talking about an overactive bladder.

There are many causes of an overactive bladder. The bladder muscle which contract when the bladder is full can be too strong and contract too early. The sensors that measure pressure in the bladder can also be overly sensitive.

The neural pathways that carry the pressure signal from the bladder along the spinal cord to the brain could also be damaged. Damage to the spine or conditions such as Parkinson`s or multiple sclerosis can also change how the nerves work, making the bladder muscle contract more often.

If you’ve often been afflicted with urinary tract infections (UTI), it could be that your bladder wall has simply been attacked by bacteria too many times, meaning the stretch sensors don’t work properly anymore. 

It seems that women are more vulnerable to bladder problems than men. The capacity of the bladder varies from person to person, but as a general rule, women can store 350 to 550 ml, while men can hold 550 to 750 ml. So it’s no wonder that ladies have to empty their bladder more often than men. On the other hand, the female urethra is seven times shorter than the male one. And because men’s urethral opening and anus are farther apart, men contend with fewer bacteria in their bladder and therefore have bladder infections far less often.

From a statistical perspective, only one in a hundred men will get a UTI in his lifetime. During menopause lack of oestrogen can also weaken the pelvic floor and connective tissues and lead to bladder or uterine prolapse. More generally, changes to the balance of the hormones can also foster an irritable bladder. If the oestrogen levels sink, the bladder might react more strongly to certain substances in our urine, and less blood is supplied to the mucous membranes, which makes us more susceptible to inflammations.

However, not every bladder-voiding disorder has an organic cause – the overactive bladder is the most common gynaecological condition that cannot be fully attributed to physical causes.