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Understanding Incontinence

Small or Overactive Bladder: Symptoms, Causes & Treatments

The condition of a small or overactive bladder results in frequent, sudden and strong urges to urinate, but often only small amounts of urine are passed. With such little warning, it can be the culprit behind Urge Incontinence. An overactive bladder can be improved, so don’t ignore it. Find out the symptoms, causes and treatments here.

Published by Jane Granger
Small or Overactive Bladder: Symptoms, Causes & Treatments

What is a ‘small’ or ‘overactive’ bladder?

Physically, no-one truly has a ‘small’ bladder, but if you’re experiencing an overactive one (or OAB), it certainly feels like it!
According to the Continence Foundation a healthy bladder:

  • Needs to be voided every 3 to 4 hours or 4 to 8 times a day
  • Can hold 400 – 600ml, with the initial sensation of needing ‘to go’ occurring around the 200 – 300ml mark. You should be able to comfortably ignore this sensation until the bladder fills closer to capacity
  • When you need to go, you have plenty of time to get to a toilet
  • Completely empties when you urinate
  • May wake you up once in the night to go to the bathroom, twice if you’re over 65
  • Doesn’t leak

In a healthy bladder, the muscle wall contracts to expel urine. This action is voluntary and occurs when we decide to urinate. In the case of an overactive bladder, the contraction is involuntary, prompting an urgent need to go and, if you also have a weak pelvic floor muscle, the ability to ‘hold on’ just isn’t there. This can result in a small leak or in some cases, once the flow has started, it can’t be stopped, and the entire bladder empties. This is known as Urge Incontinence.


What are the symptoms of an overactive bladder?

As described above, the prominent indicator is the sudden and urgent need to urinate, often accompanied by incontinence.
You may also have an overactive bladder is your urinating more than eight times a day or more than twice in the night. It can become so frequent that it interferes with daily activities and sleep.


What causes an overactive bladder?

Exactly why the bladder starts involuntarily contracting is unknown, and as the urinary system is complex, multiple factors can be contributing to an overactive bladder, including:

  • Conditions such as diabetes, Parkinson’s Disease or multiple sclerosis
  • Some medications
  • Persistent or acute Urinary Tract Infections (UTIs)
  • Bladder disease, including tumours, stones and even cancer
  • Neurological decline or disease which can inhibit messages transmitting between the bladder and brain
  • Excessive alcohol of caffeine
  • Urine retention
  • Constipation or an enlarged prostate that’s pressing on the bladder or urethra and restricting urine flow
  • Emotional distress, anxiety and depression

What are the misconceptions about an overactive bladder?

There are several misconceptions about an overactive bladder. As a result, many people do not seek treatment for it because they do not know the facts. Common misconceptions include:

  • A normal part of ageing
  • An inevitable aspect of being a woman
  • Something that just happens as men get older


In other words, it’s not something you should accept and put up. By seeking a professional opinion, the cause can be identified, treatment planned, and the problem resolved.


What treatments are available to improve or correct an overactive bladder?

Depending on the underlying cause, treatment will vary.

To assist the diagnosis, keep a Bladder Diary for a few days before your doctor’s appointment. This will keep an accurate record of your fluid intake and voiding (voluntary and involuntary) and be sure to note how strong the urge was on a ten-point scale.

The following general advice may reduce the risk of an overactive bladder and ease symptoms, including:

  • Maintaining a healthy weight
  • Not smoking
  • Regular exercise
  • A healthy diet high in fresh fruit, vegetables, whole grains and cereals and protein (dairy, meat, fish, eggs, legumes, nuts)
  • Drink plenty of water and avoid constipation
  • Avoid food and drink that can irritate the bladder. You can read about those in this article
  • Strengthen your pelvic floor muscle to improve your ability to ‘hold on’.

Managing incontinence cause by an overactive bladder 

For women, the frequent and sudden urgency to pass urine can catch you out, leading to an involuntary leak.If you’re only losing a few drops or a small gush, a TENA liner may be the solution. These are the smallest of the TENA range, and like all of our products, are designed to handle the thinner, faster flow of a weak bladder, rapidly absorbing and locking away fluid, keeping you dry, odour free and feeling confident while the cause of your retention is being addressed.

For men, you may be experiencing Overflow Incontinence, which is usually just a small quantity. For this, TENA has anatomically shaped products that fit snugly into the front of your underwear for discreet protection. There are TENA Shields and TENA Guards and you can read about the differences here.

If you require more protection for a small or overactive bladder, including pants that look and feel like regular underwear, why not take advantage of our Product Finder Tool, and Free Samples to find the product that best suits your needs.



Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.

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