Textbook Signs You Have an Overactive Bladder

Always gotta go? Here’s how to tell if it’s OAB.

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You’re sitting at your desk at work trying to bang out a few more emails before lunch, when—wham. You need to go to the bathroom, like NOW. No warning, no nothing. And when you do run to the restroom and pray for an open stall, you realize you only urinated a tiny little amount, given how badly you needed to rush there. And over weeks or months, you realize this is happening more and more, maybe even every hour or so.

This out-of-nowhere need to urinate, and the high frequency of how often you hit the bathroom, are telltale signs of overactive bladder (OAB), a condition that causes you to feel a sudden urge to urinate.

So how do you know whether it’s OAB, or just your body’s reaction to that Venti iced coffee? If you have two or more of these symptoms, it might just be OAB.


“The root [symptom] is always urgency,” says Lauri Romanzi, MD, a urogynecologist in New York City. “With urgency, you feel fine, you don’t feel like you have to go at all, you don’t feel like your bladder is even a little bit full. And suddenly you have an intense sensation of fullness that is bordering on feeling like you’re going to urinate right in that moment. It’s a sudden onset, it’s anxiety provoking,” says Dr. Romanzi.  “The coping mechanism [for urgency] often leads to frequency,” says Dr. Romanzi.


Frequency, by definition, means you’re urinating more than eight times in 24 hours. “Patients typically describe frequency in terms of rates of change. [Like,] ‘I used to urinate twice a day, now I’m urinating six times a day.’ This frequency also causes anxiety. Particularly in the workplace, because you look like you’re constantly leaving your desk,” says Dr. Romanzi.


Overactive bladder is very often, but not always, accompanied by frequent nighttime voiding, called nocturia. Most people can sleep through the night without urinating, but more than one-third of adults suffering from nocturia make at least two trips to the bathroom every night.

Urge Incontinence

Urge incontinence is when you have OAB, but your bladder squeezes or contracts at the wrong times and you begin to urinate before you get to the bathroom. This can happen at any time, even when there’s very little urine in the bladder.

“A true overactive bladder has no apparent cause other than something going on with the bladder itself. It’s just a bladder that has become very cranky and is sending signals of fullness when the bladder is nowhere close to full,” says Dr. Romanzi.

Other conditions can cause urinary changes, but these are not technically OAB, since treating them will help prevent the urgency and frequency.

  • Acute urinary tract infections
  • Neurological disorders, such as stroke and multiple sclerosis
  • Diabetes
  • Abnormalities in the bladder, such as tumors, inflammation, or bladder stones

If your OAB is bothering you and affecting your quality of life, see a doc. There are many treatment options for OAB, from behavior tweaks, like avoiding bladder-irritating foods and doing kegel exercises, to medications and, in more severe cases, Botox or surgery.

“You might want to come over a little bit earlier in the symptom development curve, not only for your own health to make sure it’s not another life-threatening condition, but also because your treatment options are more likely to work,” says Dr. Romanzi.