The physical effects of overactive bladder are obvious. But the emotional impact isn’t talked about as much.

You might avoid going out with friends, playing sports, or visiting your grandchildren because you’re self-conscious about leaking or having to stop a lot to use the bathroom.

“People start to live their lives around management of their bladder,” says Aqsa Khan, MD, a urologist at the Mayo Clinic in Phoenix, AZ.

It can affect your social life 

Even at home it can make the simplest social interactions stressful. Khan says one of her patients, a 50-year-old woman, described having a chat with her neighbor in the garden when she suddenly started to pee in the middle of her conversation.

To cover it up, she turned the garden hose onto herself.

The loss of control, Khan says, can be devastating. “It’s losing something that really defines you as a social being,” she says. “It makes you feel infantilized, in a way. It takes you back to wearing nappies.”

It can affect intimacy issues

This can affect you in several ways. You might avoid sexual activity because you’re worried about leaking.

This can then lead to bigger relationship issues. If your partner doesn’t know what’s wrong, they may think it has something to do with them.  Try your best to open up and trust your partner to be supportive.

Intimacy challenges are tough enough for couples who have been together for a while but they can be even more overwhelming when you’re just dating.

“Bladder issues can be a huge elephant in the room when starting up those more intimate relationships,” says A. Lenore Ackerman, MD, PhD the research director for UCLA Health’s Division of Female Pelvic Medicine and Reconstructive Surgery.

It can affect your sleep and be a factor in depression

You might wake up four times a night but go right back to sleep each time. Others may only get up twice a night. But they have so much trouble getting back to sleep each time that it has a huge effect on their quality of life.

When you don’t get enough rest, your body doesn’t get the chance to recuperate. This could lead to other issues, including problems with brain function.

There is a strong link between bladder issues and depression, Ackerman says, and poor sleep is a key factor.

It can affect stress levels 

The anxiety surrounding OAB can also make your physical symptoms worse. Just as you might clench your jaw without realizing it, people with bladder issues often clench their pelvic floor muscles.

You may not realise it,  but your pelvic floor is always active: supporting your pelvis, holding up your organs. If we’re constantly clenching our pelvic floor muscles to resist the urge to pee, then the anxiety surrounding that urge builds up.

There is also a physical consequence because this nonstop squeezing puts a lot of pressure on those muscles,  so much so they lose control when you need them the most.

You could see a big change in your symptoms just by working on ways to ease your anxiety and the pelvic floor tension that comes with it.

It can affect your willingness to get help

If you’re older, you might think urinary issues are a normal part of ageing, but they’re not. However for younger women bladder issues can carry an additional level of shame and self-blame. You might wonder how this could be happening or what’s “wrong” with you.

Shame can be a major block in asking for help, but this is more common than you think. By talking about it more, others will likely feel more comfortable looking for long-term treatments instead of just managing symptoms with pads, backup underwear, catheters, and other items.

They can be a great way to take back control. For instance, products are often designed with light, flattering fabrics that secretly hold lots of fluids, but they sometimes stop people from getting professional help when it is needed.

You don’t have to manage this alone, and your doctor can’t help if they don’t know you are having  a problem.

Helpful information 

It doesn’t matter if you’re 28 years old or 88 years old because your bladder can be retrained at any point in your lifetime.

The key is to be persistent and take care of your overall health, and exercises such as Kegel are found helpful by many women.

Naturally enough your hormone balance is critical for this issue. Progesterone cream applied at bedtime may help reduce the need to urinate and allow for more uninterrupted sleep and oestrogen used vaginally has been shown to improve bladder and urinary tract tissue, so for some women a combination cream may be more helpful.

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