I recently read that restless legs sometimes go hand in hand with an overactive bladder. I would never have thought of that myself.
My own bladder is also quite active. It was like that before my RLS got severe. Now that I’m in the menopause, I notice that I suddenly have a strong urine stimulus more often. I have to really do my best to make it to the toilet at times. I don’t know if I have an overactive bladder.
In this blog I take a closer look at what an overactive bladder is and its possible connection with restless legs.
What is an overactive bladder
With an overactive bladder, your bladder is extra irritable. About 1 million adults in the Netherlands suffer from it.
If urine enters the bladder, it expands. Normally you have to go to the toilet when there is 150 to 200 milliliters in it. Most people need to urinate once every 3 or 4 hours.
With an overactive bladder, you feel tension before it is full. You have to go to the toilet more often than usual, both during the day and at night. More than eight times a day and several times a night. The urge to urinate is so great that you sometimes lose some urine prematurely.
However, the more often you go to the bathroom to urinate, the harder it becomes for your bladder to hold back pee. You can do bladder training for this. You then practice tightening the pelvic floor muscles when you feel the urge. This way you learn to postpone urinating a little longer.
There are also medicines for an overactive bladder. Furthermore, in some cases neuromodulation is an option or treatments with botox.
Risk groups
There are certain medicines that cause urinary and incontinence complaints, such as antidepressants or water pills. You can also get symptoms during pregnancy or diabetes. Bladder abnormalities can cause problems or diseases in which nerves are damaged such as MS, Parkinson’s disease or Alzheimer’s disease.
Being overweight is another possible factor, as is drinking (too much) coffee, tea or other drinks with caffeine, carbon dioxide or alcohol. Stress sometimes plays a role or an excessive tension in the pelvic floor muscles. In the latter case, it is important to learn to relax the muscles again.
Older people are more likely to have an overactive bladder than younger people. In women, a prolapse or the menopause is often the reason. As they age, men develop a narrowing of the urethra due to an enlarged prostate. Incontinence is more common in women than in men.
Restless legs
In the articles I have read, it is striking that the combination of overactive bladder and restless legs is linked to another condition. This is Restless Genital Syndrome (RGS). Both men and women can have this condition.
RGS is considered the genital counterpart of restless legs. People experience similar sensations with Restless Genital Syndrome as with RLS, but now in the genital area. They experience no sexual arousal.
One description is that it is like a constant feeling of an upcoming orgasm. Previously, the condition was known as Persistent Sexual Arousal Syndrome (PSAS) or Persistent Genital Arousal Disorder (PGAD). Research has shown that people with RGS also often suffer from an overactive bladder and restless legs. A fourth component is varicose veins in the pelvis.
What also strikes me in an article about the overactive bladder is that with this condition something goes wrong in the signal transmission between bladder and brain. It seems to me that in all three disorders mentioned there is a disturbance in the neurological process.
With restless legs we are talking about a reduced production of the neurotransmitter dopamine, which causes the legs to receive wrong signals. I don’t know exactly how this works with an overactive bladder and with RGS, and perhaps it has not yet been sufficiently scientifically researched.
I do read in one of the articles that RGS may be a form of neuropathy, or in other words nerve damage. The same article mentions the possible connection with taking antidepressants and via that route with the neurotransmitter serotonin. I don’t think the last word has been said on this.
