Overactive bladder (OAB): medication treatments for women and men

(February 18, 2018); updated May 29, 2020

The most common type of incontinence in men and women is stress incontinence, which is defined as "involuntary leakage of urine from the bladder accompanying physical activity which places increased pressure on the abdomen." Examples of activities that trigger it include coughing, sneezing, laughing, or exercising. Treatment usually involves exercise and diet modifications. As a last resort, surgery options are available.

Another common type of incontinence is "overactive bladder" (OAB), which is recent terminology for "urgency incontinence." This is defined as "involuntary leakage of urine from the bladder when a sudden strong need to urinate is felt." First line treatment for overactive bladder (like stress incontinence) is diet and exercise-related. Additional treatment options for OAB include medications, electrical nerve stimulation, Botox injections, and surgery.

Patients may also have a combination of stress incontinence plus overactive bladder. Treatment choices for combination symptoms would depend on which symptoms (stress or OAB) are the most prevalent. Women are more affected than men by these conditions, and both male and female older patients are more susceptible. Hormone-related changes related to menopause in women and age-related BPH (enlarged prostate) in men are considered to be contributing factors.

Here are some frequently prescribed medications for OAB, along with examples (not a complete list) of common as well as serious side effects for each drug category. Antimuscarinics work by relaxing the bladder and/or reducing bladder spasms, while the BPH-related drugs help shrink the prostate gland. The second column provides the AskaPatient average rating score (5=highly effective, 1=not effective). Click drug name to read patient reviews.

Drugs for Overactive Bladder (OAB) in Men and Women

Common: dry mouth and constipation. Serious: may cause anaphylaxis and facial swelling
Vesicare 2.3
Detrol 3.9
Enablex 4.4
Toviaz 3.0
Oxytrol 2.3
Sanctura 3.3
Sanctura XR 4*
*only one rating
Beta-3 Agonist:
Common: increase in blood pressure
Myrbetriq 3.0

Drugs for Overactive Bladder (OAB) in Men due to BPH

Alpha Blockers
Common: dizziness, decreased blood pressure
Flomax 2.3
Cardura 2.6
Rapaflo 2.1
Hytrin 3.4
Uroxatral 3.0
5-Alpha Reductase Inhibitors
Common: sexual dsyfunction Serious: increased risk of high-grade prostate cancer
Proscar 3.0
Avodart 3.2

Sources and additional reading:

Definitions: Merriam Webster Medical Dictionary
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
The NIDDK provides the following articles discussing diagnosis methods along with descriptions of the full range of treatment options.

Women: https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women

Men: https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-men