Always Going? Why Your Bladder Is Overactive: Gemtesa & Next Steps

If you feel like you're always running to the bathroom, you're not alone. Millions of adults deal with overactive bladder (OAB)—a condition that can interrupt work, sleep, travel, and daily life.

The good news? Overactive bladder is common, treatable, and manageable. Medications like gemtesa (vibegron) are helping many people regain control.

Let's break down what's happening, why it happens, and what you can do next.

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What Is Overactive Bladder?

Overactive bladder is not a disease—it's a group of symptoms. The main symptom is a sudden, strong urge to urinate that's hard to control.

You may also notice:

• Urinating more than 8 times in 24 hours
• Waking up more than once at night to urinate (nocturia)
• Urgency that feels intense or uncomfortable
• Leakage after feeling a strong urge (urge incontinence)

OAB happens when the bladder muscle squeezes at the wrong time—even when it's not full.

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Why Is My Bladder Overactive?

Several factors can contribute to overactive bladder:

1. Bladder Muscle Overactivity

The bladder muscle (detrusor muscle) contracts involuntarily. This creates a sudden urge to urinate.

2. Nerve Signaling Issues

The brain and bladder communicate constantly. If signals misfire, your bladder may act like it's full when it's not.

3. Aging

Bladder changes are more common as we get older—but OAB is not a normal part of aging.

4. Hormonal Changes

Postmenopausal estrogen decline can affect bladder tissue.

5. Medical Conditions

Sometimes OAB is linked to:

• Diabetes
• Neurological conditions (such as multiple sclerosis or Parkinson's disease)
• Prior stroke
• Recurrent urinary tract infections
• Bladder stones

6. Lifestyle Factors

Certain habits can worsen symptoms:

• High caffeine intake
• Alcohol
• Artificial sweeteners
• Smoking
• Obesity

If symptoms are new, severe, painful, or accompanied by blood in the urine, fever, or back pain, speak to a doctor promptly. Those could signal infection or other serious conditions.

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What Is Gemtesa?

Gemtesa (vibegron) is a prescription medication approved to treat overactive bladder in adults.

It belongs to a class of drugs called beta-3 adrenergic agonists.

How Gemtesa Works

Gemtesa relaxes the bladder muscle by stimulating beta-3 receptors. This allows the bladder to:

• Store more urine
• Reduce sudden urges
• Decrease leaks
• Lower bathroom frequency

Unlike older OAB medications (anticholinergics), gemtesa does not work by blocking acetylcholine. That difference matters because it may reduce certain side effects like dry mouth and constipation.

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Benefits of Gemtesa

Clinical studies have shown that gemtesa can:

• Reduce daily urination frequency
• Decrease urge incontinence episodes
• Improve urgency symptoms
• Increase the amount of urine the bladder can hold

Many patients begin noticing improvement within several weeks, though full effects may take longer.

Gemtesa is taken once daily, with or without food.

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Possible Side Effects of Gemtesa

Like all medications, gemtesa may cause side effects. Most are mild, but it's important to be informed.

Common side effects may include:

• Headache
• Nasal congestion
• Diarrhea
• Nausea

Less commonly:

• Urinary retention (difficulty emptying the bladder)
• Increased blood pressure

If you cannot urinate, develop severe abdominal pain, or notice major changes in blood pressure, contact a doctor immediately.

Always discuss your full medical history with your healthcare provider before starting gemtesa—especially if you have bladder outlet obstruction, severe kidney issues, or uncontrolled high blood pressure.

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Is Gemtesa Better Than Other OAB Medications?

It depends on the individual.

There are two main medication classes for OAB:

1. Anticholinergics (older medications)
2. Beta-3 agonists like gemtesa

Anticholinergics can cause:

• Dry mouth
• Constipation
• Blurry vision
• Cognitive side effects in older adults

Because gemtesa works differently, it may have a more tolerable side effect profile for some people.

However, cost, insurance coverage, health history, and personal response all matter. This is a conversation to have with your doctor.

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What Else Can Help an Overactive Bladder?

Medication like gemtesa is only one part of treatment. Many people benefit from combining medication with behavioral changes.

Lifestyle Adjustments

• Reduce caffeine and alcohol
• Stop smoking
• Manage fluid intake (don't over-restrict)
• Maintain a healthy weight

Bladder Training

This involves gradually increasing the time between bathroom visits to retrain your bladder.

Pelvic Floor Exercises (Kegels)

Strengthening pelvic floor muscles can help control urgency and leaks.

A pelvic floor physical therapist can provide structured guidance.

Advanced Treatments (If Needed)

If symptoms don't improve with medication and lifestyle changes, a urologist may discuss:

• Botox injections into the bladder
• Nerve stimulation therapy
• Sacral neuromodulation

These are typically considered when first-line treatments are not effective.

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When Should You Be Concerned?

Most overactive bladder symptoms are not dangerous—but some signs require urgent medical evaluation:

• Blood in urine
• Painful urination with fever
• Severe back or flank pain
• Sudden inability to urinate
• Rapidly worsening symptoms

These could signal infection, kidney problems, or other serious conditions. Speak to a doctor right away if you experience these.

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Not Sure If It's Overactive Bladder?

Sometimes urinary symptoms overlap with:

• Urinary tract infections
• Interstitial cystitis
• Prostate enlargement (in men)
• Pelvic organ prolapse
• Bladder cancer (rare, but important to rule out if blood is present)

If you're experiencing frequent urgency or bladder control issues and want to understand your symptoms better, try Ubie's free AI-powered Overactive Bladder symptom checker. It takes just a few minutes and can help you identify whether your symptoms align with OAB before your doctor's appointment.

This is not a replacement for medical care—but it can help you prepare for your appointment.

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What to Discuss With Your Doctor

If you're considering gemtesa or another treatment, talk openly with your healthcare provider about:

• How often you urinate daily
• How many times you wake at night
• Whether you have leakage
• All medications and supplements you take
• Blood pressure history
• Any difficulty emptying your bladder

Bring a 3-day bladder diary if possible. This simple tracking tool can help guide treatment decisions.

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The Bottom Line

Feeling like you're "always going" is frustrating—but it's treatable.

Overactive bladder happens when bladder muscles contract at the wrong time. Medications like gemtesa help relax the bladder so it can hold more urine and reduce urgency and leaks.

For many people, the best results come from a combination of:

• Medication (such as gemtesa)
• Bladder training
• Pelvic floor exercises
• Lifestyle adjustments

Do not ignore new, painful, or worsening urinary symptoms. Some bladder problems can signal serious conditions. Speak to a doctor promptly if symptoms are severe, unusual, or accompanied by blood, fever, or intense pain.

You don't have to plan your life around the nearest bathroom. With the right approach—and medical guidance—you can regain control.

If you're experiencing persistent symptoms, schedule an appointment and speak to a doctor to determine whether gemtesa or another treatment is right for you.