Louise Chang, MD
Overactive bladder treatment has come a long way. Now you don't have to live with the worry that you'll have to rush to find a bathroom, or have an accident, when there are so many different options available to control the condition. Lifestyle interventions such as bladder retraining and pelvic floor exercises and medications are just a few of the methods your doctor might recommend to relieve the urge to go.
Even with so many treatment choices for overactive bladder, you might be curious about what other, alternative options are out there, including herbal remedies. "I think people may turn to these herbal therapies if they've tried other things and they haven't worked, or if they just have a preference for that with their lifestyle choices," says Tomas L. Griebling, MD, MPH, vice chair of the University of Kansas department of urology.
The herbal supplements you've seen advertised on the Internet or lining the shelves of your local pharmacy claim they can relieve your overactive bladder with virtually no side effects. You might have wondered, do these herbal remedies really work for overactive bladder, or are they nothing more than marketing hype?
Ask a urologist which herbal remedies he or she recommends for overactive bladder, and you're likely to get more questions than answers. "The problem is, we don't really know, because a lot of these things haven't been tested in a really scientific way," Griebling says. "We don't have good, objective information about what the risks or dangers are."
As director of the Integrative Urological Center at NYU's Langone Medical Center, Geovanni Espinosa, ND, LAc, CNS, specializes in alternative and naturopathic treatments for urinary tract problems, and he agrees that the research on herbal remedies for overactive bladder is virtually nonexistent. "There are herbs that are used traditionally," he says. "Whether or not they work, I don't know."
Without medical studies, he says there's no way of knowing how these treatments affect the urinary tract. "That's the limitation. You don't know exactly how they work until they're looked at scientifically."
Even without solid evidence to support their use, a few herbal remedies are formulated specifically for overactive bladder. Most of the herbal preparations contain not one, but several different herbs combined. Incorporating a variety of herbs is thought to have a synergistic effect, addressing a urinary problem from several different angles at once, Espinosa says.
Here are some of the most commonly used herbal remedies for overactive bladder, and how some experts think they work:
Gosha-jinki-gan: One of the best-studied herbal remedies for bladder problems is gosha-jinki-gan, which is made from a combination of several different herbs. A couple of small studies out of Japan found that gosha-jinki-gan improved urinary urgency, frequency, nighttime urination, and quality of life in both men and women with overactive bladder. Based on animal studies, researchers believe this herbal supplement increases bladder capacity and reduces the number of bladder contractions via its effects on the nervous system.
Buchu (Barosma betulina):South Africans have used preparations made from the buchu plant for hundreds of years to treat a number of different ailments, including bladder and kidney infections. The secret behind this medicinal plant likely lies in its anti-inflammatory, antibacterial, and diuretic properties. Buchu remedies may act like tonics to improve the overall health of the urinary system, according to Espinosa. "They nourish the bladder tissue -- make it healthier, more supple," he says.
Cleavers: This herb gets its name from the small hooked hairs on its leaves that cause it to "cleave" -- or attach to -- anything that touches it. Cleavers is an ingredient in herbal remedies for treating urinary problems, in part because of its diuretic effect. It also acts as a soothing coating along the inside of the bladder wall that may protect against irritation -- one cause of overactive bladder, Espinosa says.
Cornsilk: Gathered from the silky, hair-like threads of the corn stalk, cornsilk has been a remedy for urinary infections for so long that even the ancient Incas once used it. Cornsilk may have a soothing effect on the urinary tract.
Horsetail: This relative of the fern descends from gigantic plants that existed some 400 million years ago. Horsetail acts as a diuretic, anti-inflammatory, and antioxidant. It's been used to treat kidney and bladder stones, urinary tract infections, and incontinence, although there isn't much research to prove its effectiveness in humans.
Saw palmetto: Several studies have focused on saw palmetto for urinary symptoms, particularly in men who have an enlarged prostate gland. Doctors aren't exactly sure how saw palmetto works, but they say its benefits might have something to do with its ability to fight inflammation, as well as its effects on testosterone levels (which affect prostate growth).
Sometimes naturopathic doctors recommend herbal remedies to target the underlying processes that may contribute to an overactive bladder, including inflammation and oxidative stress. For inflammation, Espinosa recommends anti-inflammatory remedies such as bromelain or quercetin. To combat the oxidative stress that can irritate nerves surrounding the bladder, he advises his patients to take antioxidants such as vitamin C, vitamin E, and alpha-lipoic acid.
Herbal remedies seem pretty innocuous. After all, they're made from plants. However, Griebling cautions that what you see with an herbal remedy isn't always what you get. "Even if something is labeled as 'all-natural,' that doesn't mean it's without a potential risk," he says.
The FDA doesn't regulate herbal remedies like it does traditional medications. "There can be differences in what's in them from batch to batch or even from pill to pill," Griebling says. The ingredients listed on the label aren't always accurate indicators of what you'll find inside the bottle. When they were tested, some herbal remedies were found to contain prescription-strength medications, meaning they could share the same side effects as those medications.
You don't have to avoid herbal remedies entirely. They can be a useful addition to the medications or treatments your doctor has recommended for overactive bladder. But when you do try herbal supplements, use a little bit of caution.
Tell your primary care provider or urologist which herbal supplements you plan to try, and make sure they won't interact with any of the drugs you're already taking. A naturopathic or holistic doctor, who specializes in the use of herbal remedies to treat medical conditions, can steer you to the right supplements based on your symptoms, the medications you're taking, and your general health.
Although there isn't much evidence on the use of herbal remedies for overactive bladder, that may change. Griebling says medical organizations like the National Institutes of Health are increasingly recognizing herbal remedies as a legitimate addition to traditional medicine, and they're devoting more research dollars to these therapies as a result. "I think there will be more information on these types of treatments in the future," Griebling says.
If you're looking for an alternative therapy, remember that herbal remedies aren't the only "natural" treatments for overactive bladder. Avoiding foods like caffeine and alcohol that irritate the bladder, going to the bathroom on a schedule, and doing pelvic floor exercises are other ways to treat overactive bladder without medication, and they can be very effective, Griebling says.
SOURCES:Tomas Griebling, MD, MPH, vice chair, department of urology, University of Kansas.Geovanni Espinosa, ND, LAc, CNS, director, Integrative Urology Center, Langone Medical Center, New York University.Ogushi T. Hinyokika Kiyo, December 2007; vol 53: pp 857-862.Kajiwara M. Hinyokika Kiyo, February 2008; vol 54: pp 95-99.Nishijima S. The Journal of Urology, February 2007; vol 177: pp 762-765.Gotoh A. Journal of Pharmacological Sciences, 2004; vol 96: pp 115-123.Bratman, S. Collins Alternative Health Guide, HarperCollins, 2007.Elkins R. Natural Treatments for Urinary Incontinence, Woodland Publishing, 2000.University of Maryland Medical Center: "Horsetail."Nirit Rosenblum, MD, assistant professor of urology, female pelvic medicine & voiding dysfunction, Langone Medical Center, New York University.Azadzoi K. The Journal of Urology, August 2007; vol 178: pp 710-715.Suzuki M. Acta Pharmacologica Sinca, March 2009; vol 30: pp 227-281.University of Maryland Medical Center: "Saw Palmetto."
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