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Take Control of Your Bladder Without Drugs

Do any of these scenarios sound familiar?

• For years, Jane leaked urine whenever she sneezed, laughed or coughed. But now her leaky valve is such a problem that she turns down social invitations. She has even stopped taking her daily two-mile walk because she’s afraid of being away from a toilet.


• Tom wakes up to go to the bathroom anywhere from two to five times a night. He’s always tired in the morning, feeling as though he has hardly slept.


• Linda’s husband hates taking road trips with her because she gets the urge to go NOW, and has to stop at all the rest stops along the way.


• Susan and her husband used to have a great sex life. Now she avoids physical intimacy because of her embarrassing incontinence.

What do all these people have in common?

It’s called Overactive Bladder, and it affects approximately 33 million adults in the United States.1 In addition to being inconvenient, Overactive Bladder (OAB) has a significant effect on quality of life, quality of sleep, and the mental and emotional health in both men and women.2

If you have Overactive Bladder you may feel a strong, sudden urge to urinate (40% of people with OAB have involuntary loss of urine) … or you may find yourself spending too much time running to the bathroom—day and night. Either way, it’s a condition characterized by a sudden, uncomfortable need to urinate with or without urine leakage.

“Although it’s the subject of numerous jokes, Overactive Bladder (OAB) has a significant effect on quality of life, quality of sleep, and the mental and emotional health in both men and women.”

What causes Overactive Bladder Syndrome?

Although the exact cause is not completely known, the following are believed to be contributing factors:

• Enlarged prostate in men
• Urinary tract infections
• Weakened muscles (urethral sphincter and pelvic-floor) that control urination
• Obesity
• Smoker’s cough
• Stretched pelvic muscles from pregnancy and childbirth
• Side effects of certain drugs
• Frequent constipation
• Irritable bowel syndrome
• Damage to or diseases of the brain or spinal cord, including dementia, spinal cord injury, stroke or MS
• An obstruction or blockage in the urethra or bladder
• Anxiety, depression & attention deficit disorder
• Fibromyalgia

What can you do about it? The difference between natural remedies and pharmaceutical drugs

You can take a pharmaceutical drug to decrease urgency, frequency and urge incontinence—but then you’d have to cope with the possible common side effects of dry mouth, constipation, headache and blurred vision. Added to that, one researcher who studied the effect of an anticholinergic agent (the typical ingredient used to prevent involuntary contractions of the bladder muscle) found that memory loss is a real concern for people who take some of these drugs. “We transformed these people from functioning like 67 year olds to 77 year olds,” said Gary Kay, Ph.D., Associate Professor of Neurology and Director of Neuropsychology, Georgetown University, Washington D.C.3

Dr. Kay is recognized for his expertise on the effect of medications on brain functioning (memory, performance, cognitive function, safety), a consultant to federal agencies (ie. FAA, Department of Defense), developer of cognitive tests utilized in NIH trials, CDC investigations and industry (aviation and pharmaceutical). “You can take a pharmaceutical drug to decrease urgency, frequency and urge incontinence—but then you’d have to cope with the possible common side effects of dry mouth, constipation, headache and blurred vision.”

Play it safe by taking proven nutritional remedies

Like many medical conditions, a person often has three basic choices. Ignore it hoping that it goes away, take pharmaceutical drugs that attack the symptom but can cause dangerous side effects, or try proven nutritional remedies. These remedies can:

• Help control overactive bladder without side effects
• Support and sustain healthy bladder function

The combination of pumpkin seed extract and soy germ isoflavones produces excellent benefits for Overactive Bladder Syndrome. “The participants experienced a reduced number of urinary accidents as early as one week after beginning the program. ”

In three clinical trials4,5,6 participants were given a combination of lipid-free pumpkin seed extract and soybean germ extract over a period of seven weeks. Measurements were taken for frequency of urinaton during the day and night, and for number of accidents.

The participants experienced a reduced number of urinary accidents as early as one week after beginning the program. Frequency of the need to urinate at night dropped from 7.3 times to as little as 1.5 times at the end of the sixth week. This greatly improved the quality of restful sleep and their overall quality of life, in addition to reducing anxiety.

Daytime results were equally rewarding, which greatly improved the quality of life for participants. More than 80% of the participants experienced improvements after the six-week study.

Soy germ extract, especially when combined with pumpkin seed extract, has a very positive effect on Overactive Bladder Syndrome in both women and men. “More than 80% of the participants experienced improvements after the six-week study.”

Soy germ isoflavones are a class of phytoestrogens—plant-derived compounds with estrogenic activity. They have been the subject of thousands of studies over the past several decades, and have been shown to help protect against breast and prostate cancer, heart disease, osteoporosis, and menopausal symptoms. The chemical structure of isoflavones resembles human estrogen. Since incontinence is associated with decreased production of estrogen in women and enlarged prostate in men, soy isoflavones have been demonstrated to be beneficial for both conditions.

That sounds confusing, but there are estrogen receptors found on the surface of almost every cell in your body. Soy isoflavones, as other phytoestrogens, bind to estrogen receptors throughout the body, reducing or activating estrogen, as needed. When they bind to receptors the isoflavones act as adaptogens,7 which means they help balance the estrogen levels.

According to Christiane Northrup, M.D., author of The Wisdom of Menopause (Bantam Books, 2001) and Women’s Bodies, Women’s Wisdom (Bantam Books, 1998), if your estrogen levels are too high isoflavones will block the stronger estrogens, decreasing the health risks of excess estrogen. But if your estrogen levels are low the isoflavones will have an estrogenic effect.

The body’s natural level of estrogen drops in menopausal women. Isoflavones are able to compensate for this by binding to estrogen receptors, and consequently easing menopause symptoms.

On the other hand, as men age the amount of active testosterone in the blood decreases, leaving a higher proportion of estrogen. This results in an enlarged prostate gland and a condition called benign prostate hyperplasia, commonly referred to as BPH. One theory based on animal studies suggests that BPH may occur because the higher amount of estrogen within the gland increases the activity of substances that promote cell growth.

As BPH develops, the prostate gland presses against the neck of the bladder or urethra, squeezing the pipe shut like stepping on a garden hose. As the bladder wall becomes thicker and irritable, it begins to contract even when it contains small amounts of urine. This results in more frequent urination, and eventually the bladder weakens and loses the ability to empty itself. The narrowing of the urethra and partial emptying of the bladder causes many of the problems associated with BPH, including:

• Urgency—the need to go immediately
• During urination, there is a thin stream of urine that stops and starts instead of a full, steady stream
• Hesitancy or difficulty starting urine flow
• Dribbling after urinating
• Nocturia—having to get up frequently at night to urinate
• Increased frequency of urination
• Increased risk of infection if the bladder does not empty entirely and urine is retained

Soy germ extract provides beneficial effects by:

• Helping regulate estrogen levels in the body
• Providing antioxidant protection against free radical damage
• Preventing abnormal cell growth

Scientific studies

Despite the thousands of studies on soy isoflavones, there are lots of conflicting reports about its safety for use among women who have had breast cancer. The most recent literature reports that there seems to be no reason that breast cancer patients cannot eat soy foods or take soy isoflavones.8,9

However, there are conflicting reports on the benefits of isoflavones in humans, and scientists are still unsure of how it exactly works. Evidence suggests, though, that the consumption of soy isoflavones is related to lower rates of BPH and prostate cancer among Asian men.10

One study done on laboratory animals found that soy isoflavones reduced bladder pressure and reduced inflammation. The researchers concluded that the anti-inflammatory effects of soy might contribute to the lower incidence of prostatitis-like symptoms (prostate infection), and the lower risk of BPH.11

Pumpkin seed extract (Cucurbitae peponis semen)—pumpkin has been used in traditional medicine for centuries, especially to get rid of intestinal worms and parasites. Native Americans have also used pumpkin seeds to relieve irritable bladder, urinary burning, edema, gout, kidney stones, and digestive problems.

In the past two decades, pumpkin seed extract has become popular as a treatment for the urinary complaints associated with an enlarged prostate (benign prostatic hyperplasia—BPH), such as increased frequency and urgency of urination, and disruption of sleep due to frequent urination. A randomized, double-blind study with 53 patients done as early as 1990 verifies this.12

How does pumpkin seed extract work?

Pumpkin seed extract provides beneficial effects by:

• Providing a wide spectrum of nutrients, including essential fatty acids, tocopherol (vitamin E), carotenoids, selenium, and magnesium.
• Providing a rare protein called myosin, a unique protein constituent of most muscles in your body, which is involved in the chemistry of muscular contraction
• Reducing bladder pressure and urethral pressure 13
• Helping to strengthen the pelvic floor muscles

Scientific studies

A German multi-center, placebo-controlled, double-blind study was conducted on 542 men with early stage benign prostatic hyperplasia, who also had lower urinary tract infections. The patients were randomly assigned to take 500 mg pumpkin seed extract twice daily or a placebo for 12 months.

According to the International Prostate Symptom Score (IPSS)—a method of evaluating symptoms associated with BPH—a reduction of at least 5 points indicates a significant improvement. After 12 months of treatment, 64.8% of the patients who took the pumpkin seed extract improved by at least 5 points in the areas of urinary flow and frequency, residual urine and quality of life. The IPSS improved in 54.2% of the placebo group.

Frequency of urination decreased significantly during the daytime in the pumpkin seed group but did not decrease significantly during the night in either the pumpkin seed or the placebo group.

“After 12 months of treatment, 64.8% of the patients who took the pumpkin seed extract improved by at least 5 points in the areas of urinary flow and frequency, residual urine and quality of life.”

The results suggest that the pumpkin seed extract had a positive effect on the smooth bladder and prostate muscles. The researchers concluded that pumpkin seed extract should be favored over the use of alpha-blockers and finasteride, a drug used to reduce the amount of testosterone produced by the body, when treating urinary complaints associated with BPH.14

Kohki Tea Extract comes from a subtropical plant that grows wild in Southern China. It has been used medicinally in East Asia for hundreds of years and is sold over the counter in Japan today as a sweet tea. The tea contains strong antioxidants, including several dihydroflavonol glycosides that have been shown to have a significant protective effect on bladder function in rabbits that had difficulty urinating.

Kohki tea extract provides beneficial effects by:

• Providing antioxidant protection against free radical damage
• Preventing the adverse changes in the bladder that accompany BPH

Scientific studies

Although no clinical studies have been done on humans, two studies in which laboratory animals were given kohki tea found that the extract acts by protecting the bladder from the detrimental effects of repetitive stimulation and contractile damage caused by lack of oxygen,15 and from the effects of partial outlet obstruction, as in BPH.16

Despite the sparse scientific research, these two studies were carefully executed, and because of the long history of its use, we feel that kohki tea extract is of particular benefit for overactive bladder syndrome.

Cranberry Extract—from the cranberry fruit—was used by Native Americans to treat bladder and kidney ailments. It has also been used in traditional medicine for hundreds of years to treat blood disorders, digestive complaints, liver problems, and scurvy.

More recently, cranberry extract has become a popular and scientifically proven remedy for the prevention and treatment of urinary tract infections. Although many individuals resort to drinking large quantities of cranberry juice, most juice is laden with sugar—unless you get the pure cranberry concentrate, which is extremely tart. Your best bet is to take cranberry extract, which could be considered for any of these symptoms:17

• Frequency
• Urgency/leakage
• Burning Pain/stinging
• Straining
• Voiding in small amounts

Urine travels down two thin tubes called ureters to the bladder.

Cranberry extract provides beneficial effects by: Reducing the risk of E. coli adhesion to the cells that line the bladder and urethra. 18 Scientific studies: A recent double-blind randomized placebo-controlled cross-over trial tested the effectiveness of cranberry juice versus placebo on 10 men and 10 women. In addition to a normal diet, each volunteer received a single dose of cranberry juice at dinner or placebo.

The first urine of the day was used as a sample to support the growth of E. coli, previously isolated from patients with urinary tract infections. The researchers observed a dose dependent significant decrease in the adhesion of the E. coli resulting from consumption of the cranberry juice, when compared to the placebo.18

In another recent open label pilot study, 12 women (ages 25-70) with a history of a minimum of 6 urinary track infections (UTIs) in the proceeding year took a concentrated cranberry preparation for 12 weeks. The women were available for follow up two years later. During the study none of the women had a UTI. Two years later, eight of the women who continue to take cranberry continue to be free from UTIs.19

A study of 10 young women with recurrent bladder infections found that, compared with placebo, taking a capsule containing 400 mg of Cranberry extract daily for three months significantly reduced new infections. Of the 21 bladder infections that arose, only six occurred among women taking Cranberry.20

A year-long Canadian study of 150 sexually active women found that cranberry juice and tablets significantly decreased the number of patients experiencing at least one symptomatic UTI/year (to 20% and 18% respectively) compared with placebo (to 32%) (p<0.05). The study also found that taking Cranberry was much more cost effective than taking antibiotics.21

Conclusion

Overactive Bladder Syndrome can interfere with your daily work schedule and weekend social life. It can wreak havoc on your personal relationships and prevent you from living life to the fullest. And it can even lead to anxiety, depression and low self-esteem.

Let’s face it; it’s not fun having to go to the bathroom all the time. Don’t avoid dealing with overactive bladder syndrome because it’s an embarrassing issue. Take charge now of your bladder health by trying the natural remedies discussed in this Health and Wellness Update. They are safe, natural, time tested, and scientifically proven to make a difference without the unnecessary worry of side effects from pharmaceutical drugs.

References

1. Stewart WF; Van Rooyen JB; Cundiff GW; Abrams P; Herzog AR; Corey R; Hunt TL; Wein AJ. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003; 20(6):327-36 (ISSN: 0724-4983).
   Abstract
   
   
2. Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001;87:760-766.
   
   
3. Antimuscarinic Drugs and Memory Loss in Patients With Overactive Bladder: An Expert Interview With Dr. Gary Kay. Medscape Urology.  2006;8(1) ©2006 Medscape
   Abstract
   
   
4. Yanagisawa, Ei et al. Study of Effectiveness of Mixed Processed Food Containing Cucurbita Pepo Seed Extract and Soybean Seed Extract on Stress Urinary Incontinence in Women. Japanese Journal of Medicine and Pharmaceutical Science 14; No. 3:313 – 322. 2003.
   
   
5. Sogabe H. and Terado T. Open Clinical Study of Effects of Pumpkin See Extract/Soybean Germ Extract Mixture-containing Processed Food on Nocturia. Japanese Journal of Medicine and Pharmaceutical Science. Nov, 2001. 46(5):727-37.
   
   
6. Terado T et al. Clinical Study of mixed processed foods containing pumpkin seed extract and soybean germ extract on pollikiuria in night in elderly men. Japanese Journal of Medicine and Pharmaceutical Sciences 52 (4):551-561. 2004.
   Abstract


7. Elghamry, M.I., & Shihata, I.M. (1965). Biological activity of phytoestrogens. Planta Medica, 13, 352-357.
   
   
8. Messina MJ, Loprinzi CL. Soy for breast cancer survivors: a critical review of the literature. J Nutr. 2001 Nov;131(11 Suppl):3095S-108S.
   Abstract
   
   
9. Messina MJ, Wood CE. Soy isoflavones, estrogen therapy, and breast cancer risk: Analysis and commentary. Nutr J. 2008 Jun 3;7(1):17. [Epub ahead of print]
   Abstract
   
   
10. Katz AE. Flavonoid and botanical approaches to prostate health. J Altern Complement Med. 2002 Dec;8(6):813-21.
    Abstract
    
    
11. Yatkin E, Streng T, Kauppila ML, Bernoulli J, Saarinen N, Santti R. The soy effect in the disease models of nonbacterial prostatitis and obstructive voiding. Exp Biol Med (Maywood). 2007 May;232(5):674-81.
    Abstract
    
    
12. Carbin BE, Larsson B, Lindahl O. Treatment of benign prostatic hyperplasia with phytosterols. Br J Urol. 1990 Dec;66(6):639-41
    Abstract
    
    
13.  Zhang X, Ouyang JZ, Zhang YS, Tayalla B, Zhou XC, Zhou SW. Effect of the extracts of pumpkin seeds on the urodynamics of rabbits: an experimental study. J Tongji Med Univ. 1994;14(4):235-8.
    Abstract
    
    
14. Bach D. Placebo-controlled, long-term therapeutic study of a pumpkin seed extract product in patients with micturition complaints from benign prostatic hyperplasia. [originally published in German] Der Urologe B 2000;40(5):437-443.
    Abstract
    
    
15. Levin RM, Leggett RE, Whitbeck C, Murakami T, Kambara T, Aikawa K. Oral Kohki Tea and its protective effect against in vitro ischemic damage to the bladder. Neurourol Urodyn. 2004;23(4):355-60.
    Abstract
    
    
16. Levin RM, Kawashima Y, Leggett RE, Whitbeck C, Horan P, Mizutani K. Effect of oral Kohki tea on bladder dysfunction induced by severe partial outlet obstruction. J Urol. 2002 May;167(5):2260-6.
    Abstract
    
    
17. Presser, Arthur M. Pharmacists' Guide to Medicinal Herbs. Petaluma, CA: Smart Publications, 2000, 109-112.
    
    
18. Howell AB. Bioactive compounds in cranberries and their role in prevention of urinary tract infections Mol Nutr Food Res. 2007 Jun;51(6):732-7.
    Abstract
    
    
19. Bailey DT, Dalton C, Joseph Daugherty F, Tempesta MS. Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study. Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study.
    Abstract
    
    
20. Walker EB, et al. Cranberry concentrate: UTI prophylaxis. J Fam Prac 1997;45:167-8.
    
    
21. Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. Can J Urol. 2002 Jun;9(3):1558-62.
    Abstract
    
    
22. Klausner AP, Steers WD. Antimuscarinics for the treatment of overactive bladder: a review of central nervous system effects. Curr Urol Rep. 2007 Nov;8(6):441-7.
    Abstract
    
    
23. Sink KM, Thomas J 3rd, Xu H, Craig B, Kritchevsky S, Sands LP. Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes. J Am Geriatr Soc. 2008 May;56(5):847-53. Epub 2008 Apr 1.
    Abstract