Hardly anyone admits it, but bladder problems affect many people. More than 60 percent of adult women in the US experience some urinary incontinence.
Women are more often affected by incontinence (exacerbated by vaginal births, reduced estrogen, menopause, weight gain, and age) than are men.
But men are not off the hook: Benign prostatic hyperplasia (BPH), prostate surgery, poor core engagement during activity (like running or lifting), as well as general inactivity also increase risk.
Natural options are often able to reverse or reduce incontinence symptoms. This can improve quality of life and the ability to continue desired activities without fear of leakage and frequent bathroom trips and helps elders maintain independence.
Pelvic Floor Physical Therapy (PT)
This therapy is often beneficial for most people with pelvic floor and urinary problems. An experienced therapist can assess and provide customized guidance, with improvements often seen within just a few visits.
Therapies may include bladder retraining, toning or relaxing exercises, and lifestyle guidance.
Stress incontinence, prolapse, overactive bladder, excess tension, or laxity may benefit from different approaches. In some situations, surgery may be necessary. However, “We see many people preoperatively who do so well with physical therapy that they decide not to do surgery,” says pelvic floor physical therapist Susan Ramsey, PT, who practices in Scarborough, ME.
A pelvic floor physical therapist also helps ensure that exercises like Kegels are done properly.
Ramsey recommends a pelvic floor therapist with at least five years of experience and advanced training through the American Physical Therapy Association, Herman and Wallace Pelvic Rehabilitation Institute, or Pelvic Global Academy, noting that out-of-pocket PT therapists may have greater flexibility to support clients with longer, customized appointments yet fewer overall visits.
Holistic Help
Natural remedies often approach urinary leakage and pelvic floor health via a few potential angles such as hormone support, nervous system tonics, gentle astringent and toning herbs, and nutrients for pelvic tissue tone.
Many of the natural options that treat BPH also help bladder symptoms in various ages and genders.
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Pumpkin Seed Oil
Pumpkin seed oil often produces improvements within a few days or weeks, with enhanced benefits over time.
The oil may have specific effects for overactive bladder, nighttime urination, and tone, as well as 5-alpha reductase inhibition. Although 5-alpha reductase inhibition is best known for balancing androgen conversion in BPH, it also supports estrogen levels and excessive androgens in menopause and polycystic ovarian syndrome.
Studies confirm the oil’s ability to reduce symptoms of overactive bladder, frequent and nighttime urination, as well as reduced bladder tone, BPH, and lower urinary tract symptoms.
Many studies on BPH find pumpkin seed oil almost as effective as drug therapies, with minimal side effects. Research in menopause is limited but promising.
One high-dose study (10 grams oil/day) in a mixed gender group of 45 people with overactive bladder found pumpkin seed significantly reduced the symptom score at 6 and 12 weeks, with total symptoms reduced to nearly 40 percent, and urgency score reduced by 93 percent.
Of the few studies conducted on women, one that combined pumpkin seed oil with hops (estrogenic) and aromatic sumac bark (astringent) noted significant improvements in overactive bladder and incontinence. Many peri- and post-menopausal clients notice improvements with pumpkin seed oil pills.
I also like combining pumpkin seed oil with 800 to 1,500 milligrams (mg) shatavari root pills long term in people who are also experiencing menopause-related symptoms like dryness, hot flashes, stress, anxiety, and insomnia.
A typical daily dose is 500 to 1,000 mg of pumpkin seed oil.
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Nettle Root / Saw Palmetto
Nettle Root and/or Saw Palmetto also inhibit 5-alpha-reductase while improving bladder and pelvic floor health and urinary frequency.
Nettle root, an easy-to-grow weed, is less common commercially but far more sustainable than saw palmetto berries (which have limited wild range in the southeast and are increasingly threatened by overharvesting, climate change, rural development, and adulteration).
In one study, nettle root reduced urinary symptoms associated with BPH by 78 percent at three months and 91 percent at six months. Typical doses of the root extract are 600 mg twice daily or 300 mg three times daily long term.
Many studies note that the best results occur with long-term use, with full benefits presenting between six and 12 months of use, maintained with continued use with a high degree of safety.
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Mullein Root
Mullein root has a reputation in the herbal community for pelvic floor and bladder tone.
This is a different part of the mullein plant: the leaf is popular for lung health. It is often combined with horsetail (a silica-rich connective tissue support and diuretic herb) and other herbs.
It’s rare to find mullein root commercially except via a few herb farms. According to herbalist Christa Sinadinos, founder and director of The Northwest School for Botanical Studies in Fieldbrook, CA, the roots of Verbascum Thapsus and olympicum can be cultivated or wildcrafted and used to make tea or tincture.
Be sure to rule out the toxic plant foxglove, which looks similar to mullein before they bloom.
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Marshmallow / Corn Silk
Marshmallow root or leaf and cornsilk are soothing, gently mucilaginous diuretics popular in tea blends for urinary irritation and sensitive bladder. They can be taken short term when needed or longer term for chronic states.
Consider adding silica-rich nutritive herbs like oat straw or horsetail and gentle nervous system relaxants like holy basil or rose petals to the tea, suggests Ramsey, who is also a clinical herbalist.
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Topical Estrogren Support
One of the best recognized conventional therapies for menopause-related incontinence is doctor-prescribed topical estrogen cream.
While few natural therapies have explored topical options for incontinence, a 2023 study on topical hops gel was as effective as estradiol for post-menopause sexual dysfunction.
Consult an Expert
Note: Frequent urination, incontinence, and/or uncomfortable urination can be caused by many situations that warrant different care, including:
- diabetes
- nerve problems
- overhydration
- electrolyte imbalance
- urinary tract infections
Always consider visiting a doctor for assessment first.
An herbalist or naturopathic doctor may be able to provide customized natural medicine for your situation.
