Monday, May 3, 2010

Naturopathic Treatments of Urinary Incontinence

Modern medicine can often and effectively address female urinary incontinence issues, with either a combination of behavior modification, medication or surgery, or alone as strategies. Most will have some degree of success, but the proper diagnosis must be made and proper treatment executed.

The rise in popularity of naturopathic treatments for a variety of common health conditions puts the proper pressure on western medicine to revaluate what we offer patients, and presents us sometimes with new options.

Urinary incontinence (UI) in women can usually manifest as stress incontinence (urine lost during activities or straining), or urge incontinence (urine lost with an uncontrollable urge). Kegel muscle exercises are the standard fist line treatment that can help either type of UI, by either improving muscle tone of the urethra/pelvic floor, or improving the “holding power” of the pelvic floor to inhibit the bladder when the urge comes on.

It is well studied the loss of estrogen with menopause or ovary removal leads to thinning and weakness o f the vagina and pelvic floor, but estrogen replacement with pills or creams is not for everyone. Moreover, estrogen replacement does not improve stress incontinence, and may only improve somewhat urge incontinence. Natural estrogen replacement however is something many women will want to do, and I don’t mean taking bio-identical hormones. Phytoestrogens are plant estrogens that are naturally occurring and have estrogen-like effects and may reduce some of the menopausal symptoms women experience. They are found in soy and soy products (soy nuts, soy milk, tofu). Soy isoflavones which are the components of soy that have the effect can be purchased in capsule form, as well as creams that can be applied to dry vaginal tissue.
Overconsumption of water, or consumption of diuretic medication can overwhelm the bladder and lead to incontinence. Moderation or alteration of these can help. Diuretics are usually given to control blood pressure, so changing to a non-diuretic blood pressure med is something to discuss with your prescribing physician. Contrarily, adequate water consumption is necessary to create a natural dieresis of toxins out of the bladder.

Bladder irritability from acidic foods, caffeine and alcohol can lead to incontinence in some cases. Evaluating your diet and eliminating certain problem foods can improve bladder health. A blander diet is often used by people who suffer from Painful Bladder Syndrome(PBS)/Interstitial Cystitis(IC), and can found on their national website. It is a good place to start. Eating whole, unrefined and fresh foods can eliminate additives that can irritate as well.

Natural anti-inflammatories are available but the science behind them vis-à-vis the bladder can be “thin”. Bromelain, flaxseed, and Vitamins C and E are common recommendations.
Herbal medicines are taken by many but little is truly known about them, and few are tested in studies. Many have properties that are anecdotal, and the business of herbal medicine is huge.

Therefore a health “dose” of suspicion is required when evaluating these prior to spending the money, but here is a list of herbals I found online and their claims.

“The following herbs may be used to soothe and heal the urinary tract:

Buchu (Barosma betulina) – A soothing diuretic and antiseptic for the urinary system.
Cleavers (Galium aparine) – A traditional urinary tonic.
Corn silk (Zea Mays) – Has soothing and diuretic properties.
Horsetail (Equisetum arvense) – An astringent and mild diuretic with tissue-healing properties.
Marshmallow root (Althea officinalis) – Has soothing, demulcent properties. It is best taken as a cold infusion; soak the herb in cold water for several hours, strain, and drink.
Usnea (Usnea barbata) – Has soothing and antiseptic properties.”