Pumpkin seed extract and soy isoflavones blend for urinary incontinence


Integrative Medicine


An estimated 30% of women aged 30 to 60 years old have urinary incontinence (UI), while more than 50% of community-dwelling older women have the condition.1,2 Stress urinary incontinence and overactive bladder are the common types of incontinence. Although prescription drugs and OTC oxybutynin are available, their use may be associated with anticholinergic effects. Recently, Azo Bladder Control with “Go-Less,” a blend of Cucurbita pepo pumpkin seed extract and soy isoflavones, was introduced to help alleviate UI symptoms.


Stress incontinence in women occurs when there is decreased strength of the musculature surrounding the urethra, resulting in a diminished force of closure. Overactive bladder may result from increased detrusor activity, causing symptoms of urinary frequency, urgency, and nocturia. 


C. pepo has been used to lessen UI symptoms especially since its effects were recognized to help urination symptoms occurring during stage I and II prostate cancer and irritable bladder.3 In addition, soy isoflavones have the potential to alleviate symptoms associated with hormonal imbalances that occur after menopause due to their weak estrogen-like effects.4

Although C. pepo and soy isoflavones may improve urinary incontinence, their actual mechanisms of action remain unclear.


Key clinical trial


A recent Korean study of 120 women aged 35 to 70 years old evaluated the efficacy of a combination of C. pepo pumpkin seed extract and soy isoflavones on UI symptoms. This study was double blind, used a placebo control arm, randomized patients to their respective groups, and was larger than previous trials studying the effect of C. pepo and soy isoflavones on UI.5 Excluded from the trial were women with diabetes, disorders of the spine, and urinary tract infections, among many other conditions. 


Participants received pumpkin seed extract 875 mg and soy germ extract 125 mg in two divided doses during the 12-week study period. Study outcomes were assessed at 4, 8, and 12 weeks. Participants completed a bladder diary 3 days before each evaluation as well as the standardized questionnaires on overactive bladder and sexual quality-of-life issues. 


Results for women using the active product showed a statistically significant improvement in daily urination, urgency, and incontinence frequency compared with baseline values. Nocturia was also improved with the active supplement. Participants in the placebo group also showed a statistically significant decrease in daily urination and incontinence frequency from their respective baseline values. This reduction was similar between the active product and placebo. 


Azo Bladder Control


Azo Bladder Control is a dietary supplement containing 300 mg of a blend of C. pepo pumpkin seed extract and soy isoflavones. As a proprietary blend, the amount of each component is not specified. The product is taken three times daily during the first 2 weeks and then twice daily thereafter. The labeling warns against use in pregnant and nursing women and if an allergy to soy is present. Its safety in women with breast cancer is unknown, as the available studies have had conflicting results.5

What to tell patients


Urinary incontinence is a common health concern, especially among women middle aged and older. Adopting lifestyle changes such as weight loss and smoking cessation may improve bladder control, as well as optimal management of conditions such as diabetes. Kegel exercises may benefit some types of urinary incontinence. Although this dietary supplement may have modest efficacy, patients should talk with their providers about their incontinence concerns and possible treatment approaches.


References


  1. www.auanet.org/education/guidelines/​incontinence.cfm 

  2. www.cdc.gov

  3. www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_HMPC_assessment_report/2013/03/WC500140759.pdf

  4. www.ncbi.nlm.nih.gov/pmc/articles/PMC1769669/

  5. J Funct Foods 2014;8C:111–17