Herbs can treat a number of diseases of the urogenital system, including acute and chronic nephritis, cystitis, FLUTD, urinary incontinence, prostate and ovarian conditions, and urolithiasis (calcium oxalate, struvite, and urate). Herbal actions of interest include the renal protective herbs that aid chronic renal disease, diuretics, urinary antiseptics, bladder tonics, antilithic herbs, and demulcents. Herbs that benefit prostate health are also discussed.
Renal-tonic and protective herbs
Several herbs may be beneficial for nephropathies. Astragalus (Astragalus membranaceus) has been shown to increase plasma and muscle protein and reduce urinary output of protein by improving dysfunctional protein metabolism in glomerulopathy. It can also prevent glomerular sclerosis. In rats with experimental nephritis, large doses of oral astragalus improved renal function, thus supporting the traditional use of large doses for the treatment of chronic nephritis in people. In China, another species of Astragalus (Astragalus mongholicus) and Dong guai (Angelica sinensis) have been used to treat nephrotic syndrome. Both herbs together or enalapril were administered to rats with chronic induced nephrosis and compared with control rats. The treatment groups had significantly reduced deterioration of renal function and reduced histologic damage. The two herbs together retarded the progression of renal fibrosis and deterioration of renal function and were comparable to enalapril.
Cordyceps (Cordyceps sinensis) is renal protective against gentamicin-induced nephrotoxicity in animals. In a comparative, controlled clinical study, 28 of 51 patients with chronic renal failure received Cordyceps (3 to 5 g / day) and showed a significant improvement in renal function compared to the control group. Nettle seed (Urtica dioca) may also be useful because it may lower creatinine, as reported in a case series of 2 human patients by North American herbalist David Winston. A hydroethanolic (1:5) tincture of Nettle seed, 5 ml TID, reduced serum creatinine in both patients.
Crataeva (Crataeva nurvala) has been shown to improve bladder tone in dogs. In human studies, 50 ml decoction given twice daily for 3 months reduced incontinence, pain, and urine retention in prostatic hypertrophy with hypotonic bladder.
Diuretic / aquaretic activity
Traditionally, conditions affecting the urogenital tract were treated with urinary diuretics, herbs given as teas and consumed in large volumes. The diuresis that was observed was thought to flush the tract and therefore aid in recovery. Diuretic action was also seen as alterative, aiding in the elimination of wastes and therefore improving overall health. Such herbs included Red clover (Trifolium pratense), Dandelion leaf (Taraxacum offtcinale), Cleavers (Gallium aparine), Burdock (Arctium lappa), and Celery (Apium graveolens).
On the other hand, some herbs have aquaretic activity, which is more closely aligned with our conventional view of diuretics. These herbs produce diuresis by acting directly on the glomerulus to increase urine production without impacting electrolytes.
The diuretic and aquaretic herbs Nettle (Urtica dioca) and Cornsilk (Zea Mays) both have a high potassium content. Juniper (Juniperus communis) contains an essential oil that is reported to increase the glomerular filtration rate. Parsley (Petroselinum crispum) can inhibit the Na+-K+ pump, leading to an osmotic diuresis. Couchgrass (Agropyron repens), which contains the constituent mannitol, also leads to osmotic diuresis. Lavender (Lavendula officinalis) contains the aqueous extract that can produce diuresis. Dandelion (Taraxacum officinalis) leaf at a dose of 50 mL (equivalent to 2 g dried herb / kg body weight) in one study produced a comparable effect to furosemide (80 mg / kg); however, an ethanolic extract of the root did not produce a diuretic effect. Pharmacological evaluation of Bearberry (Arctostaphylos uva-ursi) showed that it increases urine flow. Others include Celery (Apium graveolens) and Buchu (Agathosma betulina).
Urinary antiseptic herbs are perhaps most valuable for chronic infections, in those with resistant strains of bacteria, and for preventing infection in vulnerable patients. Some produce antiseptic metabolites which are excreted in urine. Others may improve the mucopolysaccharide layer produced by transitional cells coating the bladder wall (demulcents fall into this category as well). Yet others prevent adhesion of bacteria to the bladder wall.
Carbenoxolone derived from Licorice (Glycyrrhiza glabra) was shown to protect against laboratory-induced lower urinary tract infections in the rabbit model by influencing the mucopolysaccharide layer. Cranberry (Vaccinium macrocarpa) inhibits bacterial adherence due to antiadhesion agents in Cranberry juice. This is most likely due to proanthocyanidins, which are shown to inhibit the adherence of P-fimbriated E. coli to uroepithelial cell surfaces and provide antiadherence activity toward gram-negative rods including Klebsiella, Enterobacter, Pseudomonas, and Proteus. Bearberry (Arctostaphylos uva-ursi) has the constituent arbutin, which is hydrolyzed to hydroquinone during excretion in urine. This metabolite is both antiseptic and astringent in action. Arbutin works best in alkaline urine, and urinary acidifiers inhibit conversion of arbutin to active hydroquinone, so it can also modify bacterial adhesion. Others include Golden rod (Solidago virgaurea); Buchu (Barosma betulina), which has very low activity against Escherichia coli; Saccharomyces cerevisiae and Stapbylococcus aureus, Couchgrass (Agropyron repens), Crataeva (Crataeva nurvala), and Saw palmetto (Serenoa serrulata).
Traditional antilithic herbs include Cornsilk (Zea Mays), Couchgrass (Agropyron repens), Stone root (Collinsonia canadensis), Gravel root (Eupatorium purpureum), and Hydrangea (Hydrangea arborescens). Uric stones have benefited from the antiseptic action (tentatively to sapo-nins) and possibly some solvent action by herbal infusions of Vervain (Verbena officinalis), Lithospermum (Lithospermum officinale), Dandelion (Taraxacum officinale), Horsetail (Equisetum arvense), Bearberry (Arctostaphylos uva-ursi), Burdock (Arctium lappa), and Silene saxifrage. In oxalate urolithiasis, Fenugreek seeds (Trigonella foenum-graecum) significantly decreased the quantity of calcium oxalate deposited in the kidneys in induced urolithiasis in rats.
Crataeva (Crataeva nurvala) on calcium oxalate lithiasis has been studied in rats. A crude extract at 100 mg / kg PO in rats significantly reduced stone formation (81%). It showed a regulatory action on endogenous oxalate synthesis and the decoction lowered stone-forming constituents in the kidneys of calculogenic rats. Also in calcium oxalate kidney stones, Cranberry (Vaccinium macrocarpa) juice decreased oxalate and phosphate excretion, increased citrate excretion, and decreased the relative supersaturation of calcium oxalate. It was concluded that Cranberry juice has antil-ithogenic properties and may help manage calcium oxalate urolithiasis. On the other hand, cranberry juice contains oxalate and 5 healthy volunteers had significant increases in urinary oxalate while receiving cranberry tablets. However, inhibitors of stone formation, magnesium, and potassium, rose as well.
Traditional demulcents used to reduce pain and dysuria associated with mucosal inflammation include Marsh-mallow (Althaea officinalis), Cornsilk (Zea mays), Couchgrass (Agropyron repens), and Licorice (Glycyrriza glabra).
Spasmolytic herbs may be considered for urinary tract disorders. These include Saw palmetto (Serenoa serrulata), Cramp bark (Viburnum opulus), and Pumpkin seed (Curcurbita pepo). A formula consisting of uva-ursi, Hops, and Peppermint, administered for 6 weeks, improved symptoms in 70% of patients (915) suffering from compulsive strangury, enuresis, and painful micturition.
Astringents may be useful in hemorrhagic conditions. Two herbs traditionally used for this include Plantain (Plantago major) and Horsetail (Equisetum arvense).