Dealing with an overactive bladder that creates urgency and bathroom visits several times a day or night, or worse yet, dealing with enuresis (bedwetting) because of a weak and leaking bladder is possibly one of the most frustrating and embarrassing problems anyone can endure.

If your patients experience these issues, they are not alone. About 17 percent of women and 16 percent of men over the age of 18 have overactive bladder issues. As we age, overactive bladder becomes more common, affecting one in five adults over the age of 40. For men, the causes of overactive bladder often overlap with symptoms of benign prostate hyperplasia (BPH). Aside from urinary urgency during the day, many men deal with nocturia—a need to go to the bathroom several times a night, which is extremely disruptive to sleep. Of course, nocturia isn’t just limited to men dealing with BPH. The chances increase with age for women, too. Others deal with daily incontinence; those who worry that every sneeze or laugh will make them wet their pants are not alone, either. Urinary incontinence, whether due to chronic bladder irritation, bladder weakness, bacteria, or BPH, affects at least 25 million Americans. Most of the sufferers are women, but one-third of women and men 30 to 70 years old have experienced some symptoms of urinary incontinence.

And while bedwetting is often associated with children, there are some adults who, because of their overactive or weak bladders, have never experienced a dry night.

Conventional prescription approaches bring side effects and risks, and aren’t always effective. Of course, in many cases, even natural approaches to dealing with bladder health and incontinence are divided between men and women. However, angelica (Angelica archangelica)—the angels’ herb—is the perfect choice for both.

Amazing Angelica
The fruits, leaves, and roots of Angelica archangelica have been used in folk medicine for centuries, and it was cultivated in the Nordic countries during the Middle Ages. Vikings even used this herb as a form of currency. In fact, banning the theft of angelica was actually written into some of the earliest law books in Iceland about 1,000 years ago. These days, angelica tea from the leaves and cereal from the seeds are popular foods in Iceland.

Icelandic angelica has been found to contain a number of important compounds, including isoquercitrin and other flavonoids, polyphenols, and polysaccharides. It is these compounds that are considered to be responsible for the plant’s many beneficial effects. Some scientists believe it is the intense arctic summer with 24 hours of daylight that spurs the growth and concentration of nutrients in this herb.

Found throughout Iceland, angelica leaves are gathered by hand by local people in an eco-friendly manner. Although abundant, wild angelica is still recognized as a valuable resource, so only sustainable methods are used to harvest the plant.

Clinical Results—Stronger Bladder, Better Sleep
Icelandic angelica has clinical research to back it up. In an 8-week, randomized, double-blind, placebo-controlled study, men suffering from nocturia (overactive bladder at night) received angelica leaf extract or placebo. The men in this study were age 45 and older, which is often when men begin noticing urinary frequency and the first symptoms of BPH.

Many times, any urinary frequency issues for men are immediately considered a prostate problem. But that’s not always the case. In fact, overactive bladder is prevalent too, and requires a very different approach than we’d use for prostate health.

Of course, one of the biggest problems with nocturia isn’t just the fact of having to go to the bathroom; it’s the disruption of sleep, low energy and grogginess the next day. After a while, the lack of sleep wears down immune resistance, reduces the ability to concentrate, leads to weight gain, and truly hurts overall quality of life.

There are a few things that are measured when researchers test those dealing with nocturia, including nocturnal urinary output and nocturnal urinary capacity. What often happens as people age (and also in many cases of diabetes, BPH, and cardiovascular issues) is that bladder capacity decreases as well, in part because the bladder never seems to stop contracting, so it simply has less room at any given time. Bladder tissue also gets weaker with age, making people more prone to accidental “leaks” before they can find a bathroom or while they sleep.

During this study, three main parameters were measured: increase in bladder volume, reduction in nocturnal voids (bathroom trips), and increase in the duration of the first sleep period. The results were excellent.

In the subgroup with a bladder capacity of less than 260 ml, those taking angelica saw an increase of over 170 percent in bladder capacity vs. the placebo group.

In the subgroup with more than three bathroom trips during the standardized 8.7 hour night, angelica reduced the number of trips by up to 48 percent.

And, in the subgroup of men age 70 or older, angelica increased the first uninterrupted sleep period by 180 percent vs. the placebo group. This is impressive, because the prevalence of nocturia for men aged 70 and older can range from 50 to 80 percent or more. No wonder so many older individuals only get a few hours of sleep each night.

This is hopeful news for a number of reasons. First, men often don’t seek medical advice for urinary frequency as they may simply figure that it is an unavoidable consequence of getting older.

Additionally, there are the complications of the prescription drugs to consider. Many of them—whether they are hormone medications themselves or receptor agents that try to balance hormone levels—carry risks and side effects with them. There are also surgical interventions that have many risks, and can be unsuccessful.

What is especially interesting about this study is that its direct action was not on the prostate, but rather on the bladder. That means it can be beneficial for both men and women. Plus, the angelica extract was very well tolerated and showed no hormonal effects. It also showed no unwanted side effects like increased blood pressure or heart rate, or reduced libido—a definite difference from many prescription drugs.

So why does it work? The authors of the study note that the isoquercitrin content in the angelica leaf extract may be at least partly responsible. Isoquercitrin influences the activity of leukotrienes (LTD4) that are derived from arachidonic acid in the smooth muscle cells of the bladder. They cause contractions in the bladder and urethra by stimulating receptors. When this happens, the result is an overactive and potentially leaky bladder and a feeling of “needing to go” throughout the day and night.

Isoquercitrin may inhibit the activity of these leukotrienes by either slowing their production or stopping them from binding on the receptor cells that trigger the bladder contractions. The result is less urinary urgency, an ability of the bladder to fill to greater capacity before needing to be emptied, and much more restful, undisturbed sleep.

Another thing to note is that angelica extract has replaced saw palmetto berry as the number one bladder product in Iceland. That’s quite a feat! If it didn’t work, it wouldn’t sell so amazingly well.

Conclusion:
For those dealing with an overactive bladder, BPH, urgency, or frequent trips to the bathroom at night, Icelandic angelica extract is an excellent choice as a primary intervention. Patients may want to start with 200 mg per day—100 mg in the morning and 100 mg at night—for the first few days, and then drop down to 100 mg per day when they start to notice less urgency and better sleep. They’ll be able to tell that it’s working quite easily by simply counting the trips they make to the bathroom.