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Do Herbal Remedies for Incontinence Work?
At this point, there is not enough high-quality evidence to recommend herbal remedies as established treatments for urinary incontinence or overactive bladder.
The 2024 American Urological Association/SUFU guideline for overactive bladder specifically states that there is currently insufficient evidence to support nutraceuticals, vitamins, supplements, or herbal remedies for OAB treatment. The guideline notes that adequately powered randomized clinical trials demonstrating effectiveness are lacking.
That does not necessarily mean every herbal product is ineffective. Some traditional remedies have shown promising results in small studies. The problem is that the evidence is usually limited by small sample sizes, short follow-up periods, inconsistent formulations, or lack of comparison with established treatments.
It is also important to distinguish between different types of incontinence. An herb promoted for urinary urgency is not necessarily relevant to stress urinary incontinence, which occurs when weak pelvic floor or urethral support allows leakage during coughing, sneezing, laughing, lifting, or exercise.
Popular Herbs Promoted for Bladder Control
Several herbs repeatedly appear in online lists of “natural bladder remedies.” Their popularity, however, is not the same as proven effectiveness.
Here is what is known about some of the most frequently mentioned options.
Gosha-jinki-gan
Gosha-jinki-gan is a traditional Japanese herbal formula containing multiple plant ingredients. It has been studied primarily for urinary frequency, urgency, and overactive bladder symptoms rather than stress incontinence.
Some small studies have reported improvements in urinary frequency or urgency, which is why gosha-jinki-gan frequently appears in discussions of herbal bladder treatment.
However, these studies have generally been small, and the treatment has not been established through the kind of large, well-controlled clinical trials expected for standard medical therapies.
Because it contains multiple active ingredients, it can also be difficult to know which component is responsible for an effect or how a commercially available formulation compares with one used in a clinical study.
Horsetail
Horsetail, or Equisetum arvense, has a long history of use in traditional medicine and is sometimes marketed for urinary health.
It also has diuretic properties, meaning it may increase urine production. That makes claims that horsetail will improve bladder control somewhat counterintuitive for someone whose main problem is urinary frequency or urgency.
There is currently little strong clinical evidence showing that horsetail treats urinary incontinence.
It should also not be assumed to be harmless simply because it is a plant-based product. Herbal preparations can have medication interactions, dosage concerns, and other adverse effects.
Corn Silk
Corn silk has traditionally been used for urinary tract complaints and is sometimes described as soothing to the bladder or urinary tract.
Most support for these uses comes from traditional practice, laboratory research, or limited preliminary evidence rather than high-quality clinical trials in women with urinary incontinence.
There is not enough evidence to consider corn silk an established treatment for stress incontinence, urgency incontinence, or overactive bladder.
Buchu
Buchu is another herb traditionally associated with urinary tract health. It has historically been described as a diuretic or urinary antiseptic.
Those traditional uses do not establish that it improves urinary incontinence. Reliable clinical evidence for bladder-leak reduction is lacking.
This is particularly important because increasing urine production is not necessarily desirable for someone already struggling with urinary frequency or urgency.
Are Herbal Bladder Supplements Safe?
“Natural” does not automatically mean risk-free.
Dietary supplements are regulated differently from prescription and over-the-counter medications. Manufacturers generally do not have to demonstrate that a supplement effectively treats urinary incontinence before it is sold.
Herbal products can also:
- Interact with prescription or over-the-counter medications
- Affect blood pressure, blood sugar, bleeding, or kidney function
- Contain several active ingredients at once
- Vary in concentration between products
- Cause allergic reactions or gastrointestinal symptoms
- Be inappropriate during pregnancy or for certain medical conditions
If you are considering an herbal bladder supplement, tell your healthcare professional or pharmacist what you plan to take, particularly if you use prescription medications or have other health conditions.
Natural Approaches With Better Evidence
If by “natural treatment” you mean avoiding medication or surgery, there are several conservative approaches with considerably stronger evidence than herbal supplements.
Pelvic Floor Muscle Training
Pelvic floor muscle training is an established first-line treatment for stress urinary incontinence.
Strengthening these muscles improves support around the bladder and urethra so they can better resist increases in pressure during coughing, laughing, sneezing, exercise, and lifting.
The challenge is that pelvic floor training has to be performed correctly and consistently. Some people struggle to identify the right muscles or maintain enough effective contractions over time.
Bladder Training
For urgency and overactive bladder symptoms, bladder training can help gradually improve the ability to delay urination and reduce frequent “just in case” bathroom trips.
This is one of the behavioral treatments supported in current overactive bladder guidelines.
Pelvic Floor Physical Therapy
A pelvic floor physical therapist can evaluate whether the pelvic floor is weak, overly tight, poorly coordinated, or a combination. Treatment can then be matched to the actual problem rather than assuming everyone needs more Kegels.
This can be particularly important when bladder symptoms occur alongside pelvic pain, prolapse, constipation, or difficulty relaxing the pelvic floor.
Weight, Diet, and Lifestyle
Lifestyle changes can also help reduce factors that worsen bladder symptoms.
For women who are overweight or have obesity, moderate weight loss has been shown in clinical trials to reduce urinary incontinence, particularly stress leakage.
Preventing constipation can reduce unnecessary pelvic pressure and straining. Appropriate hydration is also important; deliberately becoming dehydrated to avoid leaks can contribute to constipation and concentrated urine.
Caffeine, alcohol, carbonation, acidic foods, and other possible bladder irritants affect people differently. Rather than eliminating everything at once, identify whether a particular food or drink consistently worsens your symptoms.
See our diet guidelines for incontinence for a more practical approach.
What About Vaginal Estrogen?
Vaginal estrogen is sometimes grouped into discussions of “natural” menopause remedies, but it is important to distinguish it from herbs and dietary supplements.
Low-dose vaginal estrogen is a prescription medical treatment used for genitourinary syndrome of menopause. Declining estrogen can affect vaginal and urethral tissues and contribute to symptoms such as dryness, irritation, recurrent urinary tract infections, and some urinary symptoms.
Vaginal estrogen is not the same as systemic hormone therapy, and it should not be presented as a general treatment for every type of urinary incontinence.
If menopause-related urinary or vaginal symptoms are part of the picture, a healthcare professional can determine whether local estrogen therapy is appropriate.
A Drug-Free Option With Clinical Evidence: Elitone
If your goal is to avoid medication or surgery, “natural” does not have to mean relying on an unproven supplement.
For women with stress or mixed urinary incontinence, Elitone is an FDA-cleared, noninvasive treatment that uses neuromuscular electrical stimulation to produce repeated pelvic floor contractions and strengthen the muscles responsible for bladder and urethral support.
Elitone does the contractions for you during a 20-minute treatment, so treatment does not depend on remembering to perform enough Kegels or wondering whether you are activating the correct muscles.
Unlike an herbal supplement, Elitone is specifically designed and FDA-cleared to treat urinary incontinence rather than being marketed based primarily on traditional use or preliminary evidence.
It also provides a drug-free treatment option without adding another medication or supplement that could interact with something you already take.
The most useful question is not simply, “Is it natural?” It is, “Is there good evidence that it treats the type of incontinence I have?”
