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Needing to wake up to urinate at night


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#1 calengineering

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Posted 13 November 2010 - 02:21 AM


I have always needed to wake up around 6-7am to wake up to pee. Sometimes, if I drink any liquids before going to sleep, I'll need to go twice, once at 2-3am and again at 6-7am. The issue is that even if I don't drink much in the evening, I'll still need to wake up for the 6-7am one and the urine volume is pathetically low.

I don't think I have nocturia (where you have to wake up and pee multiple times per night), nor do I think I have an abnormally enlarged prostate (I'm 22).

"Most people can sleep for 6 to 8 hours without having to urinate. Middle aged and older men often wake to urinate once in the early morning hours.
Read more: http://www.healthlin...n#ixzz157sANe3C Healthline.com - Connect to Better Health"

My best guess of the reason behind all this is that my prostate is enlarging with age naturally and possibly masturbation/sex. Apparently it's completely natural as a man, for your prostate to increase in size throughout life. An observation that supports this is that I don't think that I had to wake up to urinate when I was younger. Back then, I could probably drink a lot more at night without needing to wake up and urinate.

I know this may be very common to need to pee once or twice per night, but i don't think this is optimal. I want to need to pee after waking up naturally (e.g. to sunlight). I value my sleep tremendously as anyone should and it makes sense that if I could get another half of a sleep cycle in, I'll be more prepared for the rest of the day, or I can cut back on half hour of time in bed.

Any thoughts or suggestion?

I heard that Saw Palmetto can prevent enlarged prostate.

Edited by calengineering, 13 November 2010 - 02:35 AM.


#2 niner

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Posted 13 November 2010 - 03:33 AM

I have always needed to wake up around 6-7am to wake up to pee. Sometimes, if I drink any liquids before going to sleep, I'll need to go twice, once at 2-3am and again at 6-7am. The issue is that even if I don't drink much in the evening, I'll still need to wake up for the 6-7am one and the urine volume is pathetically low.

I don't think I have nocturia (where you have to wake up and pee multiple times per night), nor do I think I have an abnormally enlarged prostate (I'm 22).

"Most people can sleep for 6 to 8 hours without having to urinate. Middle aged and older men often wake to urinate once in the early morning hours.
Read more: http://www.healthlin...n#ixzz157sANe3C Healthline.com - Connect to Better Health"

My best guess of the reason behind all this is that my prostate is enlarging with age naturally and possibly masturbation/sex. Apparently it's completely natural as a man, for your prostate to increase in size throughout life. An observation that supports this is that I don't think that I had to wake up to urinate when I was younger. Back then, I could probably drink a lot more at night without needing to wake up and urinate.

I know this may be very common to need to pee once or twice per night, but i don't think this is optimal. I want to need to pee after waking up naturally (e.g. to sunlight). I value my sleep tremendously as anyone should and it makes sense that if I could get another half of a sleep cycle in, I'll be more prepared for the rest of the day, or I can cut back on half hour of time in bed.

Any thoughts or suggestion?

I heard that Saw Palmetto can prevent enlarged prostate.

You're right that it's natural for the prostate to enlarge over time, although like some other natural things, it's neither optimal nor desirable. At your age, it wouldn't be the first thing I'd suspect. Probably the first thing to look at is what drugs (particularly alcohol & nicotine) and supplements you're taking, as well as your intake of water, sodium, and other electrolytes. There's a circadian variation in antidiuretic hormone that helps us get through the night, and it's conceivable that something is wrong there. Have you ever had a PSA level done, or had your prostate checked by a urologist? I agree that having to get up even once to pee, much less multiple times, is very disruptive to sleep. The first order of treatment would be to not drink anything after dinner and reduce diuretic drugs. I'm a little leery of Saw Palmetto.

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#3 calengineering

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Posted 13 November 2010 - 04:43 AM

You're right that it's natural for the prostate to enlarge over time, although like some other natural things, it's neither optimal nor desirable. At your age, it wouldn't be the first thing I'd suspect. Probably the first thing to look at is what drugs (particularly alcohol & nicotine) and supplements you're taking, as well as your intake of water, sodium, and other electrolytes. There's a circadian variation in antidiuretic hormone that helps us get through the night, and it's conceivable that something is wrong there. Have you ever had a PSA level done, or had your prostate checked by a urologist? I agree that having to get up even once to pee, much less multiple times, is very disruptive to sleep. The first order of treatment would be to not drink anything after dinner and reduce diuretic drugs. I'm a little leery of Saw Palmetto.


I had a comprehensive blood/urine test done where the results showed no abnormalities or figures outside of healthy ranges. No PSA test was done unfortunately, so I can look into this in a few weeks after I get health insurance. Nevertheless, I think these "healthy ranges" for any tests are references for prevention of disease or other serious problems. I'm looking for optimal functioning, which then involves a finer range and varies for everyone based off of bladder size, body weight, sodium intake, etc... The problem with these wide "healthy ranges" they give is also that if we trust them, we may neglect to take a certain action because the tests come out negative. Case in point: I'll get a healthy score on this PSA test and be persuaded not to take Saw Palmetto and never know if it'll help.

Well I guess I'll start by not drinking any liquids after 8pm tonight and see what happens.

Why are you leery of Saw Palmetto? Are you leery of its effectiveness or the side effects.

Edited by calengineering, 13 November 2010 - 04:51 AM.


#4 niner

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Posted 13 November 2010 - 02:24 PM

You're right that it's natural for the prostate to enlarge over time, although like some other natural things, it's neither optimal nor desirable. At your age, it wouldn't be the first thing I'd suspect. Probably the first thing to look at is what drugs (particularly alcohol & nicotine) and supplements you're taking, as well as your intake of water, sodium, and other electrolytes. There's a circadian variation in antidiuretic hormone that helps us get through the night, and it's conceivable that something is wrong there. Have you ever had a PSA level done, or had your prostate checked by a urologist? I agree that having to get up even once to pee, much less multiple times, is very disruptive to sleep. The first order of treatment would be to not drink anything after dinner and reduce diuretic drugs. I'm a little leery of Saw Palmetto.

I had a comprehensive blood/urine test done where the results showed no abnormalities or figures outside of healthy ranges. No PSA test was done unfortunately, so I can look into this in a few weeks after I get health insurance. Nevertheless, I think these "healthy ranges" for any tests are references for prevention of disease or other serious problems. I'm looking for optimal functioning, which then involves a finer range and varies for everyone based off of bladder size, body weight, sodium intake, etc... The problem with these wide "healthy ranges" they give is also that if we trust them, we may neglect to take a certain action because the tests come out negative. Case in point: I'll get a healthy score on this PSA test and be persuaded not to take Saw Palmetto and never know if it'll help.

Well I guess I'll start by not drinking any liquids after 8pm tonight and see what happens.

Why are you leery of Saw Palmetto? Are you leery of its effectiveness or the side effects.

On Saw Palmetto, there was a trial that said it didn't work, and I seemed to remember an anecdote about sexual side effects. I checked medline, and there's a recent Cochrane review that says while it doesn't do anything for BPH, it does help for nocturia. It also found side effects similar to placebo. Therefore, I'll retract that leeryness. It could be worth a try, but I would still start with a look at any substances you're taking and your liquid intake.

#5 mikeinnaples

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Posted 13 November 2010 - 05:04 PM

Oddly enough ...this happens to me every single time I take NAC just before bed time. Like clock work I am up pissing at 5am regardless of how much I drink.

#6 leviathans

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Posted 13 November 2010 - 06:01 PM

No, at your age it can't be BPH (benign enlargement of the prostate) but it could be a inflammation of the prostate. The only cases of BPH in young persons I heard off was about steroid users who had a prostate enlargement because of their steroid use.

Go see an urologist to check this out. It's always possible that it's not related to the prostate.

Do you feel any pain in the prostate, do you have any difficulty starting to urinate and do you feel like you can't empty completely your bladder?

#7 calengineering

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Posted 13 November 2010 - 06:12 PM

No, at your age it can't be BPH (benign enlargement of the prostate) but it could be a inflammation of the prostate. The only cases of BPH in young persons I heard off was about steroid users who had a prostate enlargement because of their steroid use.

Go see an urologist to check this out. It's always possible that it's not related to the prostate.

Do you feel any pain in the prostate, do you have any difficulty starting to urinate and do you feel like you can't empty completely your bladder?


No pain urinating.

#8 leviathans

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Posted 13 November 2010 - 06:19 PM

No, at your age it can't be BPH (benign enlargement of the prostate) but it could be a inflammation of the prostate. The only cases of BPH in young persons I heard off was about steroid users who had a prostate enlargement because of their steroid use.

Go see an urologist to check this out. It's always possible that it's not related to the prostate.

Do you feel any pain in the prostate, do you have any difficulty starting to urinate and do you feel like you can't empty completely your bladder?


No pain urinating.


Do you feel like you have a weak stream of urine when urinating? Do you have any tenderness/pain in the prostate after sex? Do you sometimes have a burning feeling when urinating? Do you have any discharge in your urine?

#9 calengineering

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Posted 13 November 2010 - 08:10 PM

Do you feel like you have a weak stream of urine when urinating? Do you have any tenderness/pain in the prostate after sex? Do you sometimes have a burning feeling when urinating? Do you have any discharge in your urine?


No weak stream of urine. No burning feeling while urinating ever. Both before or after sex.

However, sometimes I feel discomfort (a dull pain) in the prostate area (or that general vicinity i'm presuming) after sex. It starts a few hours later later and lasts for a few hours. This will happen regardless of urination.

#10 calengineering

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Posted 13 November 2010 - 08:12 PM

Oddly enough ...this happens to me every single time I take NAC just before bed time. Like clock work I am up pissing at 5am regardless of how much I drink.



Well, do you take NAC only when you drink? My intuition tells me that it's the alcohol, not the NAC.

#11 leviathans

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Posted 13 November 2010 - 08:24 PM

Do you feel like you have a weak stream of urine when urinating? Do you have any tenderness/pain in the prostate after sex? Do you sometimes have a burning feeling when urinating? Do you have any discharge in your urine?


No weak stream of urine. No burning feeling while urinating ever. Both before or after sex.

However, sometimes I feel discomfort (a dull pain) in the prostate area (or that general vicinity i'm presuming) after sex. It starts a few hours later later and lasts for a few hours. This will happen regardless of urination.


It could be a small or just beginning case of prostatitis. In my case, I just had difficulty emptying my bladder at first and then after a while(6 months or more) I started having pain and more and more difficulty urinating.

Go see an urologist and find a good one. Some are really idiot and won't do much because if a prostatis is not caused by a virus, most doctors are clueless about how to treat you.

#12 calengineering

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Posted 13 November 2010 - 08:24 PM

On Saw Palmetto, there was a trial that said it didn't work, and I seemed to remember an anecdote about sexual side effects. I checked medline, and there's a recent Cochrane review that says while it doesn't do anything for BPH, it does help for nocturia. It also found side effects similar to placebo. Therefore, I'll retract that leeryness. It could be worth a try, but I would still start with a look at any substances you're taking and your liquid intake.


I did not drink any liquids after 8pm last night and also, before going to bed at 1am, relieved myself of any remaining fluids. The result? I was able to sleep in until 10am (wknd), but only because at that time, I felt the need to urinate. This is actually an improvement! Before, I normally would need to wake up at 6am when I'm only abstaining from liquids from 10pm onwards.

I'll need to try a few more nights. If I wake up earlier around 8am as I normally would on a weekday, I may avoid needing to wake up to pee with certainty. Only concern: I usually get thirsty at night. Also, any exercising or partying at night would require drinking fluids. Also, on any given night, I'll need to eat an earlier dinner. Thus without a strict adherence to watching my fluid intake, I'll have more than a few nights a week where I'll have my sleep disrupted.

I'll experiment on this a few more days and post my findings. Might try Saw Palmetto after that. I'm jealous of the idea that kids can drink a class of milk before bed and not have to wake up to pee. If this is even true.

#13 calengineering

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Posted 13 November 2010 - 08:31 PM

It could be a small or just beginning case of prostatitis. In my case, I just had difficulty emptying my bladder at first and then after a while(6 months or more) I started having pain and more and more difficulty urinating.

Go see an urologist and find a good one. Some are really idiot and won't do much because if a prostatis is not caused by a virus, most doctors are clueless about how to treat you.


Ok. Thanks.

#14 tham

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Posted 13 November 2010 - 09:00 PM

You could try a low dose of a urinary
antispasmodic, normally given for
overactive bladders, in the meantime
to see if it might help you out.

Two of the newer ones are darifenacin
(Enablex) and solifenacin (Vesicare,
both selective M3 blockers.

#15 tham

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Posted 13 November 2010 - 09:04 PM

Apart from them, alpha-1a blockers
for BPH may also be considered.

The latest one is silodosin, which has
just been approved by your FDA.

http://en.wikipedia.org/wiki/Silodosin


Tamsulosin would be the second choice.

#16 ajnast4r

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Posted 13 November 2010 - 09:23 PM

what supplements are you taking?
do you use caffeine?
how soon before bed are you drinking water?

#17 leviathans

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Posted 14 November 2010 - 12:31 AM

Apart from them, alpha-1a blockers
for BPH may also be considered.

The latest one is silodosin, which has
just been approved by your FDA.

http://en.wikipedia.org/wiki/Silodosin


Tamsulosin would be the second choice.

Alpha blockers have a lot of very bad side effects like Orthostatic hypotension which is very annoying...
It also leads to muscle weakness.
Not cool.

Btw, Tamsulosin is reknown for its horrible side effects. It also gave me anorgasmia and loss of libido.
In many cases, it's just not worth it.

The idea of taking an antispasmodic seems interesting. Thanks

#18 leviathans

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Posted 14 November 2010 - 12:40 AM

Tamsulosin is great for one thing though. In some extreme rare cases it can cause priapism. So much fun...

#19 Matt

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Posted 14 November 2010 - 06:36 AM

It could be prostate inflammation. Might be worth having tests because if it is something like a prostate infection you would want to catch it early as leaving it would cause things to get worse and be harder to treat. You could try something called quercetin. http://www.ncbi.nlm....pubmed/10604689
you could also try somethign called d mannose, but if there was bacteria its not an acute infection. It is unusual for you to wake up at night to pee for your age, especially if you have not consumed much liquid before bed and you only pee a little.

You might want to try a supplement called AllicinMax. It's used in some hospitals here in the UK for MRSA infections. There was one study, but no control group, where it cured all 52 patients of MRSA who had failed all antibotic therapies for upto 2 years. Some patients using cream and supplement, some just using supplement. Both worked. And also a double blind placebo controlled trial showing that stabilised allicin protects from colds. so allicin does seem to have an effect on infections in vivo. Which you can also see here in a study on mice with CBP. http://www.ijaaonlin...0097-1/abstract

Good luck!

Edited by Matt, 14 November 2010 - 06:47 AM.


#20 leviathans

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Posted 14 November 2010 - 10:21 PM

It could be prostate inflammation. Might be worth having tests because if it is something like a prostate infection you would want to catch it early as leaving it would cause things to get worse and be harder to treat. You could try something called quercetin. http://www.ncbi.nlm....pubmed/10604689
you could also try somethign called d mannose, but if there was bacteria its not an acute infection. It is unusual for you to wake up at night to pee for your age, especially if you have not consumed much liquid before bed and you only pee a little.

You might want to try a supplement called AllicinMax. It's used in some hospitals here in the UK for MRSA infections. There was one study, but no control group, where it cured all 52 patients of MRSA who had failed all antibotic therapies for upto 2 years. Some patients using cream and supplement, some just using supplement. Both worked. And also a double blind placebo controlled trial showing that stabilised allicin protects from colds. so allicin does seem to have an effect on infections in vivo. Which you can also see here in a study on mice with CBP. http://www.ijaaonlin...0097-1/abstract

Good luck!


Quercetin is great but it just reduces the tenderness and pain. It does not reduce the urinary problems.

90-95% of the protatitis cases are not caused by a virus (source Wikipedia) so I wouldn't be that much afraid of having a virus.

#21 ajnast4r

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Posted 15 November 2010 - 12:49 AM

i think before you start self diagnosing (road to ruin) your self with bph, you should #1 go see a dr. to see if it actually is enlarged as opposed to guesswork and #2 evaluate your supplement/dietary regimen to see if your using anything that could be diuretic

#22 Matt

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Posted 15 November 2010 - 01:11 AM

viruses are not known cause of prostatitis, but it's usually bacterial and non bacterial. Quercetin WILL help with urinary symptoms if it can reduce the inflammation ftp://ftp.dshoskes.com/qarticle.pdf read the study. Yeah go to the doctor first and get a proper diagnoses, you dont want to mask the symptoms with supplements before you rule out certain causes. Oh and i'm speaking from previous personal experience.

#23 leviathans

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Posted 15 November 2010 - 01:25 AM

viruses are not known cause of prostatitis, but it's usually bacterial and non bacterial. Quercetin WILL help with urinary symptoms if it can reduce the inflammation ftp://ftp.dshoskes.com/qarticle.pdf read the study. Yeah go to the doctor first and get a proper diagnoses, you dont want to mask the symptoms with supplements before you rule out certain causes. Oh and i'm speaking from previous personal experience.

Sorry, I meant bacteria and not virus. Here is the citation : "There are no definitive diagnostic tests for CP/CPPS. This is a poorly understood disorder, even though it accounts for 90%-95% of prostatitis diagnoses."(http://en.wikipedia....c_pain_syndrome) CPPS stand for chronic pelvic pain syndrome and it means that no bacteria were found in your urine but you still have prostatitis. Some people suggest some weird virus or nanobacteria to be causing CPPS but I think it's bullshit.

I guess you're right about quercetin. It's just that in my case, it didn't help at all my urinary symptoms.

#24 hamishm00

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Posted 15 November 2010 - 09:27 AM

If you are waking up with an urge at 6-7am regardless of how much urine is in your bladder (i.e. the volume of urine is low in your bladder) and you do no appear to be suffering from frequency issues during the day, I should ask: do you have a weakened stream, or sensations if incomplete voiding?

The issues with the prostate and frequency of urination starts when the prostate expands massively in size and causes the urethra to constrict - like a kinked hosepipe - this will cause higher intravesical pressures in the bladder and result in hypertrophy of the bladder and the detrusor muscle and this may interfere with the storage phase of the bladder, resulting in an increase in frequency (urge incontinence). This generally happens MUCH later in life - it would be HIGHLY unlikely to be affecting you at 22 unless you had prostatitis that caused your prostate to expand significantly in size, but you would likely feel this and it would reflect in your urine stream being significantly weaker.

The bladder has two modes, the storage phase and the voiding phase. It sounds like there is something wrong with your nocturnal storage phase meaning that the micturition reflex is being triggered after a certain number of hours of sleep, and if you can rule out any kind of bladder infection (which will increase voiding frequency) and for your own peace of mind rule out prostatitis and you still really want to crack the problem you should maybe consider having Urodynamics done to rule out a mild overactive bladder syndrome, but it doesn't sound like your problem is severe enough to me to warrant this kind of testing.

You might have some success if you actually have a small bladder (say your average volume voided during the day is 200ml), you could do some bladder training and increase the functional size of your bladder slightly by training your bladder during the day (by holding on) to void at higher volumes only. This could make you 'go the distance' at night.

By the way, older Men with overactive bladder syndrome caused by BPH have had some success with Melatonin supplementation reducing the urge to void at night.
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#25 mikeinnaples

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Posted 15 November 2010 - 07:20 PM

Oddly enough ...this happens to me every single time I take NAC just before bed time. Like clock work I am up pissing at 5am regardless of how much I drink.



Well, do you take NAC only when you drink? My intuition tells me that it's the alcohol, not the NAC.


WOW ....what an assumption, and dead wrong.

I hardly drink, and when I do it is never more than a glass or two.

#26 tham

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Posted 15 November 2010 - 08:08 PM

My 90-year old father, now in a nursing
home, has been having problems with
frequency and voiding of urine for some time.

Recently, a female relative who was visiting
the blind inmate sharing his room, and who
also happened to be a doctor, observed
my father's symptoms and advised my
elder brother that he had overactive bladder.

I'm not even sure if that is correct, as my
father have had a stroke preceded by
spinal injury from a fall not too long ago,
and both these conditions can cause
either an overactive (spastic) or underactive
(flaccid or atonic) bladder.

Anyway, the lady doctor above suggested
giving him Ditropan (oxybutynin, old drug
with lots of side effects including heart
rate increases) or Detrusitrol (tolterodine,
second generation, but still has positive
chronotropic effects).

I told my brother these are far better
third generation drugs. I'm about to
order darifenacin for him in lieu of
the above. The first two are M3 selective.

Darifenacin (Enablex)
Solifenacin (Vesicare)
Trospium (Sanctura, Regurin, Spasmex)
Propiverine (Mictonorm, Detrunorm)


The thing is, I've been telling my brother
for ages that saw palmetto would help
my father's condition, regardless of
whether BPH is the cause (which is
likely to be a factor for his age anyway).

However, my brother has never heard
of saw palmetto, let alone pygeum, and
thinks that supplements are nonsense.

" The improvement of voiding symptoms
in patients taking SPE may arise from
its binding to pharmacologically relevant
receptors in the lower urinary tract, such
as alpha(1)-adrenoceptors, muscarinic
cholinoceptors
, 1,4-dihyropyridine
receptors and vanilloid receptors. "

" Thus, SPE at clinically relevant doses
may exert a direct effect on the
pharmacological receptors in the
lower urinary tract, thereby improving
urinary dysfunction in patients with
BPH and an overactive bladder. "

http://www.ncbi.nlm....t_uids=16784248


" The binding activity of SPE for muscarinic
receptors was four times greater
than that
for alpha 1-adrenergic receptors. "

http://www.ncbi.nlm....t_uids=17572227


" ..... smooth muscle contraction, a
response mediated through alpha(1)-
adrenoceptors "

http://www.ncbi.nlm....t_uids=16784248



However :

" Unexpectedly, saw palmetto extract
caused contractions of the rat prostate
gland
that could be attenuated by
prazosin, phentolamine, nifedipine,
guanethidine, cocaine, and desipramine
but not by any of the other
pharmacological tools. "

"Similar contractile effects were observed
in rat-isolated vas deferens preparations
but not in rat-isolated bladder preparations.

CONCLUSIONS: In the rat prostate gland,
saw palmetto extract causes indirect
alpha1-adrenoceptor-mediated contractions
via the release of noradrenaline from
sympathetic neurons. "

http://www.ncbi.nlm....t_uids=16114061


From the foregoing, one could
conclude that saw palmetto's
usefulness in BPH largely comes
from its activity on muscle receptors,
which would also explain its
benefit for overactive bladder.

Edited by tham, 15 November 2010 - 08:09 PM.

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#27 calengineering

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Posted 15 November 2010 - 08:32 PM

You might have some success if you actually have a small bladder (say your average volume voided during the day is 200ml), you could do some bladder training and increase the functional size of your bladder slightly by training your bladder during the day (by holding on) to void at higher volumes only. This could make you 'go the distance' at night.

By the way, older Men with overactive bladder syndrome caused by BPH have had some success with Melatonin supplementation reducing the urge to void at night.


The possibility that I simply have a smaller bladder seems very likely to me. I'm a relatively skinny guy and when I drink a lot, need to use the restroom more often then others.

Bladder training sounds like an excellent idea to try.

Here is more info on exercises and training for bladder control if anyone is interested: Link to NAFC website








#28 tham

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Posted 19 November 2010 - 11:25 AM

This supports the above studies on saw
palmetto's predominant action on the
lower urinary tract muscles.

" My husband and I both take this for
overactive bladder. Thus, we get
more sleep at night. "

http://www.iherb.com...-Caps/1747?at=1
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#29 justwalkingaround

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Posted 20 November 2010 - 02:31 AM

Assuming you do not have BPH, prostatitis, and have otherwise been cleared by your physicians......

Consider licorice root liquid, assuming no underlaying medical conditions (can cause fluid retention, thereby elevating intravascular fluid volume, blood pressure, etc)

The bottle says to take 1tsp.

I wouldnt, as it was way too much for me.

Consider 10drops placed onto the teaspoon, swallow, follow with small sip of water to clear the mouth/throat.

Then back off until you find a satisfactory dosage........and balance this idea.....i get up 4times a night to urinate for YEARS. So, I take 3 drops a night and only get up 1-2 times.

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#30 calengineering

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Posted 20 November 2010 - 08:40 PM

Assuming you do not have BPH, prostatitis, and have otherwise been cleared by your physicians......

Consider licorice root liquid, assuming no underlaying medical conditions (can cause fluid retention, thereby elevating intravascular fluid volume, blood pressure, etc)

The bottle says to take 1tsp.

I wouldnt, as it was way too much for me.

Consider 10drops placed onto the teaspoon, swallow, follow with small sip of water to clear the mouth/throat.

Then back off until you find a satisfactory dosage........and balance this idea.....i get up 4times a night to urinate for YEARS. So, I take 3 drops a night and only get up 1-2 times.


Have you tried Saw Palmetto?




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