Cranberry juice for Bladder Infections: Fact or Folklore?

 

We’ve all heard it.  ”Drink cranberry juice to flush out a bladder infection!”  Is this really a medical remedy?

The answer is, Yes!

According to new research published in Archives of Internal Medicine, cranberry- containing products, especially cranberry juice, protect women against bladder infections, especially those prone to recurrent infections. (1)
Bladder infections, or urinary tract infections (UTI’s), are on the most commonly acquired bacterial infections, leading to approximately 7 million office visits and 1 million visits to emergency departments each year in the US, with estimated annual cost of $1.6 billion dollars. Approximately, 40-50% of women will experience at least one episode of UTI during their lifetimes.   Some of my patients experience many more!

Fact or folklore?
For years, cranberry juice, and its derivative tablets and capsules, were perceived merely as a folk remedy to prevent UTI’s. Now, findings indicate that cranberry-containing products legitimately do contain powerful substances which protect against UTI’s – in the general population of women, as well as highly susceptible women, such as pregnant women or elderly patients.
The research reviewed 13 different randomized, controlled trials involving over 1,600 men, women and children of different populations including the elderly. The majority of trials were conducted in North America with the remainder performed in Finland, Italy and the United Kingdom.
How do cranberries help prevent bladder infections?
Cranberry ( genus Vaccinium) has been shown to contain a specific substance, known as A-type proanthocyanidins (PAC’s) which interfere with the way bacteria attach to the bladder wall.

To get a bit more technical, the PAC’s inhibit the adherence of P-fimbriated Escherichia coli (or E. coli, the most common bacteria leading to UTI) to urogenital mucosa. Cranberry juice was more effective than capsules or tablets, most likely due to the fact the women drinking the juice consumed approximately 2-3 glasses of cranberry juice /day and thus were better hydrated. The exact dose of PAC’s to prevent UTI’s has yet to be determined, so limit your intake of juice and increase water intake.
Here are 5 tips to decrease your risk of UTI.

1) Stay hydrated. Drink 6-8 glasses of water every day. If you feel some symptoms of UTI coming on, such as burning when you urinate or urinating more frequently, add 1-2 glasses of cranberry juice to your daily intake. (One caution: cranberry juice contains a large amount of sugar so if you are diabetic, speak with your physician before this.)

2) Be careful with personal hygiene. Always clean your genital area from front to back to avoid spreading bacteria from your rectum to your vagina.

3) Urinate after sex. This will help flush out the bacteria that may be heading towards your urethra, which is the opening where urine comes out from your bladder.

4) Avoid the use of scented soaps, feminine deodorants and colored toilet paper. These may contain chemicals which can irritate your genital area.

5) Avoid prolonged activities that may increase urinary tract infections such as prolonged bicycle rides, horse riding or motorcycles. Instead, take a break every 1-2 hours and empty your bladder.
If you are persistently prone to UTI’s, especially after having sex, your physician may prescribe an antibiotic which will prevent these infections.

So stock up on some cranberry juice! Your bladder will thank you for it.

Lighting the way…

Dr. Diana

Dr. Diana

Citations:

1) Wang, CH., et al(2012).  Cranberry-Containing Products for Prevention of Urinary Tract Infections in Susceptible Populations:  A Systematic Review and Meta-Analysis of Randomized Controlled Trials.  Arch Intern Med; 172 (13); 988-996.

Please share any other tips you may have to reduce or treat bladder infections.  The Listen To Your Libido Community is waiting to hear from you!

Birth Control for Men?

Sounds like an oxymoron, right?  But it’s true.

Now it’s the man’s turn to assume some responsibility in the contraceptive arena!  No longer is it just a man’s choice between using condoms  or getting a vasectomy.  Amazing new options are on the horizon!  Researchers are investigating various forms, targeted solely towards men, which are showing very promising results.  These options range from a long-acting injectable gel to a quick-acting male pill that could potentially markedly reduce the transmission of HIV.

According to a recent survey conducted by the U.S. Government’s Center for Disease Control (CDC), more than 80 percent of heterosexual women have used birth control pills at some point in their lives to prevent pregnancy.    Birth control pills became available to women in the 1960’s and represent the most common contraceptive used in the United States today.  Interestingly, global demand for male birth control appears increasingly popular, with a 2005 German survey revealing that 60 percent of men in Spain, Germany, Brazil and Mexico are willing to use a male contraceptive.

What is this new injection procedure?

It’s called Vasalgel and involves an injection into a man’s genitals which inhibits sperm motility.  It’s a new form of contraception known as, RISUG, reversible inhibition of sperm under guidance (1).  Yes, many men may become queasy just imagining a needle being injected into these tender areas.  After receiving a local anesthetic, a small amount of polymer gel is inserted into the vas deferens of each testicle.   The vas deferens is the conduit which transports sperm from the testicle to the penis.  The procedure apparently takes less than 15 minutes, works by destroying the sperm, lasts up to 10 or more years and is more easily reversible than a vasectomy!

When and if the man decides to return his sperm back to speedy and motile swimmers, another shot is given.  Within 2-3 months, active, functional sperm are functioning again.

These studies have been ongoing for the past 25 years and found to be safe in both humans and animals.  Researchers are optimistic that the procedure will become available in the U.S. by 2015, with clinical trials beginning this year.  At present, trials are only being conducted in India.

What about the new male birth control pill

In Papua Island, Indonesia, tribesmen have discovered a shrub called “Gandarusa” that acts like a birth control pill for men.  Per one tribesman, “If you chew the leaves often enough, your wife won’t get pregnant.”  The potential benefits derived from this shrub are undergoing close evaluation and appear to work by slowing down the activity of certain enzymes in the sperm that allow them to penetrate a woman’s egg.  For fertilization to occur, a sperm must enter the egg.  According to Sugiri Syarief, the head of Indonesia’s state-run National Family Planning Coordination Board, multiple animal and human trials have been conducted since the 1990’s and the plant’s effective compound was patented in 2007.  Researchers have tested the pill on two different groups of male volunteers, the first 36 men, and later with 120 men.  Trials involving more than 350 men are presently being done to verify that the sperm remain healthy yet are incapable of this critical penetration process in fertilization.

What else is looming on the horizon? 

Possibly another type of male birth control pill may become available.  Discovered by accident while studying male infertility patients, a group of Scottish scientists recently found a key gene essential for sperm development.   Per Dr. Lee Smith at the University of Edinburgh in Scotland, if scientists are able to regulate the Katna1 gene in the testes, they could prevent sperm from maturing completely, making them ineffective without changing hormone levels (2).

So why hasn’t the male birth control pill become available in the United States?

Profit, or lack thereof, is the apparent culprit!   Per Elaine Lissner, director of the non-profit Male Contraception Information Project in San Francisco, the impasse to male birth control pills has been the lack of profitability for the pharmaceutical giants.  “It’s a nightmare from the ‘for-profit’ standpoint.  We have to accept that the needs of for-profit entities and the needs of the public don’t always perfectly match.”

Definitely makes one wonder – what are pharmaceutical companies actually pouring their financial resources into?  Another drug for erectile dysfunction which makes a hearty return on investment or a male birth control pill which yields little return but carries huge global population impact?  Well, time will tell but I’m thinking the former!

What do you think?  Please share your comments!

Citations:

1. http://www.globalpost.com/dispatch/news/asia-pacific/indonesia/110224/indonesia-birth-control-pill-papua-men

2. http://www.globalpost.com/dispatch/news/health/120525/sperm-gene-discovery-could-lead-to-male-birth-control-pill

 

Lighting the way…

Dr. Diana

Dr. Diana
 

One Step Closer to a “Female Viagra”?

We’ve all seen the commercials for the little blue pill, Viagra. Men jumping for joy while the song , “We are the Champions”, by Queen, is blasting in the background. Ever wonder why the little blue pill that has worked wonders for male sexual dysfunction never made it into a little “pink” pill?

Well, new research led by a team of researchers at Pfizer’s labs in England, using a novel prototype drug may pave the way for discovering more about the mechanisms underlying female sexual arousal and developing a “female Viagra”. (1),

It is estimated that approximately 40% of women experience some type of sexual disorder, with desire and arousal being the most common (2,3). At present there is not a single US FDA approved medication for treatment of sexual problems in women. When Pfizer initially marketed Viagra for men, there were high hopes that Viagra, sildenafil citrate, would work as effectively for women and represent the “Holy Grail” that many pharmaceutical companies were vying to find.

The Advent of the “Blue Pill”

Viagra was initially developed by British scientists and brought to market by Pfizer, becoming available in 1998. Since this time, sildenafil has been the primary treatment for erectile dysfunction in men. Viagra works by increasing blood flow, or vasocongestion, in the erectile tissue located in the penis. For those biochemists out there, the mechanism of action involves the protection of cyclic guanosine monophosphate (cGMP) from being metabolized by a certain enzyme, phosphodiesterase type 5, leading to smooth muscle relaxation and increased inflow of blood into the spongy tissue of the penis, causing an erection (4).

What did studies in women taking Viagra find?

Definitely not the same results as in men! One large study involved premenopausal and postmenopausal women with female sexual arousal disorder comparing 10-100 mg sildenafil with matching placebo. Unfortunately, there was no perceived difference in improvement of sexual response in the women in the Viagra compared to placebo (5). Other studies also confirmed these findings.

So how are we a step closer to a “female Viagra”?
A research group led by Chris Wayman at the Pfizer lab found that electrically stimulating the pelvic nerve increases blood flow to the genitalia and that by using a prototype drug ( UK-414, 498) this effect was enhanced. The drug which was tested on rabbits and found increased blood flow specifically to the genitalia. The key component is that arousal was initially stimulated in the female rabbits and then the drug was administered. “The drug would not create arousal out of nowhere, however, would boost blood flow when accompanied by desire and sexual stimulation”, said Wayman.

According to Sheryl Kingsberg at Case Medical Center in Cleveland, this new discovery will help only a minority of women who have diagnosable arousal disorders, approximately 5% of women (6). “This is the closest thing out there to Viagra for women, but the problem is that a Viagra-like effect will not solve the majority of sexual dysfunction cases in women. In contrast to men in whom erections have played a huge role in sexual health, for women arousal is not the key problem, desire is.”

Though the prototype itself is unlikely to become a drug according to Wayman, “Testing the drug has helped to defog the mystery behind Female Sexual Arousal Disorder.”So we are left with the million dollar question of how to increase desire in women.

As we know female sexual response is complex and can’t be flipped on like a light switch. It’s more like a complex control panel.

Presently, researchers are investigating specific medications which work “above the belt” in women, targeting areas in the brain responsible for desire…because for women, the main sexual organ is the brain!

In the meantime, start doing your own research.

What make you feel more desire?
What makes you feel more desirable?

I believe that “you first need to feel desirable — to then have desire- “

Citations:
1. Wayman, CP. et al. UK-414,495, a selective inhibitor of neutral endopeptidase, potentiates pelvic nerve-stimulated increases in female genital blood flow in the anaesthetized rabbit. British Journal of Pharmacology. 2010; May: 160 (1): 51-59.

2. Laumann, EO. et al. Sexual Dysfunction in the United States: Prevalence and Predictors. JAMA, 1999; 281 (6): 537 -544.

3. Laumann, EO et al. A population- based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America. Int.J. Impot. Res. 2009; May-June: 21(3): 171-178.
4. Webb, DJ et al. Sildenafil citrate and blood-pressure lowering drugs : results of drug interaction studies with an organic nitrate and a calcium antagonist. Am. J. Cardiol, 1999; 83: (5A): 21C – 28C.

5. Basson, R. et al. Efficacy and safety of sildenafil citrate in women associated with female sexual arousal disorder. Journal of Women’s Health and Gender-Based Medicine. 2002;11:367-377.

6. Are We a Step Closer to a Viagra for Women? http://abcnews.go.com/Health/Wellness/viagra-women-female-sexual-dysfunction-spotlight.

Antidepressants: Are they Killing Your Sex Drive?

Did you know that over the past two decades the rate of antidepressant use has increased nearly 400%? It is estimated that approximately 11% of all Americans aged 12 and older are now taking some form of anti-depressant medication. According to the US National Health and Nutrition Examination which analyzed data from 2005-2008, antidepressants are now the third most common prescription drug taken by Americans of all ages and most frequently used by those aged 18 – 44 (1).
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Can I use my husband’s Viagra?

photo credit: Paul-in-London

If your partner’s doctor diagnoses him with erectile dysfunction, he may be prescribed a medication such as Viagra.  While this little blue pill has done wonders for men, it has not panned out to be a panacea for women.  For men, Viagra causes smooth muscle relaxation, which increases blood flow to the penis, allowing it to engorge and become erect.  In women, the issue with
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Certain medications can sedate your love life

photo credit:  D Sharon Pruitt

If you’re experiencing diminished libido, it could be the result of a medical condition.  Have you had a physical recently? 

What habits (poor diet, smoking, etc.) might be negatively impacting your health and/or sexual desire? 

Are you currently taking any medications (prescription and/or nonprescription)? 

Would it surprise you to know that both prescription and nonprescription medications can alter sexual desire, arousal, and orgasm?  They can.

Some medications interfere with libido by affecting the…
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Is there a Viagra for Women?

Presently pharmaceutical companies are working on finding a new female libido-enhancing drug – what might be termed as the new “pink Viagra”.  Their studies have led to the development of
Read More