DEAR DR. ROACH: I’m an 81-year-old mother of five, and I have an overactive bladder. My situation was the usual “can’t get there in time.” I had taken an expensive drug for this, which worked but gave me a “brain fog” feeling that I didn’t need or want. My doctor, a female specialist, recommended pumpkin seed oil. I took it for about two months before improvement. Could you review the evidence? The pharmacists I talked to did not know about this. — P.C.D.

ANSWER: I found a 2014 study from Japan that treated 25 women and 20 men with overactive bladder for three months with 10 grams (about 2 tablespoons) pumpkin seed oil. The results showed significant benefit, especially in people who had what we call “urgency,” the sense that you have to get to the bathroom right away. No side effects were noted, and there were no significant changes in cholesterol levels.

I can conclude that although this was a small study from Japan — which may not be exactly applicable to a U.S. or Canadian population — pumpkin seed oil has some potential for benefit. I’d like to see a larger study done to confirm these results before I recommend it; however, especially for people who have side effects from their current treatment, it might be worth a try. People should recognize that in the study, it took three months for maximum benefit.

When I looked online for pumpkin seed oil, I found the liquid oil, but also 1,000-mg capsules. To replicate the study findings, it would take 10 capsules a day. I don’t know if less would work as well.

DEAR DR. ROACH: I seem to have an opposite problem of many of your readers: My blood seems to be too thin. A needle prick takes 20 minutes to coagulate. I have not had any serious bleeding. I have been taking a baby aspirin (81 mg) three times per week. I am a healthy, somewhat athletic male, 64, a vegetarian with BMI of 28. I take only vitamins. I have normal blood pressure and no diabetes, and my cholesterol level is good. Should I stop taking the aspirin? I understand that it also prevents inflammation, so there is a benefit other than blood-thinning. — K.S.

ANSWER: Aspirin is prescribed to people with cholesterol plaques, as its ability to prevent the blood from clotting has been clearly shown to reduce heart attack risk in people with known blockages in the arteries. Aspirin works by decreasing the function of platelets, the specialized blood cells that start forming clots. For decades, people at higher risk for heart disease have been recommended aspirin to prevent a first heart attack, even if they aren’t known to have blockages. This is based on several studies that showed a benefit. However, more recent studies have not shown that benefit, and physicians are divided now about who should receive aspirin. The downside is that it can cause serious bleeding, especially in the stomach and intestines.

Aspirin has at least one other major benefit, which is to reduce the risk of colon (and to a lesser extent other) cancers. People with high risk of colon cancer due to polyps or family history may also be recommended to take aspirin for this benefit.

The decision to take aspirin requires an individualized assessment of risk. The U.S. Preventive Services Task Force recommends aspirin for men age 40-60 if their 10-year risk of heart disease is 10 percent or higher (you can estimate yours at http://www.cvriskcalculator.com/).

Twenty minutes is a very long time to bleed, even on aspirin (and your dose is very low). I would be concerned about a separate bleeding problem, such as von Willebrand’s disease. Mention this to your physician.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.

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