Which Chinese Herbs Are Effective for Frequent Urination and Urgency Caused by Ureaplasma urealyticum?

Ureaplasma urealyticum infection is a common clinical disease of the genitourinary system. One of its main complaints is frequent urination and urgency—patients often urinate ≥8 times during the day and ≥2 times at night, cannot hold urine for more than 10 minutes after feeling the urge, and some experience mild urethral burning or lower abdominal heaviness, severely affecting daily life. 

As a sexually transmitted infection, treatment requires both pathogen elimination and relief of urinary discomfort. Antibiotics can lead to resistance (with resistance rates exceeding 30% in some regions). Traditional Chinese Medicine (TCM), with its approach of syndrome differentiation and holistic regulation, has become an important option for alleviating urinary frequency and urgency and controlling infection.

In TCM, ureaplasma infection is classified as "Lin Syndrome", with the core pathogenesis being "damp-heat evil invading the lower burner, impairing bladder qi transformation". The essence of frequent urination and urgency is "damp-heat obstructing the bladder, causing water metabolism disorder."

I. TCM Understanding of Ureaplasma Infection and Urinary Symptoms: Causes and Symptom Characteristics

To choose the correct herbs, it is necessary to clarify the TCM logic and symptom differences of ureaplasma-induced urinary frequency and urgency, avoiding blind medication:

1. Core Cause: Damp-heat invasion impairing bladder qi transformation

TCM believes urinary frequency and urgency from ureaplasma infection is mainly caused by:

External damp-heat invasion: Often due to unclean sexual activity or poor genital hygiene, leading to damp-heat evil (corresponding to ureaplasma pathogens) entering the urethra and descending to the bladder, obstructing bladder "qi transformation"—normally the bladder can "store and excrete urine," but damp-heat obstruction results in "unstable urine storage" (urgency) and "incomplete urination" (frequency, incomplete voiding).

Internal damp-heat accumulation: Diet high in spicy foods, alcohol, and prolonged sitting generate internal damp-heat, combining with external evil, further obstructing the bladder and making urinary frequency and urgency recurrent and difficult to relieve. Prolonged damp-heat may also cause lower abdominal stabbing pain.

2. Accompanying Symptoms: Key for Syndrome Differentiation

Urinary frequency and urgency often come with other symptoms, which can guide syndrome differentiation and herb selection:

Damp-heat descending type (most common): Urgency and frequency with urethral burning, yellow or reddish urine; men may have slight urethral discharge ("morning smear"), women may have increased yellow vaginal discharge; tongue coating yellow and greasy.

Damp-heat with stasis type (disease course >1 month): Urinary frequency and urgency with lower abdominal or perineal heaviness or stabbing pain (worse after sitting); occasional painful urination; tongue edges may show blood stasis spots.

Spleen-deficiency with dampness type (weaker constitution): Urinary frequency and urgency with weak urination, incomplete voiding, worsened after fatigue; accompanied by tiredness and loose stools; tongue pale with greasy coating.

II. Chinese Medicine Treatment for Urinary Frequency and Urgency: Syndrome-Based Herbal Options

The core principle for TCM treatment of ureaplasma-related urinary frequency and urgency is "clear heat, drain dampness, promote urination", while also addressing "blood stasis and spleen deficiency" as needed. Clinically, treatments fall into "classic syndrome-based formulas" and "patented herbal medicines", suitable for different syndromes and severity.

(A) Classic Syndrome-Based Formulas: Targeted Urinary Relief

1. Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver): Preferred for Damp-Heat Descending Type

Indications: Urinary frequency and urgency with urethral burning, yellow or reddish urine; men may have prostatitis (perineal heaviness), women may have vaginitis (yellow sticky discharge); tongue coating yellow and greasy.

Core Effects: Clears liver and gallbladder heat, drains dampness, restores bladder qi transformation, relieving "unstable urine storage" caused by damp-heat.

Herb Composition Logic: Gentian, Scutellaria, Gardenia clear heat and drain fire (target damp-heat); Plantago seed, Alisma, Akebia promote urination and relieve frequency; Angelica and Rehmannia nourish blood and prevent cold herbs from injuring yin; Bupleurum regulates liver qi, improving damp-heat obstruction.

Precautions: Herbs are bitter-cold; patients with spleen-stomach deficiency (prone to diarrhea or cold intolerance) should take after meals or add ginger and jujube under physician guidance; course generally 7–10 days, adjust after symptoms relieve.

2. Ermiao Wan / Simiao Wan: For Damp-Heat with Lower Limb Discomfort

Ermiao Wan: For mild damp-heat: yellow turbid urine, slight lower abdominal heaviness, tongue yellow-greasy; clears heat and dries dampness, Alisma and Phellodendron relieve lower burner damp-heat, suitable for mild or recovery-phase patients.

Simiao Wan: For damp-heat with urethral burning, lower limb heaviness, male epididymitis, female pelvic inflammation; clears heat, drains dampness, promotes circulation, relieves pain; add Coix seed, Achyranthes to enhance dampness elimination and improve reproductive system discomfort.

Precautions: Avoid raw/cold or greasy foods; contraindicated in pregnancy.

3. Wuwei Xiaodu Yin: For Local Redness and Swelling

Indications: Urgency and frequency with mild urethral redness or pain, acute urethritis from ureaplasma infection.

Core Effects: Clears heat and detoxifies, reduces pathogen proliferation, relieves urethral inflammation, alleviating urgency and frequency.

Herbs: Honeysuckle, wild chrysanthemum, dandelion, Viola, Herba Taraxaci—all clear heat and detoxify; honeysuckle and dandelion also promote urination.

Precautions: Herbs are cold; avoid in external wind-cold (cold/flu); course ≤7 days, then switch to milder damp-draining formula.

4. Single Herbs & Combinations: Daily Support for Urinary Symptoms

Clear Heat & Promote Urination: Honeysuckle 10g + Forsythia 10g + Poria 15g, boiled as tea once daily; suitable for early damp-heat with frequency and urethral burning; honeysuckle/forsythia clear heat, Poria strengthens spleen, prevents overcooling.

Promote Circulation & Relieve Pain: Rehmannia 12g + Salvia 10g + Yam 15g, boiled as tea; suitable for damp-heat with stasis, urinary frequency with lower abdominal stabbing pain; Rehmannia and Salvia invigorate blood, Yam strengthens spleen and kidneys, also supports constitution.

(B) Patented Herbal Medicines: Multi-System Support for Men and Women

For ureaplasma infection causing urinary frequency + genitourinary inflammation (male prostatitis, female pelvic inflammation), patented TCM is preferred, especially for mixed syndromes or long-term antibiotic resistance:

1. Diuretic and Anti-inflammatory Pill (Male)

Indications: Male ureaplasma infection with urinary frequency/urgency, concurrent prostatitis or epididymitis.

Composition & Effects: Includes Plantago seed, Qu Mai, Bi Xie (promote urination), Honeysuckle, Houttuynia (clear heat, inhibit ureaplasma), Angelica, Red Peony (invigorate blood); triple effects: clear heat/drain damp, promote urination, invigorate blood.

Advantages: Increases urine volume, relaxes urethral smooth muscle, reduces residual urine, relieves incomplete voiding + urgency; clears pathogens to reduce bladder irritation and prevent recurrence.

Dosage: 1 sachet (~15g) twice daily with warm water, no boiling needed; 3 months per course; suitable for busy men.

2. Fuyan Pill (Female)

Indications: Female ureaplasma infection with urinary frequency/urgency, vaginitis, cervicitis, or pelvic inflammation.

Core Effects: Clear heat, detoxify, strengthen spleen, drain damp, invigorate blood; Poria and Atractylodes strengthen spleen and drain dampness; Honeysuckle and Forsythia clear pathogens, improve urethral and reproductive inflammation.

Advantages: Enhances bladder qi transformation, reduces unstable urine storage, promotes urination to flush urethra, relieving frequency and urethral burning.

III. Key Safety Considerations When Using TCM

1. Syndrome differentiation first, avoid "one-size-fits-all"

Damp-heat descending type: avoid warming herbs (Aconite, Cinnamon) to prevent aggravating damp-heat.

Spleen-deficiency with dampness: avoid strong cold herbs (large doses of Honeysuckle/Forsythia) to prevent diarrhea.

If unsure, consult TCM practitioner for tongue diagnosis and symptom assessment.

2. Follow prescribed dosage and full course, avoid stopping early

Mild: 2–3 weeks for classic formulas, 1–2 months for herbal prescriptions.

Severe or with other inflammation: 3–4 months; continue 1 month after symptom relief to prevent recurrence.

3. Avoid self-combination or overuse

Do not take multiple heat-clearing formulas simultaneously (e.g., Longdan Xiegan Tang + Wuwei Xiaodu Yin), to avoid spleen/stomach damage.

If taking antibiotics, separate by 1–2 hours to prevent interaction.

4. Combine with local care

Wash external genitalia daily with warm water; avoid irritating soaps; keep dry to reduce pathogen growth.

Drink 1.5–2 liters water daily to flush urethra and enhance herbal urination-promoting effects.

IV. Preventing Recurrence: Key to Reducing Recurrent Urgency and Frequency

Control transmission: Avoid sexual activity during treatment; partners should be checked and treated; use condoms and avoid multiple partners.

Improve habits: Avoid spicy foods, alcohol; prevent prolonged sitting (stand every 45 min for 5 min); wear breathable cotton underwear.

Enhance immunity: Maintain regular sleep (≥7h), avoid late nights; exercise 3–5 times/week (jogging, swimming) for 30 min to improve pelvic blood flow and bladder/urethra resilience.

Regular follow-up: Check ureaplasma at 1 and 3 months after symptom resolution; adjust herbs if pathogen persists to prevent chronic infection and recurring urinary symptoms.