Hi David, I have a 45 year old female patient who started taking ashwagandha and noticed that she had some urinary leakage (she made the connection in her head later). That was several months ago. She stopped the ashwagandha for no good reason, and recently started taking it again, and went for a walk and had a slow dribble of urine at various points in the walk. She asked me if ashwagandha can cause this. I didn't think it was a diuretic or should affect the bladder or pelvic floor in such a way to cause this symptom, but I wonder if you have heard of this at all? In my online research, I came upon this! https://www.ehealthme.com/ds/ashwagandha/urinary-incontinence/

I have not seen this with my patients nor seen it in the literature. Based on the case you have and the few in the report you found, it seems possible, albeit quite rare. Ashwagandha is an antispasmodic and perhaps it relaxes the urinary sphincter in some cases.