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CBD for Overactive Bladder – August 2022
Overactive bladder syndrome or OAB is a condition where one feels an uncontrollable and sudden urge to urinate.
OAB or urinary incontinence is caused when the bladder muscles or detrusor muscles involuntarily contract. These contractions can cause a person to urinate regardless of urine volume in the bladder.
Some conditions that may cause a person to experience OAB include diabetes, urinary tract infections, bladder stones or tumors, stroke, Parkinson’s d isease, multiple sclerosis (MS) , or hormonal changes.
A person with OAB may pass urine several times a day. Persons with this condition may experience emotional stress, interrupted sleep cycles, or sexuality issues affecting their social or work life (4) .
Some behavioral changes may allow a person to manage OAB and improve bladder control and overall wellness.
These changes include engaging in physical activity, exercising the pelvic floor muscles, maintaining a healthy diet, scheduling urination , and limiting smoking and consumption of alcohol (5) .
For OAB , other treatment options include taking prescription drugs, Botox injections, nerve stimulation, and surgery (6) .
Prescription drugs for OAB include oxybutynin, tolterodine, solifenacin, darifenacin, or fesoterodine. Oxybutynin may be taken as a pill or used as a gel or skin patch (7) .
What Studies Say About CBD ’s Effects on the Bladder
A pilot study by Maniscalco , Aponte , Bruzzese , and other researchers on the effects of cannabidiol on patients with multiple sclerosis OAB was conducted in 2017.
The researchers conducted clinical trials on several MS patients and evaluated leakage , detrusor muscle pressure, and spasticity .
The observation was done before and after tetrahydrocannabinol – cannabidiol oromucosal spray was applied to the patients.
Urodynamic findings after the treatment indicated a significant reduction of post-void residual volume. Bladder volume at the first desire and maximal cystometric capacity also increased. However, the amounts were insignificant.
The results showed that THC – CBD oromucosal sprays may improve bladder symptoms and detrusor overactivity (8) .
A 2010 review was published in the Indian Journal of Urology on the role of cannabinoid receptors in the bladder . T he researchers said that endocannabinoid receptors CB 1 and CB 2 in the bladder periphery may contribute to controlling bladder stimulus (9) .
Cannabinoids extracted from the Cannabis plant , like CBD , CBG , and THC , affect the CB 1 and CB 2 receptors . Unlike THC , CBD has no psychoactive effect characterized by a high sensation.
As of 2021, CBD has only been approved by the FDA to treat epilepsy (10) . Studies are still ongoing to determine and confirm the efficacy of CBD and medical marijuana on OAB .
How CBD Lowers Inflammation and Urinary Frequency
CBD may help manage various illnesses like neuroinflammation, epilepsy, vomiting and nausea, oxidative injury, and anxiety (11) .
Neuroinflammation is an inflammatory response in the central nervous system associated with various diseases like multiple sclerosis and stroke (12) . These diseases are some of the conditions that can trigger bladder dysfunctions like OAB .
CBD works by interac ting with the endocannabinoid system. The ECS contains receptors that regulate various body functions (13) , like CB 1 receptors in the central nervous system responsible for regulating inflammatory responses.
Can CBD Be Used to Manage Overactive Bladder Conditions?
The study by Maniscalco and colleagues showed that CBD as an oromucosal spray may effectively manage OAB (14) .
More clinical trials must be conducted to determine if other CBD oil products are as effective as THC – CBD oromucosal sprays .
How CBD Works on the Bladder
CBD may affect the bladder through the ECS, particularly the CB 1 and CB 2 receptors . This effect may help with controlling bladder stimulus (15) .
CBD also affects the ECS receptors that regulate inflammatory responses triggered by various neurological conditions like MC or stroke. These neurological conditions are known to cause OAB (16) .
Does CBD Create a Positive Effect on the Bladder?
The results from the 2017 study by Maniscalco and his team showed that CBD may have a favorable impact on detrusor muscle activity and help manage OAB symptoms (17) .
CBD is well tolerated and does not have the same psychoactive effects as THC , although both compounds are Cannabis extracts. However, the use of CBD may still cause side effects like diarrhea, reduced appetite, dry mouth , and fatigue (18) .
Patients with OAB are encouraged to consult a physician or professional health worker to determine if CBD is a practical option in managing OAB .
Cannabis & Incontinence
Scissor-walks and stutter-steps: the familiar dance performed by nearly 33 million Americans suffering from Overactive Bladder ( OAB ) – also known as Spastic Bladder and Detrusor Overactivity. OAB tends to plague people struggling with Multiple Sclerosis ( MS ) or other neurodegenerative diseases. While not exactly a given as we age, OAB also seems to affect a disproportionate number of older women and men.
Currently, two types of medications are available to treat OAB – antimuscarinics and Mirabegron (Myrbetriq). Doses of these powerful drugs must be carefully controlled. But even when used properly, these drugs can generate dry mouth, constipation, dry or itchy eyes, blurred vision, indigestion, urinary tract infection, urinary retention, drowsiness, high blood pressure and headaches. Taking too much accidentally can have more serious consequences, resulting in heart rhythm changes, hallucinations, seizures, and coma.
Because bladder control falls mostly to the central nervous system, it’s no surprise that cannabis may present novel and effective treatment options. We know that cannabinoid receptors are profusely expressed in both the central nervous system and peripheral nervous system. And we also know that these receptors are activated by endogenous compounds as well as components of the cannabis plant. Thanks to ongoing research on cannabis and MS , quite a bit of useful data about incontinence has been collected, both in preclinical studies and a few small clinical trials.
How bladder control works
The bladder is a pretty simple structure as far as organs go. Its major component is the smooth detrusor muscle. To facilitate urination, the lower detrusor muscle – located near the bottom of the bladder and contiguous with the urethral sphincter that controls outflow – contracts. During the filling stage, the detrusor remains relaxed and the sphincter closed.
The role of the central nervous system in continence appears to be fairly straightforward. Neural circuits in the brain and spinal cord enable the healthy function and voluntary control of the bladder. According to research at the University of Pittsburgh School of Medicine, “The central nervous mechanisms controlling the LUT [lower urinary tract] are organized in the brain and spinal cord as simple on-off switching circuits that are under voluntary control.”
Neural circuits in the brain and spinal cord enable the healthy function and voluntary control of the bladder.
However, as reported in the journal Urology, “Damage to central inhibitory pathways or sensitization of peripheral afferent terminals [nerve fibers] in the bladder can unmask primitive voiding reflexes that trigger bladder overactivity.”
Summarized, this means that after we’ve been potty trained, we can control our bladders through the sensory inputs and our intent. But with overactive bladder conditions, communication through the nervous system between bladder and brain goes a little haywire. Fortunately, it looks like medical science is poised to make a breakthrough by targeting our endocannabinoid system.
Endocannabinoids and bladder function
The bladder and its surrounding layers contain both types of cannabinoid receptors — CB 1 and CB 2. A 2017 report by South Korean scientists showed that detrusor overactivity can be affected by known agonists (activators) of the two cannabinoid receptors. In the urothelium, where the smooth detrusor muscle cells meet the sensory neurons, CB 1 activity exhibited special promise as a modulator in cases of OAB .
Human studies have shown that cannabis treatments decrease incontinence episodes.
A precise understanding of the pathways of cannabinoid remediation of OAB remains up for debate and more study, but the evidence emerging from ongoing research is that cannabis therapeutics can certainly play a beneficial role.
Given that most medications designed to treat OAB act to calm the nerves, it makes sense that cannabis, an anti-anxiety botanical, could confer a similar effect. In a detailed 2017 meta-analysis of the scientific literature, a team of European scientists screened thousands of articles in search of quality human trials. They found three, and those studies used either tetrahydrocannabinol ( THC ) or a combination of THC and cannabidiol ( CBD ) to study efficacy against overactive bladder in MS patients.
THC and CBD in human incontinence trials
The meta-analysis describes two random controlled trials and one open label trial comprising 426 male and female MS patients. They were treated with THC / CBD , administered either by capsule or oromucosal spray. The scientists found that the cannabis treatments “relevantly decreased incontinence episodes in all three studies.”
No side effects were reported in the tablet trials, but some of those who received the spray reported dizziness, headaches, vomiting, dry mouth and urinary tract infection. These side effects were considered mild compared to conventional treatments. Whether the administered drugs were synthetics, natural plant extracts or both was not reported in the meta-analysis.
The possibility of safe and effective cannabis-derived remedies for incontinence (without harsh side effects) spurs excitement in the holistic health community. However, it remains to be seen if CBD isolate or CBD -rich hemp with little or no THC will prove to be as effective as CBD combined with THC for OAB patients.
Linda M. June writes for the natural health and wellness community. She can be found at TheLetterista.com.
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