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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 .
THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study
Lower urinary tract dysfunctions (LUTDs) are commonly reported in multiple sclerosis (MS) patients and are mainly related to neurogenic overactive bladder (OAB). The aim of this observational study was to assess the effect of a tetrahydrocannabinol-cannabidiol (THC/CBD) oromucosal spray on resistant OAB by means of clinical and instrumental tools. Twenty-one MS patients were screened, and 15 cases have been evaluated. They underwent a specific clinical assessment (overactive bladder symptom score, OABSS) and a urodynamic assessment evaluating the maximal cystometric capacity (CCmax), bladder compliance (Qmax), maximum detrusor pressure (Pdet max), detrusor pressure at the first desire (Pdet first), bladder volume at the first desire (BVFD), leakage volume (LV), and post-void residual volume (PVR), before and after 4 weeks of THC/CBD administration. A complete neurological evaluation, including the assessment of their spasticity using the Modified Ashworth Scale (MAS) and the spasticity 0-10 numerical rating scale (NRS), was performed at the same times. Mobility was evaluated through the 25-ft walking-time test (T25-WT). The THC/CBD treatment successfully reduced the OAB symptoms (p = 0.001). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced (p = 0.016). Regarding the urodynamic findings after the end of treatment, PVR was significantly reduced (p = 0.016), while BVFD and CCmax were increased although the difference was not statistically significant. THC/CBD oromucosal spray has shown to be effective in improving overactive bladder symptoms in MS patients demonstrating a favorable impact on detrusor overactivity.
Keywords: Cannabinoids; LUTDs; Multiple sclerosis; Nabiximols; Sativex; Spasticity.
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