Compare the Best CBD Oil for Overactive Bladder in 2022

How CBD May Help With Overactive Bladder

The ECS (endocannabinoid system) is present in almost all areas of the body⁽¹⁾.

Evidence suggests that the components of the ECS, including anandamide and cannabinoid receptors, may be involved in bladder function regulation at several levels of the urination (micturition) pathway⁽²⁾. 

Anandamide is an endogenous cannabinoid or endocannabinoid⁽³⁾. Research indicates that the body has receptors for the cannabinoids CB1 and CB2 in the brain, bladder, and other body parts⁽⁴⁾. 

CB1, and to a lesser degree CB2, work at different levels on the detrusor muscles⁽⁵⁾. Studies suggest that CB1 receptors may affect urination, and their manipulation with cannabinoids from marijuana may help with overactive bladder (OAB). 

The detrusor muscle contracts during urination to push the urine out of the bladder and into the urethra⁽⁶⁾. When the detrusor muscle is relaxed, it allows the storage of urine in the urinary bladder. 

Individuals with OAB may experience urinary symptoms like sudden and frequent urination urges that are hard to control⁽⁷⁾. 

While no conclusive data can validate CBD’s benefits for OAB, recent results are promising.

A 2020 study hypothesized that a sudden strong need to urinate that is difficult to delay may result from damage to a descending pathway that starts with the excitatory neurons in the prefrontal cortex⁽⁸⁾. 

Meanwhile, research shows that CBD may act on targets throughout the brain, including the prefrontal cortex⁽⁹⁾. Hence, CBD may help individuals with OAB. 

CBD, unlike THC (tetrahydrocannabinol), has a very low affinity for cannabinoid receptors⁽¹⁰⁾. Still, the activation of the cannabinoid receptors can help the detrusor muscles function properly⁽¹¹⁾.

Like CBD, THC is a cannabinoid found in the cannabis plant⁽¹²⁾. THC is the predominant psychoactive constituent of cannabis (sometimes called marijuana)⁽¹³⁾. 

A 2018 observational study hypothesized that THC-CBD oromucosal spray may effectively improve OAB symptoms in multiple sclerosis patients, demonstrating a favorable impact on detrusor overactivity⁽¹⁴⁾.  

Multiple sclerosis or MS is a disabling illness of the central nervous system consisting of the brain and the spinal cord⁽¹⁵⁾. Urinary tract infections are often experienced by MS patients⁽¹⁶⁾.  

However, some researchers believe that CBD may reduce the efficacy and potency of THC⁽¹⁷⁾. 

Benefits of Using CBD for Overactive Bladder

Overactive bladder affects approximately 33 million people in the United States⁽¹⁸⁾. The condition is not an expected part of aging, contrary to what many people assume. OAB is an actual medical condition that needs treatment.

A pilot prospective study suggested that THC–CBD oromucosal spray may help improve overactive bladder symptoms in MS (multiple sclerosis) patients⁽¹⁹⁾.  

Common symptoms of MS are problems with bladder function and spasticity, which causes the muscles to feel heavy and stiff. 

A 2020 mini-review article published in the journal Frontiers in Physiology indicated that neural circuits extending from the cerebral cortex to the bladder avoid urinary incontinence⁽²⁰⁾.   

Urinary incontinence or leaking urine by accident is common among older people. Research suggests that one-fifth of individuals over 65 will lose some continence control⁽²¹⁾. 

The authors of the 2020 mini-review hypothesized that a sudden strong need to urinate that is difficult to delay may result from damage to a descending pathway that starts with the excitatory neurons in the prefrontal cortex⁽²²⁾.

The prefrontal cortex is the part of the brain covering the front part of the frontal lobe. 

Although CBD has multiple targets, it may influence the activity of excitatory and inhibitory signaling pathways. CBD may act on targets throughout the brain, including the prefrontal cortex⁽²³⁾. 

OAB occurs when the nerve signals between the brain and the bladder do not work correctly⁽²⁴⁾. Hence, using CBD may be beneficial for people with overactive bladder. 

A review article from the University of Leicester stated that dysregulation of the ECS in the human bladder may be responsible for developing OAB and detrusor overactivity⁽²⁵⁾.  

The detrusor muscle is a smooth muscle found in the bladder. Detrusor overactivity refers to a urodynamic observation marked by involuntary detrusor contraction during the filling phase that may be spontaneous or provoked⁽²⁶⁾.  

A randomized controlled trial involving multiple sclerosis and neurogenic detrusor overactivity patients explored the effect of cannabinoids on reducing urge incontinence episodes without affecting voiding⁽²⁷⁾. 

About 630 patients were randomized to receive oral administration of the cannabis extract, THC, or matched placebo. 

Based on incontinence diaries, there was a 25% reduction in the cannabis extract group. THC indicated a 19% reduction in urinary incontinence episodes relative to placebo. 

The results suggested that cannabis may modulate detrusor function⁽²⁸⁾. 

Any incontinence may affect a person’s overall quality of life. An individual with OAB may also experience emotional distress, anxiety, sleep disturbances, and issues with sexuality⁽²⁹⁾. 

A 2019 Permanente Journal study suggested that CBD may hold benefits for anxiety-related disorders⁽³⁰⁾.  

The study consisted of 72 adults with anxiety concerns and poor sleep. About 57 patients reported reduced anxiety scores within the first month and remained decreased during the study duration. 

Meanwhile, 48 patients reported improved sleep scores within the first month, although their scores fluctuated over time. CBD was also well tolerated in most participants, excluding three patients. 

The results suggested that CBD has a calming effect and may hold benefits for anxiety-related disorders⁽³¹⁾.  

While the results of these studies are promising, they are still inconclusive. Hence, further longitudinal research and more clinical trials are warranted to determine the possible benefits of CBD for overactive bladder.  

How Long Does CBD Take to Help Overactive Bladder?

CBD’s efficacy depends on various factors, including individuals’ body weight, metabolism, CBD potency, and route of administration. 

A study hypothesized that THC–CBD oromucosal spray may help with OAB symptoms in patients with multiple sclerosis⁽³²⁾.

An oromucosal spray may be administered via the sublingual (under the tongue) route. CBD administered sublingually usually takes effect within 15 to 30 minutes⁽³³⁾.    

How Long Will CBD Help With Overactive Bladder?

CBD is being pursued as a treatment option for several medical conditions, usually by oral delivery⁽³⁴⁾. 

A systematic search was conducted to retrieve all articles reporting the pharmacokinetic data of cannabidiol in humans⁽³⁵⁾. 

Out of the 792 articles retrieved, about 24 articles included pharmacokinetics parameters in humans. 

The half-life of CBD was reported between 1.4 and 10.9 hours following oromucosal spray, two to five days after chronic oral administration, 24 hours after intravenous therapy (delivery of substances into the veins), and 31 hours after smoking⁽³⁶⁾. 

The bioavailability of CBD after smoking was 31%⁽³⁷⁾. 

Half-life is the length of time needed for the concentration of a specific drug to decrease by 50% of its starting dose in the body⁽³⁸⁾.  

Meanwhile, bioavailability refers to the extent to which a drug or substance becomes entirely available to its intended biological destination⁽³⁹⁾.  

The Possible Side Effects and Risks of Using CBD for Overactive Bladder

The Food and Drug Administration (FDA) does not recognize CBD as a medical treatment for overactive bladder.

In addition, like other pharmaceutical drugs, alternative treatments, and supplements, CBD may also carry some risks and side effects. 

The most commonly known side effects of CBD include⁽⁴⁰⁾:

• Dry mouth
• Diarrhea
• Reduced appetite
• Drowsiness
• Fatigue 

Another cause for concern is a possible drug interaction. CBD, when taken with other drugs, may inhibit cytochrome P450 enzyme production at high doses⁽⁴¹⁾.

Cytochrome P450 enzymes are a family of liver enzymes that metabolize nearly 60% of the pharmaceutical drugs people consume⁽⁴²⁾. 

Tolterodine is used to treat overactive bladder. It is included in a class of medications called antimuscarinics that relax the bladder muscles⁽⁴³⁾.  

Tolterodine is also metabolized by cytochromes P450⁽⁴⁴⁾. Therefore, CBD may interact with tolterodine.   

Legality of CBD

The United States Congress ratified the 2018 Farm Bill, decriminalizing the commercial use of industrial hemp and products obtained from hemp plants⁽⁴⁵⁾. 

The bill indicates that Cannabis sativa L. and other derivatives of cannabis with no more than 0.3% THC content on a dry weight basis are considered federally legal⁽⁴⁶⁾. 

The Federal Comprehensive Drug Abuse Prevention and Control Act of 1970 created a drug schedule to classify substances into five categories based on the potential for drug abuse and possible medical use of various substances⁽⁴⁷⁾.

Some states have passed laws permitting recreational and medical marijuana. However, these state laws do not change the fact that, under federal law, marijuana is still listed as a Schedule I drug⁽⁴⁸⁾. 

Substances listed in the Schedule I drugs have a high abuse potential with no acceptable medical use⁽⁴⁹⁾. Thus, medications under this category may not be dispensed, prescribed, or administered under federal law. 

Rules and regulations regarding medical cannabis may be confusing. Therefore, consumers should familiarize themselves with various state laws. 

Colorado is one of the states that legalized recreational and medical marijuana⁽⁵⁰⁾. 

Under HB 21-1317, Colorado limits the daily purchase of marijuana to two ounces of flower and eight grams of concentrates, like shatter and wax, for medical marijuana patients⁽⁵¹⁾.

The concentrate limit for medical patients between 18 and 20 is two grams per day⁽⁵²⁾.

Exceptions to the limits apply to patients whose physicians confirm in writing that the patients have a physical hardship that should allow them to exceed their daily purchase limits⁽⁵³⁾.