CBD for Overactive Bladder: Does It Work? 

 Key takeaways

• An overactive bladder (OAB) is a condition that causes urgent and frequent urges to urinate.
• Age, gender, and obesity are some risk factors for developing OAB.
• Evidence from research suggests that CBD can help improve overactive bladder symptoms. 
• Other treatment options for OAB include lifestyle changes, medication, and surgery. 

Overactive bladder, also known as OAB, is a medical condition that affects about 33 million people in the United States. It is a common problem among adults aged 40 and above and occurs more in women or people assigned female at birth (AFAB). 

Apart from age and gender, other risk factors for OAB include:

• Obesity
• Neurological disorders such as multiple sclerosis 
• Hormone changes after menopause
• Consuming too much caffeine or alcohol 

Cannabidiol (CBD) is one of the cannabinoids (active components) found in the Cannabis sativa plant. Over the past decade, CBD as a treatment has gained popularity, and many believe it can help alleviate symptoms of overactive bladder.  

This article examines research-based evidence on whether CBD really improves OAB symptoms or if it’s all hype. Before diving in, let’s define what an overactive bladder is. 

 What is an overactive bladder?

Overactive bladder or OAB is the term used to describe a group of urinary symptoms. People with OAB experience sudden and strong urges to urinate, often accompanied by increased frequency of urination. 

OAB happens when the nerves and muscles that control the bladder do not work properly, leading to an urgent need to urinate even when the bladder isn’t full. 

There are two types of OAB: 

• Wet OAB: This type of OAB is characterized by sudden, frequent urges to urinate and incontinence (loss of bladder control).
• Dry OAB: Like wet OAB, individuals with this type of OAB experience regular, abrupt urges, but they can hold it in until they get to the bathroom.  

 Can CBD help with overactive bladder? What research says

Studies indicate that CBD may help with overactive bladder in some people. In 2017, after reviewing three studies with a total of 426 participants, a team of researchers reported that tetrahydrocannabinol-cannabidiol (THC/CBD) capsules and oromucosal sprays significantly improved bladder control issues in OAB induced by multiple sclerosis. 

The results of a study published in 2018 also point in the same direction. THC/CBD oromucosal sprays successfully reduced OAB symptoms in 15 patients with multiple sclerosis. 

More high-quality research is needed before firm conclusions can be made. However, available evidence suggests that CBD might be an effective and safe treatment option for OAB caused by multiple sclerosis. 

 How CBD can help improve overactive bladder

CBD interacts with the body’s endocannabinoid system (ECS) when consumed. The ECS is a complex signaling system made up of cannabinoid receptors, endocannabinoids (cannabinoids produced naturally in the body), and enzymes responsible for breaking them down. 

The two main cannabinoid receptors are: 

• CB1: Primarily found in the central nervous system 
• CB2: Located in the peripheral nervous system, especially the immune cells 

By binding to cannabinoid receptors in the body, CBD produces certain positive effects that can benefit people with OAB, such as: 

 1. Easing inflammation

CBD reduces neuroinflammation. Its anti-inflammatory properties may help alleviate bladder overactivity in patients with neurological diseases like multiple sclerosis and Parkinson’s disease, which have a high prevalence of neuroinflammation. 

 2. Relaxing the bladder

The sudden urge to urinate experienced in OAB is caused by the involuntary contractions of the detrusor muscle located within the walls of the bladder. 

CBD may act on the cannabinoid receptors in the detrusor muscle to prevent it from going into overdrive. 

 3. Reducing anxiety

CBD has been shown to have calming effects and can help reduce anxiety. Stress and anxiety worsen OAB, so CBD’s potential to promote relaxation might indirectly alleviate symptoms. 

 Tips for trying CBD for overactive bladder

If you’re looking to try CBD for the first time, here are some tips to ensure you do so safely:  

• Talk to your doctor first: CBD interacts with several drugs, including blood thinners and antidepressants. Therefore, if you’re taking any medication, speak to your doctor before trying CBD to avoid complications. 
• Buy from trusted brands: Only buy CBD products from well-known brands that adhere to quality control guidelines and submit their products for regular third-party testing. The CBD market is largely unregulated. As a result, mislabeling and other discrepancies are common. 
• Use it during leisure or bedtime: Drowsiness is a common side effect of CBD, so it’s not advisable to use CBD products if you’re performing or about to perform a task that requires mental concentration — at least until you learn how well your body tolerates it.  
• Start with a low dose: It’s generally recommended to start with a low dose of CBD and gradually increase it if necessary. Wait at least a week before upping your dose to give the product you’re using enough time to work. 
• Monitor your symptoms: Keep track of your OAB symptoms before and during CBD use. This can help you evaluate the effectiveness of CBD in improving your symptoms and quality of life. 

 Other treatments that can help with overactive bladder

An overactive bladder can disrupt your work life, social life, and nighttime rest. For these reasons, it’s important to get a handle on it as soon as possible. 

Although there’s currently no cure for overactive bladder, the good news is that you can manage it effectively. The treatment options for OAB can be divided into four categories. 

 Lifestyle changes

You can implement these changes on your own without visiting the doctor’s office. Consider: 

• Losing weight if you’re overweight or obese 
• Cutting down on beverages that can make you pee more frequently, like coffee and alcohol
• Doing kegel exercises to strengthen your pelvic floor muscles 
• Trying bladder training techniques such as delaying urination to increase the time between bathroom visits 

 Medications

Your doctor may prescribe medications like darifenacin and tolterodine to help control involuntary contractions of the bladder muscle.

Botox treatment is also an option if you don’t respond to oral medication or have a contraindication. Your doctor will inject Botox into your bladder walls to stop the detrusor muscle from contracting too much. The effects of the injection wear off after 6 to 12 months, so you’ll have to repeat the process periodically. 

If you’re a woman or person AFAB that has reached menopause, your doctor may recommend estrogen replacement therapy. Estrogen is a hormone that contributes to the optimal functioning of the urogenital system. After menopause, estrogen production permanently reduces. 

 Nerve Stimulation

Nerve stimulation involves the use of electrical signals to regulate bladder contractions. There are two types of nerve stimulation treatments: 

• Sacral nerve stimulation (SNS): This is a minimally invasive procedure. During the surgery, the surgeon implants a small battery-powered pulse generator under the skin of your buttocks or lower abdomen. The pulse generator delivers electrical impulses to the sacral nerves, which help to modulate the contractions of the bladder. 
• Percutaneous tibial nerve stimulation (PTNS): Unlike SNS, this is a non-surgical procedure. A thin needle is placed in the tibial nerve located above the ankle. The needle sends electrical stimulation via the tibial nerve to the spine and nerves that control the bladder to prevent bladder spasms (involuntary muscle contractions). This process is repeated over the course of several weeks until the desired result is achieved.    

 Surgery

Your doctor will consider surgery as a last resort to treat OAB symptoms. Surgery carries many risks and is only recommended if the potential benefits outweigh the risks.

The surgeries used to treat overactive bladder are: 

• Augmentation cystoplasty: This surgical procedure increases your bladder’s capacity. A piece of your intestine or stomach lining is attached to your bladder to make it bigger so it can store more urine. 
• Bladder removal: The bladder is removed surgically, and your surgeon constructs a new one using a piece of your small intestine. Another option after bladder removal is to reroute the flow of urine to the outside of your body through an opening known as a stoma. You’ll then have to collect the urine with an ostomy bag, a small, waterproof bag used to collect waste. 

 Seeking medical support for overactive bladder

If you’re experiencing OAB symptoms that don't get better with suitable lifestyle changes, it’s best to book an appointment with your primary healthcare provider. 

Your doctor is in the best position to determine the cause of your symptoms and recommend a suitable treatment plan or refer you to a specialist.