Whether it’s a sudden urge to go to the bathroom or involuntary urine leaks at unfortunate times, a loss of bladder control can be embarrassing. And it can negatively impact lives and relationships. Urinary incontinence has a number of causes and takes several different forms.
But bladder leaks aren’t something you have to live with forever. Recent research reveals that cannabis can act on pathways in the brain and bladder. So, marijuana could improve bladder control and relieve symptoms of urinary incontinence—without the side effects of prescription medications. And it’s a little-known cannabinoid called cannabigerol that may play a major role in cannabis’s influence on the bladder.
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What Causes Urinary Incontinence?
Urinary incontinence is a fairly common problem that affects both men and women. But women are more likely to experience some kind of problem with bladder control than men will.
Urinary incontinence becomes more common with age, too. It’s estimated that about one in 10 people over the age of 65 will experience urinary incontinence.
Bladder control depends on a complex set of signals between a muscle called the detrusor, which lines the bladder wall, and the brain via signaling in the central nervous system. The detrusor muscle relaxes to hold urine. Then, in response to neurological signaling that the bladder is full, this muscle contracts to let it out. If the detrusor muscle is weakened or overactive, or if those signals aren’t transmitted properly by nerves in the spinal cord and brain, that’s when incontinence can happen.
Urinary incontinence is an umbrella term that covers several kinds of bladder control problems, including:
- Stress incontinence: When sudden pressure is put on the bladder from coughing, sneezing or lifting a heavy object.
- Urge incontinence: A sudden, strong urge to urinate that can also be followed by leaking urine, or the urgent need to urinate often.
- Overflow incontinence: A condition in which the bladder doesn’t completely empty, so that urine frequently leaks or dribbles.
- Overactive bladder syndrome: A condition in which the detrusor muscle is hypersensitive and contracts frequently.
Factors ranging from lifestyle choices to chronic neurological problems can cause a loss of bladder control. Common causes include:
- Certain foods and beverages such as alcohol, caffeine, carbonated drinks and spicy foods
- Childbirth, pregnancy and menopause, which account for the higher incidence of incontinence among women
- Smoking, obesity and a sedentary lifestyle
- Chronic neurological conditions such as multiple sclerosis (MS) and Parkinson’s disease, which affect nerve and muscle function throughout the body
- Some types of medications
More rarely, serious conditions such as a tumor in the bladder or bowel can cause urinary incontinence. But in general, urologists view most cases of incontinence as a neurological problem. This is because most times it involves the muscles and nerves that regulate urine retention and signaling to release it.
A number of conventional incontinence medications such as oxybutynin (Ditropan) and solifenacin (Vesicare) have been developed to target those pathways. But research reveals that cannabis can affect the same processes, thanks to the many endocannabinoid receptors in the bladder, central nervous system and brain.
RELATED: HOW THE ENDOCANNABINOID SYSTEM AFFECTS WOMEN’S HEALTH
Cannabinoids Can Support Bladder Control
The endocannabinoid system (ECS) is a widespread system of receptors found in most areas of the human body. These receptors, called CB1 and CB2, respond both to natural cannabinoids produced by the body itself and to cannabinoids found in cannabis. All of the pathways related to bladder function are rich in the cannabinoid receptor CB1, including:
- The bladder itself
- The central nervous system
- Areas of the brain that respond to signaling from the bladder
Bladder control issues are particularly common among people who have neurological disorders like Parkinson’s disease and MS. These disorders affect nerve and muscle functions throughout the body. For that reason, a number of studies on the use of cannabis for incontinence has focused on people with these kinds of conditions.
Recent research done in both the U.K. and U.S. reveals that cannabis extracts of various kinds helped to improve bladder control in a significant number of study participants with MS. These results were relatively consistent even though different cannabis formulations were used and some studies relied on patients reporting their own marijuana use.
For example, one study explored the use of a nasal spray containing both tetrahydrocannabinol (THC) and cannabidiol (CBD). Other studies used CBD tinctures and extracts, and still other researchers asked patients who already smoked cannabis to report their experiences.
The bladder and its signaling pathways in the spinal cord and brain respond to both THC and CBD. But research on the effect of various cannabinoids on bladder function and other health issues has revealed that cannabigerol (CBG), a lesser-known cannabinoid, may make a major contribution to improving muscle and nerve strength for better bladder function.
Like CBD, CBG has anti-inflammatory properties and is non-psychoactive. It also stimulates brain cells and supports bone growth. While researchers still aren’t sure exactly how it contributes to better bladder control, it appears to work directly on bladder contractility: the ability of the detrusor muscle to expand and contract as needed to contain and void urine.
Marijuana Can Replace Incontinence Medications
In general, cannabis compounds appear to act directly on CB receptors throughout the suburothelial mechanosensory apparatus—the mechanism by which the bladder responds to mechanical stimuli such as filling with urine. That’s something standard medications for incontinence don’t do.
Common pharmaceutical treatments for incontinence target various parts of the bladder control network to provide some relief for bladder control problems. But these medications can have side effects such as:
- Dry skin
- Digestive problems
More severe side effects can also occur. One medication, tolterodine, is also linked to a risk of hallucinations. And taking these medications along with other drugs such as antihistamines can cause more serious problems such as heart arrhythmia, which raises the risk of sudden death.
In multiple studies, cannabinoids including CBD, THC and CBG have been shown to relieve bladder control problems just about as successfully as standard prescription medications. But cannabis works directly with natural cannabinoid receptors in the body’s bladder control pathways. This means the plant can improve urinary incontinence conditions safely, without the potentially serious side effects of conventional pharmaceuticals.
Photo credit: Leo Rivas
If you’re new to cannabis and want to learn more, take a look at our Cannabis 101 post. HelloMD can help you get your medical marijuana recommendation; it’s easy, private and 100% online.