Cannabis and Prostate

February 2024 by Sandy Yanez

The prostate gland is a part of the male reproductive system and though it’s only about the size and shape of a walnut, its impact on men’s health can be significant. The prostate sits just below the urinary bladder and surrounds the upper portion of the urethra (the tube that carries urine out of the body). If the prostate becomes infected or enlarged, not only can it become challenging and painful to urinate, but it can also lead to serious problems.

Two common conditions that affect the prostate are prostatitis and benign prostatic hyperplasia (BPH). Although both conditions can cause discomfort and difficulty when urinating, they have different root causes.

The difference between Prostatitis and BPH

Prostatitis refers to inflammation of the prostate and is a common issue among men. It can affect any male of any age, and it is the most common urinary tract condition to affect males under age 50. The inflammation can be caused by a traumatic injury to the prostate or by bacteria that made its way into the prostate from urine or during sex. Prostatitis is not the same as prostate cancer, but it’s a condition that almost half of all men will experience at some point in their lives.

Prostatitis has four types, and their symptoms can vary. Scientists have identified the four types as 1) chronic prostatitis or chronic pelvic pain syndrome, 2) acute bacterial prostatitis, 3) chronic bacterial prostatitis, and 4) asymptomatic inflammatory prostatitis.

With chronic prostatitis or chronic pelvic pain syndrome, the exact cause is unknown. Researchers believe a microorganism, though not a bacterial infection, may cause the condition. This type of prostatitis may relate to chemicals in the urine, the immune system’s response to a previous urinary tract infection (UTI), or nerve damage in the pelvic area.

Acute bacterial prostatitis tends to start quickly and lasts a short time. Chronic bacterial prostatitis tends to develop slowly and lasts a longer period of time. Asymptomatic inflammatory prostatitis does not have symptoms and is often discovered when diagnosing something else.

Some of the common signs of prostate inflammation include:

  • pelvic pain

  • sexual dysfunction

  • pain during intercourse

  • frequent or urgent urination

  • disturbed sleep

  • urinary pain and problems

  • difficulty emptying the bladder

Benign prostatic hyperplasia (BPH) is a condition in which your prostate grows in size. BPH is the most common prostate problem in men. Almost all men who have a prostate will develop some enlargement as they grow older. In fact, by age 60, about 50% of men with a prostate will have some signs of BPH. By age 85, about 90% will have signs of the condition. Research shows that having BPH doesn’t increase your risk of developing prostate cancer. However, BPH and prostate cancer have similar symptoms. BPH tends to develop gradually over time, with symptoms gradually getting worse.

The prostate surrounds the urethra and when BPH causes your prostate to grow, it can cause blockage in your urethra. As a result, early symptoms of BPH include:

  • slowness or dribbling when urinating

  • difficulty starting to urinate

  • leaking (incontinence)

  • sudden need to urinate

  • need to get up at night to urinate

  • inability to completely empty your bladder

  • pain after ejaculating or while urinating

  • your pee changes color and or smells

Both prostatitis and BPH can have overlapping symptoms, making a comprehensive medical evaluation necessary for an accurate diagnosis.

Treatment options

Treatment will depend on the type of prostate issue you have. For chronic prostatitis/chronic pelvic pain syndrome, the treatment aims at decreasing pain, discomfort, and inflammation with medications and antibiotics. Even if you do not need an antibiotic, your physician may opt to give you one in order to rule out bacterial prostatitis.

Treatment for bacterial prostatitis typically involves a course of antibiotics to target the specific bacteria causing the infection. For chronic bacterial prostatitis, people may need longer courses of antibiotics, often lasting several weeks or months. With asymptomatic inflammatory prostatitis, no specific treatment is typically required.

Some medications can help manage symptoms of BPH and prostatitis. Alpha-blockers like tamsulosin (Flomax) or doxazosin (Cardura) relax the muscles of the prostate and bladder neck, improving urine flow. Drugs called 5-alpha reductase inhibitors like dihydrotestosterone (DHT), block the conversion of testosterone to a substance that contributes to the benign prostate growth. These drugs also include dutasteride (Avodart) and finasteride (Proscar).

There are minimally invasive procedures that can provide relief to those with moderate to severe symptoms that include transurethral resection of the prostate (TURP), laser therapy, transurethral incision of the prostate, and others. These procedures aim to remove or reduce excess prostate tissue to alleviate urinary symptoms.

In more advanced cases or when other treatments have not been effective, surgical interventions such as open prostatectomy or robotic-assisted prostatectomy may remove part or all of the prostate gland.

Can Medical Cannabis Help?

The degree of pain experienced by someone suffering from prostatitis or BPH can be severe, limiting their capacity to work and enjoy life. Traditional medicines can relieve pain, but they often have undesirable side effects that may include a drop in blood pressure. Due to this and other side effects from prescribed medications, I’m often asked “Will medical cannabis help my prostate?”

Like other types of tissues in our body, prostate cells have CB1 and CB2 receptors (cannabis receptors). However, did you know that prostate cancer cells have an abnormally high number of them? This is a good thing. It means that they have a greater ability for cannabinoids like THC and CBD to bind to them.

While there are no current cures for prostatitis or BPH, there is a lot of anecdotal evidence and a few studies suggesting CBD can help reduce symptoms. CBD is known for its pain-relieving effects and CBD does not drop blood pressure. It is an excellent anti-inflammatory drug in clinical trials, and it does not carry the same risks associated with non-steroidal anti-inflammatory drugs (NSAIDs).

Studies show

A 2014 survey asked chronic prostatitis/chronic pelvic pain syndrome patients to self-report the efficacy of medical marijuana for their symptoms. Roughly 37% of clinical respondents and 75% of online respondents said cannabis improved their symptoms, most of them specifying improved mood, reduced pain, higher quality sleep, and fewer muscle spasms. Additionally, 57% of clinical respondents and 63% of online respondents rated cannabis as ‘somewhat to very effective’ for CP/CPPS. Unfortunately, this study was an online questionnaire, and it did not discuss the dosage of cannabis, frequency, or type (THC, CBD, CBC, etc.) used.

CBD oil is known for its anti-inflammatory and pain-relieving properties, making it a popular choice for treating conditions like enlarged prostate. A 2013 study published in the Journal of Urology found that CBD oil effectively reduced inflammation and cell proliferation in the prostate, while a 2014 study found that it reduced symptoms of benign prostatic hyperplasia (BPH).

In another study, scientists investigated three unique human prostate cancer cell types. They cultivated these cells in the lab and then added a variety of cannabinoids, one of which was a potent CB2 stimulant. The scientists discovered that cannabinoid-induced CB2 receptor activation inhibited the development of all three cell types. Furthermore, cannabinoids that target CB2 induced apoptosis, killing prostate cancer cells.

The results showed the three cannabinoids: CBD, CBC, and CBG – reduced cellular inflammation by degrading COX-2 in the microenvironment through the TLR4-NFκB inhibitory pathway, making them a promising approach for the treatment of chronic prostatitis and chronic pelvic pain syndrome.  

How to use CBD for Prostate Problems

One of the easiest ways to use CBD oil for an enlarged prostate is to apply it topically. Simply add a few CBD oil drops directly to your skin and massage gently until it is fully absorbed. If you are taking CBD oil orally, it is important to start with a low dose, 10 mg two to three times daily, and increase gradually every week until you reach the desired effect.

Unlike THC, there is no intoxication or high with CBD. Also, CBD takes some time to work – so you will not feel the effects right away. It may take a few days to weeks before you notice changes. The most common side effects are mild and include drowsiness, upset stomach, and dry mouth, which for many tend to fade after a while.

Take away

Prostatitis and BPH are two distinct conditions affecting the prostate gland. Prostatitis involves prostate inflammation, which can be caused by infection or other factors. BPH, on the other hand, refers to the noncancerous enlargement of the prostate gland.

Although research regarding CBD and the prostate may still be limited, evidence indicates it could be an effective and safe treatment option for men suffering from prostate issues.

If you have any symptoms of prostatitis or BPH, make an appointment to see your doctor. They can help determine the cause and provide treatment if needed. Early detection and treatment of the condition can help prevent serious complications.

References

Barry MJ, Collins MM. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia: Saunders; 2011: 805–810. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate

Corona, G., Vignozzi, L., Rastrelli, G., Lotti, F., Cipriani, S., & Maggi, M. (2014). Benign prostatic hyperplasia: a new metabolic disease of the aging male and its correlation with sexual dysfunctions. International Journal of Endocrinology, 2014, 329456. https://doi.org/10.1155/2014/329456

Murphy, A. B., Macejko, A., Taylor, A., & Nadler, R. B. (2009). Chronic prostatitis: management strategies. Drugs, 69(1), 71–84. https://doi.org/10.2165/00003495-200969010-00005

Nickel J. C. (2008). Inflammation and benign prostatic hyperplasia. The Urologic clinics of North America, 35(1), 109–vii. https://doi.org/10.1016/j.ucl.2007.09.012

Nickel J. C. (2011). Prostatitis. Canadian Urological Association journal = Journal de l’Association des urologues du Canada, 5(5), 306–315. https://doi.org/10.5489/cuaj.11211

Shin, D., Piao, J., Kim, S., et. al. Mp15-08 cannabinoids reduce chronic prostatitis and chronic pelvic pain syndrome by modulating tlr-4/nf-kb signaling pathway. Journal of Urology, 2023;209(4S):e194. https://doi.org/10.1097/JU.0000000000003235.08

Tripp, D. A., Nickel, J. C., Katz, L., Krsmanovic, A., Ware, M. A., & Santor, D. (2014). A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome. Canadian Urological Association Journal, 8(11-12), E901. https://doi.org/10.5489/cuaj.2268