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Treating Endometriosis with Cannabis

Karen Watts, the 59-year-old co-founder of the boomer blog Comfortably Numb, began smoking cannabis at 16 to treat what she describes as “genetic anxiety.” When she developed endometriosis in her thirties, she found cannabis enabled her to help deal with severe menstrual cramps, which she describes as “a burning knife stuck in my abdomen that would twist around for three hours.”

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As cannabis was still illegal in California during this time, Watts had to keep her use a secret. “It was hard to tell people because you were looked at as the ‘drug addict’. Whenever I traveled internationally, I had to schedule my trips around my periods.”

Fast-forward to the current era where Roo, a Maine-based Medical Marijuana Caregiver employee, was able to find information online about treating endometriosis with cannabis from various resources including chronic illness Facebook groups. As medical marijuana has been legal in Maine since 1999, with adult-use cannabis approved in 2016, Roo can consume her medication without the stigma Watts and other women experienced during the days of marijuana prohibition.

For those unfamiliar with endometriosis, Dr. Bryan Peguero of the Kalapa Clinic, a medical consultancy in Europe specializing in cannabinoid therapy, describes endometriosis as when “the endometrial tissue develops outside of the uterus, it forms in other places within the abdomen. These formations are sensitive to hormones, so during the menstrual cycle, the affected women will suffer the proliferation of the endometrial tissue (which is responding to the oestrogens). This generates inflammation around the endometrial tissues and can cause pain, discomfort, inflammation, infertility and even peritonitis [an inflammation of the membrane that lines your inner abdomen wall], in the worst cases.”

While there is no cure for this condition, traditionally, anti-inflammatory and analgesic pain killers have been prescribed to reduce the pain, along with hormone treatments and surgery. Long-term use of these conventional practices can produce a range of side effects including gastritis, diabetes, drug dependence, hormonal changes, surgical complications, and insomnia.

According to Dr. Peugero, “Currently there is no evidence that cannabis serves to eliminate the disease, but the anti-inflammatory, analgesic, antispasmodic, and anxiolytic properties that it provides to patients makes it a useful tool in terms treating the symptomology related to endometriosis.”

  Illustration by Sarah Brown

Illustration by Sarah Brown

Dr. Frank D’Ambrosio, an orthopedic surgeon turned cannabis advocate, cites multiple reasons why cannabis can be an effective treatment for endometriosis.

●       Cannabinoids such as tetrahydrocannabinol (THC) and cannabidiol (CBD) may reduce inflammation by suppressing T-cell function.

●       The uterus contains the reproductive system’s highest concentration of the endocannabinoid anandamide (AEA). Anandamide is analogous to THC, and taking THC may increase oestrogen production, and cannabidiol may bind to oestrogen receptors.

●       Anandamide “regulates function and implantation of the developing embryo”. Cannabinoids therefore may function as an aid to fertility.

●       Women with endometriosis have lower levels of CB1 receptors in their endometrial tissue. Reduced endocannabinoid system (ECS) function may lead to growth of endometriosis and increase pain. Cannabinoids may promote embryonic and adult hippocampus neurogenesis, and may induce growth of CB1 receptors in endometrial tissue as well as the brain.

●       Cannabinoids may be useful in reducing muscle cramps and spasticity, usually associated with conditions like multiple sclerosis. Cannabinoids may also be useful for treating cramps associated with endometriosis.

●      TRPV1 receptors and calcium ion channels are said to be associated with menstrual bleeding, and desensitizing this receptor may help beat pain associated with PMS.

If you’re suffering from endometriosis and are interested in using cannabis to relieve symptoms, smoking isn’t your only option. Some of the products on the (legal) market used by women suffering from endometriosis include Empower BodyCare’s soaking salts and oil; they’re currently only available in Oregon and Washington. Their 4PLAY sensual oil can be added when the pain gets particularly intense, or to relieve pain during penetration. Whoopi & Maya produce a Signature Line of medical cannabis products designed specifically for relief from menstrual discomfort; these items are available in California and Colorado for now.  And Oregon’s Genesis Pharms’ personal massage oil has been used by women both vaginally and internally to reduce pain.  

To treat her symptoms, Roo varies between using sativa and indica strains. “A nice sativa can help with fatigue, while a nice indica can soothe the muscles. I find a good heavy indica can help relax my body and get me a good night’s rest when pain and insomnia hit. Often, I find I use cannabis intuitively. The days where I'm not in as much pain I typically just smoke at night, and the days where I'm in the most pain I smoke more.”

As long as cannabis remains classified as a schedule 1 drug, medical professionals cannot recommend any product, legally speaking. However, Dr. Frank observes they can give some advice in choosing products. “Does the company test their products for safety? Do they show the cannabinoid-terpenoid profile of the product? Are they at least trying to do some sort of patient research? Basically, is the company making the product willing to put their money where their mouth is? Such medications must be free from pathogens, pollutants, pesticides and anything else that may cause harm.”

Dr. Jess Peatross, an internal medicine doctor who was recently appointed Chief Medical Officer at MyDX –the first handheld chemical analyzer for correlating the chemical profile of cannabis to experiences and effects – notes that “patients cannot legally obtain any products containing more than 0.3% THC if marijuana has not been medically approved in your state. You can, however, obtain full spectrum CBD products which is sufficient for most people.”


Story by Becky Garrison
Illustration by Sarah Brown

Some names have been changed or withheld to protect identity.
Van der Pop does not condone the illegal consumption of cannabis.

           

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