My sister has endometriosis, and in her words, it’s “a whole bunch of hurty sh*t f*ckery.”
These colourful (and appropriate) superlatives refer to a range of debilitating symptoms affecting up to 1 in 9 Australian women diagnosed with endo by the age of 44.
Symptoms present as severe menstrual and/or ovulation pain that often requires heavy-duty opioid-based pain relief, hellish periods, gastrointestinal symptoms such as constipation and bloating, painful sex and urination, low back pain and chronic fatigue.
To put the pain in perspective, my sister told me that she once fractured three ribs, which wasn’t as painful as some endo flare-ups.
But the real ‘kick you while you’re down’ aspect of this chronic, progressive disease is it’s thought to be one of the leading causes of female infertility.
There is no known ‘cure’ for endo, and sufferers are usually prescribed oral contraceptives, NSAIDs to manage the pain, or in extreme cases, surgery to remove abnormal tissue or a total hysterectomy.
Given the average timeline between symptom onset and diagnosis is 6.5 years (WHAT!), it’s no wonder women are seeking alternative, natural options to help manage these symptoms.
Given CBD and medical cannabis has the ability to effectively treat a range of chronic pain conditions, can CBD help with endometriosis?
Good question! Let’s find out what the latest research says and whether women are successfully eliminating symptoms by using CBD.
What is Endometriosis?
Endometriosis refers to a condition where abnormal cells – similar to the endometrium tissue that lines the uterus – grow in other areas of the body where it’s not supposed to be. It is most commonly found growing in the pelvic region, the abdominal cavity, the ovaries and the fallopian tubes.
Like the uterine lining, the abnormal tissue responds to the hormonal messengers that initiate your period, prompting the misplaced tissue to shed.
When shedding occurs, it causes bleeding, and it’s this blood that irritates the nerves in the abdomen, causing severe pain.
Over time as the condition progresses, the monthly cycle of shedding leads to the formation of scar tissue, furthering inflammation and perpetuating the cycle of pain.
While many believe this to be a hormonal condition, research in fact suggests that endo is linked to immune dysfunction rather than hormonal imbalances .
“Endometriosis is not like other period problems. It’s not a hormonal condition like PMS and PCOS. It’s affected by hormones, yes, but fundamentally endometriosis is a disease of immune dysfunction.” Lara Briden
Causative factors behind endometriosis
There are many moving parts to endometriosis, and it’s not as straightforward as a hormonal condition.
These are a few of the conditions that are commonly diagnosed alongside endo.
While estrogen doesn’t cause the disease, it stimulates the endometrial lesions causing them to proliferate. Estrogen can be especially potent when in the presence of a bacterial toxin called LPS (Lipopolysaccharide).
Interestingly, progesterone works to halt the proliferation of cells. However, endometrial lesions appear to be resistant to the effects of progesterone.
We are more bacteria than human; when it’s in balance, it plays an essential role in keeping us functioning. But when bacteria are out of balance, often referred to as dysbiosis, it can cause an array of negative effects on our health.
Specifically, a bacterial toxin known as lipopolysaccharide or LPS disrupts macrophages, altering the immune system and allowing the proliferation of endometrial cells.
Where does LPS come from? Both our gut and vaginal microbiome house this bacteria.
Conditions like leaky gut allow this bacteria to escape the confines of our colon and spread systematically, and from the vaginal microbiome, it relocates into the uterine lining .
A 2019 study confirmed that LPS promotes the development of the early stages of endometriotic lesions .
Pesticides and environmental toxins
Studies have found that early life exposure and chronic ongoing exposure to environmental toxins and pesticides may be a causative factors behind endometriosis .
These chemicals can cause epigenetic changes that lead to disease states. Furthermore, your mother or grandmother’s exposure to these toxins may also be passed down genetically.
Dysfunctional endocannabinoid system (ECS)
When the ECS is functioning correctly, it should be able to regulate the immune system to cause apoptosis (cell death) of the stray endometrial cells and halt proliferation.
However, when the ECS is dysfunctional, the CB1 and CB2 cannabinoid receptors don’t work correctly, which can cause a range of symptoms, including an increase in pain symptoms.
Conventional treatments for endometriosis
The medical establishment hasn’t found a cure for this condition, and presently treatment focuses on relieving symptoms rather than addressing the root cause.
“The medical consensus has not yet caught up with the new research into endometriosis and immune dysfunction so hormonal suppression remains the primary treatment.” Lara Briden
Currently, treatments include :
Most women are prescribed NSAIDs for pain relief; while this may help relieve symptoms in the short term, the long-term risks include damage to the gut lining
The oral contraceptive pill or intrauterine devices like the Mirena, are used to suppress the hormones associated with the menstrual cycle; this works by stopping ovulation which in turn leads to estrogen deficiency which stops or slows tissue growth.
This keyhole surgery is used to both identify endometriosis and also remove the misplaced endometrium. Surgery can be either excision (removal by cutting), ablation (or removal using diathermy), or a combination of both.
In severe cases where other conventional therapies have failed, a total hysterectomy will be performed; this includes the removal of the uterus, cervix and fallopian tubes.
CBD oil for Endometriosis Pain: Can it help?
My sister has been told by doctors that “it’s just bad period pain”, “you just have a low tolerance to pain”, and “the pain is in your head”.
Given it takes SIX YEARS for doctors to catch on and make an actual diagnosis, I’d hazard a guess and say the above sentiments aren’t unique to my little sister.
This is a systemic problem that women all around the world are facing.
So it shouldn’t come as a surprise that women are taking power back and finding alternative treatment options to alleviate the pain and misery.
We know that CBD is good for external skin conditions so can it help with internal nerve irritations and pain?
CBD may help reduce pain
We know that CBD interacts with our endocannabinoid system by targeting CB1 and CB2 cannabinoid receptors throughout our body, but studies also show it interacts with important receptors such as TRPV1 (a pain receptor) as well 5-HT1A (a serotonin receptor) to reduce pain.
TRPV1 (Transient Receptor Potential Vanilloid 1) is thought to play a role in pain signalling and has been found to be upregulated in women diagnosed with endometriosis .
Studies have found that CBD’s potential to treat pain and inflammation may come through its ability to stimulate TRPV1 vanilloid receptors, thus inhibiting or desensitising neuronal TRPV1 signalling leading to a reduction in pain .
CBD may slow cell proliferation
In patients diagnosed with endometriosis, there is a large amount of abnormal cell growth in places it shouldn’t be.
This is somewhat reminiscent of how cancer grows in the body. So it stands to reason that if CBD can induce cancer cell death, it can do the same for stray endo cells.
A study conducted in 2006 demonstrates CBD’s ability to induce apoptosis in cancer cells through the activation of CB2 receptors .
Additionally, CBD blocks the GPR18 receptor, allowing abnormal cells to migrate to parts of the body where they don’t belong .
CBD may reduce inflammation
Chronic inflammation is a major contributing factor to pain symptoms experienced by endo patients.
According to a study published in Future Medicinal Chemistry, cannabinoids like CBD and THC reduce symptoms of inflammation by suppressing inflammatory responses and are considered to be a novel anti-inflammatory medication .
Cannabinoids calm an overactive immune system
As we discussed earlier, there’s a link between endometriosis and immune system dysfunction.
One of the primary functions of the endocannabinoid system is to keep the immune system in check. So, if your ECS is out of whack, there’s a fair chance your immune system is out of balance as well.
Consuming cannabinoids like CBD and THC can help to balance an out-of-control immune system by binding to CB1 and CB2 receptors and activating the ECS.
CBD and THC: The magical combo?
When combined, CBD and THC can be a potent combination of cannabinoids for many conditions, including insomnia, pain conditions, autism, depression and anxiety.
THC is highly regarded for its potent analgesic properties, reducing pain related to a range of conditions and diseases.
THC achieves its powerful anti-inflammatory and pain-relieving effects through its direct interaction with CB1 and CB2 receptors.
According to a 2010 study, THC was effective at reducing chronic nerve pain compared to a placebo .
“A single inhalation of 25 mg of 9.4% tetrahydrocannabinol [THC] herbal cannabis three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated.”
A recent study examined the effects of THC in rodent models with endometriosis, finding that daily treatments of THC dosed at 2 mg/kg alleviated pain, restored cognitive function and, importantly, inhibited the development of endometrial cysts .
Anecdotally, many endo forums are filled with stories of women using both CBD and THC to get the best pain relief.
What’s the Best way to take CBD for Endometriosis?
First and foremost, a full-spectrum CBD oil is far superior to an isolate or broad-spectrum product, this is because full-spectrum products contain trace amounts of THC, which contribute to the entourage effect.
As the science suggests, THC can be very beneficial for pain symptoms.
If you find that a sublingual full-spectrum CBD oil isn’t enough to conquer symptoms, you may need to consider a product with a higher concentration of THC.
When you visit a cannabis clinician or clinic, they can prescribe products with varying ratios of CBD and THC based on your symptoms.
Additionally, vaping a CBD or THC flower is an excellent way to get almost instant relief.
Inhalation offers the fastest onset time of all consumption methods.
CBD oil takes anywhere from 30 to 60 minutes for the effects to be felt.
Do CBD suppositories work for Endometriosis?
Cannabinoid-infused suppositories offer a new way of administering CBD and/or THC directly to inflamed areas.
When a CBD suppository is inserted, it slowly melts and releases cannabinoids which are absorbed by the mucus membranes in the vagina and quickly enter the bloodstream.
The benefit of this method is you avoid metabolising CBD or THC via the digestive system, which can take much longer.
The low down on CBD for Endometriosis
As you can appreciate, endometriosis is a complex condition with a variety of underlying factors that need to be considered.
While medical cannabis can absolutely provide symptom relief and restore a dysfunctional ECS, amongst many other mechanisms, you should dig deep to discover the root cause of your endo.
Do you need to go on a gut detox and balance your microbiome?
Perhaps you should consider further testing to see what chemicals or heavy metals are burdening your system.
But while you investigate the root cause of endo, CBD and THC can go a long way to relieving symptoms which can help to give back some normalcy in your life.
Invisible illnesses are difficult, especially when doctors don’t believe in or support you.
If your doctor isn’t open to prescribing CBD, feel free to reach out in the comments below or send us an email, and we’ll provide you with further information on accessing CBD in Australia.