One night in 2014, intense menstrual cramping had driven me home from a dinner out with a friend, leading to full-on sobbing by the time I got back to my apartment. It wasn’t the first time I’d experienced severe endometriosis symptoms, I’d been diagnosed long ago, but I usually kept the pain from complete meltdown levels with cannabis. Unfortunately, this was pre-legalization, and “my guy” was dry.
As I Googled to see how much Ibuprofen I could take before endangering myself, the pain shot up again. Twenty minutes later, I’d broken out in hives, and waves of darkness flooded the corners of my vision. I prayed I’d lose consciousness, to no avail. It was a very, very long night.
When endometriosis pain gets like that, it feels like barbed wire has been looped all over your guts, and some jerk is slowly, yet fiercely, twisting the wire—pulling on the entangled tissues and organs, threatening to rip them apart. (And then someone dares to say, “It’s just your period,” and you claw their face off!)
It’s actually bodily tissue looped all over your guts
Unfortunately, what endometriosis feels like is actually pretty accurate to what it is.
A woman’s period is a result of the shedding of endometrial tissue built up from the hormonal cycle. But in endometriosis, this tissue grows outside of the womb, where it’s unable to shed. This tissue is often described as looking like a web, wrapping itself over organs outside of the womb, and even connecting them. (In extreme cases, the organs actually become fused together, called “frozen pelvis.”)
Because this tissue becomes trapped in the body, when it’s time for the body to do its monthly thing—it really freakin’ hurts. But endometriosis doesn’t stop there. In addition to “severe menstrual cramps” (an infuriatingly minimizing description), this wandering tissue also leads to chronic lower-back, abdominal, and pelvic pain; painful intercourse; painful urination and/or bowel movements; IBS symptoms; and infertility. Endo fighters—an estimated 11% of women—also have increased rates of ovarian cancer.
The treatment options offered to fighters are paltry. Hormonal birth control is usually the first thing recommended, but many women react adversely to it. Painkillers are the next line of defense, from stomach-damaging NSAIDS to life-ruining opioids—none of which a great option for decades of ongoing use. Other fighters get the endometriosis tissue surgically removed, which obviously has substantial side effects, as well as doing nothing to keep it from growing right back.
Luckily, we have cannabis.
From cannabis concern to convert
Foria is a cannabis company that specifically targets female health concerns, like endometriosis, offering innovative products like suppositories—an invention that’s arguably better than anything the pharmaceutical industry has offered sufferers in decades.
We spoke with Kiana Reeves, Director of Education at Foria, to see how their efforts are faring—and so far, so great. These sales are accompanied by thank you notes that serve as a testament to the power of cannabis to treat endo’s symptoms.
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One such testimonial comes from Ashley, who was raised to fear cannabis, but worked her way to it from general herbal medicine after years of negative experiences trying to combat endo with pharmaceuticals. In addition to bringing back her sex life, cannabis treatment led to less endometrial tissue needing to be removed in surgery—to say the least, she’s now a convert. Her initial fears about cannabis were further compounded as a mother, but she now has a non-intoxicating arsenal of CBD and low-dose/topical THC tools at her disposal.
The science on endometriosis and cannabis
Traditional methods of endometriosis treatment merely attempt to mitigate symptoms, but there’s evidence that cannabis can potentially treat the actual condition. Cannabis and the endocannabinoid system (ECS) work together to fight aspects of endo in many ways—and, for once, the science on why cannabis is so successful at treating endometriosis is (relatively) abundant.
Migration and growth
Since the source of endometriosis is cells being where they shouldn’t be, tapping into the ways they migrate will be crucial in understanding, and eventually curing, endometriosis. The most promising development in regard to this area is how cannabis interacts with the N-arachidonyl glycine receptor (NAGly receptor), more commonly referred to as the GPR18 receptor, which works with the cannabinoids in cannabis as well as the body’s natural endocannabinoids.
The name of the game with the ECS is all about balance, and endometriosis is no exception to the rule. While the cannabinoid CBD blocks the activation of the GPR18 receptor, which can stop endometrial cells from migrating, there’s also evidence pointing to THC causing the migration of cells by activating this receptor. Because of this, it might be wise to counteract pain-relieving THC with CBD for treating endometriosis. Endometrial cells multiply, like cancer, and there’s also evidence that cannabinoids can also stop these cells from this proliferation.
The pain involved with endometriosis is the most impactful aspect of the disease for most women. As described above, this literally “gut wrenching” pain is often completely debilitating—and for many women it lasts a whole lot longer 2-7 days, with pain extending outside of menses or a longer menses duration. But cannabis comes to the rescue again, fighting pain in several ways.
THC does its pain-squashing magic not by merely distracting from symptoms—which sure doesn’t hurt—but by deactivating nerves in endometrial cells via endocannabinoid receptors. CBD also has its own super power, desensitizing the pain receptor TRPV1. And cannabis has one more pain-fighting weapon in CBD with its ability to take down inflammation, which leads to less irritated nerves, thereby, less pain.
Improving the tone of the endocannabinoid system
There’s mounting evidence to show that imbalances in the endocannabinoid system (ECS) are the force behind many common chronic illnesses, and while endometriosis isn’t in the disease rubric, dysmenorrhea (painful periods) is—and the rubric isn’t thought to be comprehensive. The fact that cannabis is able to interact with the endocannabinoid system to help fight symptoms is another sign that a negatively impacted ECS could be the cause of endo, but more research is needed.
Tamás Bíró, Professor and Director General of the Hungarian Center of Excellence for Molecular Medicine and Director of Applied Research for Phytecs told me via email that reaching optimal ECS tone (to balance endocannabinoid levels) is a balancing act of its own.
“The most important thing you can do to keep the ECS healthy is to avoid the extremes—to name a few examples: avoid extreme and chronic stress, avoid being overweight, control alcohol consumption, and try to curtail dependencies in general,” he said.
Though simply taking full-spectrum CBD may also help boost tone, all-in-all, getting a healthy ECS is all about living a healthy lifestyle. Other frequent advice on the matter entails eating right for your body (elimination diets are a great help here) and getting regular exercise. If that were the whole “cure” of endometriosis, we’d have a lot more cured patients out there. But, to this fighter anyways, it’s nice to know science might at least be close to the origin of this disease.
And in the meantime, at least there’s cannabis.