What is Endometriosis?
Endometriosis occurs when the tissue that lines the inside of the uterus, called the endometrium, grows outside your uterus. Endometriosis impacts 10% of all women, a total of 176 million women worldwide. Symptoms can range from no pain at all, just infertility, pain and heavy bleeding only during menstrual periods and disabling pain 24/7. There is no cure and diagnosis may take up to a decade.
Endometriosis can be found growing in the ovaries, bowels or pelvis, but occasionally grows in the lungs, brain and other areas. Endometriosis sheds similarly to uterine lining, causing bleeding and pain in organs during the menstrual period. Severe endometriosis can cause adhesions and scar tissue. Organs to attach to each other or the spine, causing severe pain and reducing mobility permanently.
How is the Endocannabinoid System (ECS) Disrupted in Endometriosis?
Many components of the ECS are found in endometrial tissue and their levels are regulated by the menstrual cycle in rodent models of the disease. These include cannabinoid receptors type 1 and type 2 (CB1 and CB2), N-acyl phosphatidylethanolamine phospholipase D (NAPE-PLD), an enzyme that synthesizes endocannabinoids, and fatty acid amide hydrolase (FAAH), and enzyme that breaks down endocannabinoids. The highest concentration of the endocannabinioid anandamide (AEA) in the reproductive system is found in the uterus.
Endometriosis is linked to endocannabinoid deficiency (ECD). Women with endometriosis have lower levels of CB1 receptor in endometrial tissue. Reduced ECS function leads to growth of endometriosis throughout the body and more pain, and endometriosis pain is mediated through the CB1 receptor.
Human endometriosis cells proliferated (divided and grew) less when stimulated with a synthetic cannabinoid called WIN 55212-2. Rodent studies of endometriosis found animals had more pain when treated with AM251, a drug that inhibits the cannabinoid receptors, and less pain when treated with WIN 55212-2.
Why is the ECS disrupted in women with Endometriosis?
Environmental toxins such as dioxin have been linked to endocannabinoid deficiency. Dioxin decreases levels of CB1 in endometrial tissue. As we are subjected to pollution in our air, water, grass, and food as well as BPA in water bottles and receipts, it’s no wonder why so many women in developed countries now have severe endometriosis. In the future we are certain more toxins will be linked to endometriosis risk as well as endocannabinoid deficiency.
Should I Discontinue Hormonal Treatment For Endometriosis?
Please see our section on how Hormonal Birth Control disrupts the Endocannabinoid System.
Hormonal treatments for endometriosis carry other risks, such as deep vein thrombosis (DVTs) which are blood clots in your legs that can travel to your lungs and kill you. Our founder, Dr. Michele Ross, was diagnosed with endometriosis and was put on hormonal birth control and Lupron to manage her symptoms. She was hospitalized for lung blood clots which almost killed her. She hopes that cannabinoid products will help other women avoid the same life-threatening condition, which feels like a heart attack and stops your ability to breathe.
How Should I Take Cannabis to Treat Endometriosis?
It is very important that women with endometriosis on hormonal treatments do not SMOKE, and this also means smoke cannabis. Smoking increases your risk of deadly blood clots, which I described above. If you prefer to inhale rather than eat your cannabis, please vape. Vaporizing cannabis is better than smoking cannabis in a joint, pipe, or bong because it doesn’t burn the cannabis. Smoking cannabis releases toxins similar to cigarettes, can cause lung irritation and often disintegrates cannabinoids with healing properties. Vaporizing cannabis heats the air around the cannabis, releasing a range of cannabinoids, each with unique health benefit.
Eating large doses of cannabis oil daily is essential if you want to make the switch from pills to cannabis only. You can purchase cannabis oil in capsules to make it easier to swallow and remember dosing. If capsules are not available in your area, you can also purchase preloaded syringe of oil that you squirt into your mouth, or take cannabis tincture drops that you put under your tongue. If you have sleep issues, eating an edible (brownie, candy, etc) infused with cannabis at night can help.
Cannabis topicals, in the form of creams or lotions you put on your skin, can help with pelvic or back pain during the day.
A new way to get cannabis into your body is via a transdermal patch, similar to the birth control patch or the nicotine patch. This discrete method provides extended release medication for up to ten hours and is perfect for people who feel uncomfortable with other methods such as vaporizing cannabis. It’s a great way for women with endometriosis to be able to be active and return to their normal lives. Imagine having a social life again? You can use non-psychoactive versions such as CBD-only patches to get through work or other functions would don’t want to feel “high” at.
Juicing raw cannabis may reduce pain and inflammation associated with endometriosis, without that high you get from heated cannabis. That’s because raw cannabis has THCA and CBDA, the non-psychoactive forms of THC and CBD. Juice strains of cannabis with high levels of CBD(A) for best results. We’re especially excited about this new method, as daily juicing may cause remission of endometriosis.
Women with endometriosis are also encouraged to avoid chemicals in their food, hair and beauty products, and environment in addition to using cannabis therapy. Go green!
Further Research Needed
Endocannabinoid levels in human women need to be studied.
Currently the only way to diagnose endometriosis is through an expensive surgery called a laparoscopy which is often not covered by health insurance. This means diagnosis with endometriosis takes about a decade for the average woman. A simple biomarker of endometriosis, such as reduced endocannabinoids in blood or endometriosis tissue, could save millions for the healthcare system and years of unnecessary pain for 176 million women suffering from the disease.
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Progesterone-dependent regulation of endometrial cannabinoid receptor type 1 (CB1-R) expression is disrupted in women with endometriosis and in isolated stromal cells exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Resuehr D, Glore DR, Taylor HS, Bruner-Tran KL, Osteen KG. Fertil Steril (2012).
Antiproliferative effects of cannabinoid agonists on deep infiltrating endometriosis. Leconte M, Nicco C, Ngô C, Arkwright S, Chéreau C, Guibourdenche J, Weill B, Chapron C, Dousset B, Batteux F. Am J Pathol (2010).
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