What is Endometriosis?
Endometriosis is a debilitating condition where the endometrial tissue lining in a woman’s uterus grows outside of the uterus. When the body detects the growth outside of the uterus, it responds to the foreign substance and attacks it by triggering an inflammatory response which leads to scarring, pain, and occasionally infertility. Nearly 11% of the female population is affected by endometriosis.
In a healthy female, the body will shed endometrial tissue that is built up during their hormonal cycle. However, in a female with endometriosis, this web-like tissue grows outside of the uterus so it is unable to be shed and instead wraps itself around the organs and in extreme cases can even lead to organs fusing together.
Since the body is unable to shed this tissue, it tends to cause extremely painful periods for women – much more severe than a typical menstrual cramp. In addition to more intense menstrual cramps, since the tissue spreads to other areas of the body, endometriosis can also cause chronic pain in a woman’s back, abdomen and pelvic area which leads to painful intercourse, urination or bowel movements. These symptoms can also affect a woman’s sleep patterns, subsequently lowering her pain threshold and creating a cycle of continually worsening symptoms. Between 30-50% of women with endometriosis will also experience infertility, most often due to the structural damage that causes the fallopian tubes to become blocked.
Obtaining a Diagnosis
Unfortunately, diagnosing endometriosis can be pretty invasive as the only way to get a definitive diagnosis is by having surgery. More experienced doctors may be able to differentiate normal vs. abnormal on an ultrasound and make a presumptuous diagnosis, but this isn’t a failsafe and won’t work for someone with milder symptoms.
While there is a blood test (CA-125) that is typically used to detect cancer, but can indicate the potential presence of endometriosis but again, this too is not 100% accurate (between 61-88% accurate). This test is not considered a reliable stand-alone diagnostic tool for endometriosis but may be useful as a complementary tool – however, many doctors aren’t even aware of its potential in assisting endometriosis diagnosis.
There is also the issue of the stigma surrounding women’s reproductive health that hinders the diagnostic process. People are unwilling to talk about endometriosis – many young women are afraid to speak up about their painful periods or are written off by physicians who are reluctant to acknowledge it. It’s important to raise awareness and break down that stigma so that other women know they don’t need to suffer in silence anymore.
Living with Endometriosis
I was diagnosed with endometriosis when I was 26 years old. My entire life my periods felt painful but as someone who also lives with multiple other chronic health issues, I assumed it was normal. At the time I went in for my annual PAP appointment, and my OB ordered a vaginal ultrasound to get a better look at what was going on. While doing the ultrasound he noted the presence of a couple large cysts on my fallopian tubes that would need to be removed laparoscopically. Since I had just recovered from back surgery the year before and been under the knife a few times prior to that, a laparoscopic procedure didn’t scare me as one would think.
The day of surgery, the doctor comes in to go over the plan with me and my parents, who had come for support. As the doctor was discussing the plan and the potential risks, such as depending on what he finds when he gets inside, he may have to take one or both of my ovaries and fallopian tubes out… I watched the look on my mom’s face drop from interest to concern to panic but she sat quiet as I acknowledged the risks and said we’ll hope for the best. When it was just the three of us again, she asked me if I knew that was a potential outcome, and I nodded and said yes but that I couldn’t not get these cysts out – if they ruptured, it would be so much worse.
For whatever reason, having my own biological children was never super important to me – if it happened, great, but otherwise I sort of just assumed I would foster or adopt some day. Some may consider this selfish, but I think of it as self care – I knew that my only chance of relief at that point was to have these cysts removed regardless of what else had to go.
Many women suffering from endometriosis also experience infertility.
When I woke up from surgery, I found out that they did not need to remove my ovaries or tubes, they were able to get both cysts out cleanly – but during the procedure he had made another discovery… endometriosis. He said he believed they had removed all of the tissue that he could find but that it would come back if I didn’t get on birth control. He gave me a couple weeks to decide what I wanted to do, but because of the experiences I had prior to this when trying to find the right birth control, I made the choice not to get back on any form of birth control. He was not happy – he told me that hormonal birth control was the only way to keep the endometriosis under control. Needless to say, I switched OBs to one who was supportive of my decision to use cannabis to manage my symptoms.
Traditional Treatment Options
Traditional treatment options for women with endometriosis leave much to be desired. Outside of hormonal birth control, women are often prescribed pain medications to deal with the pain and many end up undergoing multiple surgeries to remove cysts and the endometrial tissue build up outside of the uterus.
Hormonal birth control pills alleviate the symptoms without addressing the cause, interfering with estrogen production to prevent the endometrium build up. Another option is Lupron, an injected pituitary suppressant, which induces temporary menopause. Lupron addresses the symptom but is not a sustainable option. These “treatment options” heavily inhibit estrogen production, but tend to have a wide range of undesirable side effects, weight gain, memory loss, bone loss, hot flashes, mood swings, acne, loss of libido, insomnia…I could go on, but you get the picture. Essentially you trade in pain and potential infertility with all of these other terrible side effects – I choose to manage the former with the help of medical cannabis.
How Cannabis can Help
I think it’s best if we break down the main symptoms of endometriosis so that we can better understand exactly how medical marijuana can be helpful to women experiencing them.
CBD has been shown to reduce inflammation along several key pathways in the body, making it an effective treatment against certain inflammatory conditions.
When you’re in a great deal of pain from endometriosis, you often don’t have much of an appetite. Through its interactions with the body’s endocannabinoid system, THC has been found to help regulate functions such as pain sensitivity and appetite.
Loss of Appetite
CBD & CBN
Studies have shown CBD’s ability to alleviate both neuropathic and inflammatory pain. CBN has been shown to have impressive analgesic properties which helps to induce relaxation (also said to help with insomnia).
CBD alleviates nausea and vomiting by interacting with serotonin receptors. THC also possesses antiemetic properties and reduces vomiting by binding with CB1 receptors in the brain.
CBD & THC
Terpenes are incredible, natural sleep aids. Linalool being the main terpene found in lavender, which promotes calmness and relaxation.
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