I was officially diagnosed with endometriosis when I was 23, after years of being misdiagnosed and told that my symptoms were a “normal part of being a woman.” The diagnosis came after I finally underwent a laparoscopy, a surgical procedure used to determine the presence and severity of endometriosis. And so for the next decade, countless gynecologists and endometriosis specialists would tell me that my treatment options were limited: Invasive surgery, hormonal therapies (with side effects that were worse than my actual symptoms), prescription painkillers, or a hysterectomy seemed like the extent of what I had to choose from.
My story is not unusual, as most endometriosis patients spend years (7.5 years on average) seeing several specialists before finally getting a diagnosis. And despite that 1 in 10 women suffer from the condition, very little progress has been made in research or treatment options. Endometriosis can present in girls as young as eight years old and can continue after menopause.
In fact, millions of women with endometriosis may experience pelvic pain, excess bleeding, painful intercourse, and difficult menstrual cycles, says Joanna Matson, clinician, wellness counselor, and founder of cannabis/ayurveda service Canna-Veda. “Displaced interior cells [that are] responding to hormonal changes proliferate outside the uterus, causing excess growth and adhesions which can spread throughout the pelvic area and create painful attachments to the ovaries, bowels and surrounding tissue," she told Civilized.
Endometriosis is a painful, chronic condition where the endometrium (tissue that forms the lining of the uterus) grows outside the uterus, where it doesn’t belong. The endometrium attaches to other organs, such as the lungs, bowel, bladder, ovaries, and intestines, generating lesions. These lesions can form scar tissue and adhesions that can cause organs to stick together over time. Symptoms include lower back pain, gastrointestinal problems, painful periods, chronic pelvic pain, infertility, and pain during intercourse.
While not considered a treatment per se, pregnancy is believed to stave off symptoms for a period of time, yet 30 to 50 percent of endometriosis patients experience infertility. Those not looking to conceive will often be put on birth control or some other type of hormone therapy that wreaks havoc on the body.
One of those therapies is a drug called Lupron, which has caused thousands of deaths, autoimmune diseases, physical disabilities, increased risk of cancer, severe pain issues (worse than before treatment), gastrointestinal conditions, and more. There are even several Lupron survivor groups online, as well as the resource guide Lupron Victims Hub, founded by registered nurse and paralegal Lynne Millican, who became disabled from the drug.
Other treatments to mitigate the symptoms of endometriosis include excision surgery, antidepressants, and opioid painkillers, including morphine and oxycodone, says Dr. Michele Ross, CEO of Infused Health and author of Vitamin Weed: A 4-Step Plan to Prevent and reverse Endocannabinoid Deficiency. And often these treatments are ineffective. "Women with endometriosis are often on multiple prescriptions, not only for their symptoms, but [also] to manage the side effects of those medications," she tells Civilized.
No one really knows the exact cause of endometriosis, but some theories posit that environmental factors (such as food pesticides), genetic predisposition, and the age a girl begins her period play a role. But there's one more factor Dr. Ross says could trigger endometriosis: endocannabinoid dysfunction.
"Reduced function of the endocannabinoid system leads to the growth of endometriosis throughout the body, and more pain," she says. CB1 cannabinoid receptors mediate the pain from endometriosis and, according to a 2010 study are present in the nerve cells that supply nerve impulses to the endometrial growth. Hence activating these receptors (through cannabinoid therapy) can reduce the pain sensations this area.
However, the endometrial cells of women with endometriosis have a lower expression of CB1 receptors — which could explain why activating the few that are expressed is even more important for those in pain.
In response to having lower CB1 expression, Ross explains, women with endometriosis also have greater blood levels of the endocannabinoids anandamide and 2-AG. In fact, women with high levels of endometrial pain had lower levels of anandamide than those with moderate pain symptoms, she adds.
For Stephanie Kerns, cannabis has been working successfully to treat the symptoms of her endometriosis. The longtime medical marijuana patient from Oregon says that not only has it worked better than the plethora of other herbs and alternative therapies she's tried, but that it also comes without the side effects she experienced with pharmaceuticals. As Kern's main source of pain management, cannabis made it possible for her return to work after being bedridden for ten years with pain.
For me, CBD was the only form of therapy that offered safe pain relief. After many years of trial and error with pharmaceuticals and alternative therapies, I came to CBD, although I was initially skeptical. Nonetheless, what I found was that it gave me the ability to control my own treatment — which was a welcome relief following a decade of having medical professionals ignore my concerns about the drugs they were prescribing to me.
As Dr. Ross says, cannabis offers a variety of pain management options without the risk of overdose or death. "And not only does [cannabis] treat pain, spasms, nausea and vomiting, GI problems, sexual dysfunction, and mood issues associated with the disease, but it actually may halt and even reverse the progression of the disease," she says.
Topicals like lotions and salves help with pelvic and abdominal pain, while spray and personal moisturizers can help relieve pain associated with sex and menstruation. One product I use, for example, is called Vajay Spray by Meowchemy: It's a CBD topical analgesic that helps with a long list of symptoms. Mel Meow, founder of Meowchemy, says that CBD has proved to be an effective anti-inflammatory and antispasmodic herb. “CBD can help relax abdominal and pelvic muscles, in effect easing the pain of the intense cramping of most endometriosis suffers endure,” she says.
When I use CBD and other cannabis topicals or tinctures, I notice a major difference in the quality of my sleep, in my ability to focus, in my mood, and in my other symptoms. While I understand that there is no miracle cure, and there's still a need for more research, the emerging evidence is encouraging, especially for a disease that is so misunderstood.
As Matson from Canna-Veda makes clear, other lifestyle alterations should supplement cannabis treatment. “From a holistic perspective, pelvic inflammation in its acute form requires special attention to the liver and blood, through cleansing and detoxifying actions," she says, recommending a few dietary changes such as refraining from salt, alcohol, refined sugar and most oils (except coconut and sunflower). Matson also recommends taking organically grown herbs like cannabis flower (in the form of tincture and topicals), aloe gel, dandelion, and shatavari. "Finally, learning and incorporating new tools to access deep emotional healing around trauma — including stress-relieving activities such as walking in nature, practicing yoga and meditation, and most importantly self-love — are necessary to engage in all levels of healing."