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“It’s still very taboo”: How medical cannabis helps relieve the pain of vulvodynia

There is an increasing body of evidence which suggests that medical cannabis can be helpful for women in the treatment of vulvodynia

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Some women have found cannabis-based medicines helpful in the treatment of vulvodynia

Freya was diagnosed with the debilitating gynecological condition, vulvodynia, aged 20, she explains how cannabis has helped relieve some of the symptoms and why she felt let down by conventional medicine.

Vulvodynia is persistent, unexplained pain in the vulva – the female genital area including the skin surrounding the opening of the vagina.

This condition can affect women of all ages and is often a long-term problem that’s very distressing to live with.

What are the symptoms?

The main symptom is persistent pain in and around the vulva and vagina. The vulva usually looks normal and the pain can arise in a variety of forms:

  • burning, stinging, throbbing or sore genital area
  • it can be triggered by touch, such as during sex or when inserting a tampon
  • it can be constantly in the background
  • it can get worse when sitting down
  • it can be limited to part of the vulva, such as the opening of the vagina
  • it can be more widespread – sometimes it can spread over the whole genital area and the anus.

Having persistent vulval pain can affect relationships, reduce sex drive, and cause low mood and depression. It can be emotionally extremely distressing and have profound effects upon the patient’s sex life. There is also a huge stigma around this type of condition with women being frequently embarrassed to talk about it or seek help. 

What treatment options are available?

Vulvodynia is unlikely to get better on its own and some of the treatments are only available on prescription and may not have the desired effect long term.

Lifestyle changes may help reduce symptoms such as only wearing cotton underwear, using lubricants before attempting sex, cool packs to sooth the pain of the vulva and sitting on a donut shaped cushion. 

A combination of treatments can often help relieve the symptoms and reduce its impact on your life.

Conventional painkillers, such as paracetamol, will not usually relieve the pain. Doctors may prescribe antidepressants such as amitriptyline and nortriptyline, which can have unpleasant side effects including drowsiness, weight gain and dry mouth.

Sometimes anti-epilepsy medicines such as gabapentin and pregabalin are prescribed but again these can cause horrible side effects including dizziness, drowsiness and weight gain. If you have pain in a specific area of your vulva, injections of local anaesthetic and steroids into a nearby nerve may provide temporary pain relief. Physiotherapy and counselling can also both be useful in a patient’s overall treatment plan.

But even with all of the above intervention, sometimes the condition continues to devastate the patient’s life.

Can medical cannabis help?

There is an increasing body of evidence which suggests that cannabis-based medicines can be helpful for certain women in the treatment of vulvodynia and other gynaecological pain-related conditions such as endometriosis, if patients feel that standard pain medicines are no longer working or providing relief. 

Sophie Hayes, specialist practise nurse at Integro Clinics, says: “Cannabis medicines can be helpful in the management of vulvodynia, particularly in relaxing the muscles of the vagina during intercourse and if used before and after. They can also be helpful in relieving vulva pain as the THC is an effective neuropathic pain killer.”

The patient’s story

Freya is a dynamic and politically active woman, who has a complex range of interacting conditions including fibromyalgia and vulvodynia.

Here, she describes the physical and mental aspects of this condition, the stigma that still exists around seeking help, and the difficulties and prejudices with diagnosis.

Headshot of Freya Papwrorth

Freya was diagnosed with vulvodynia aged 20.

At what age did vulvodynia first become an issue for you? How does it impact on your life and relationships?

I was diagnosed at 20 and at the time I was in a very violent relationship. In fact, it’s only within the last year that I was told by a specialist that this is often the trigger for a condition like mine.

Back then they didn’t know why I had it, just that I did. I was told to try a lidocaine lubricant which just numbs everything so removes the pleasure from sex – for me at least – and that was that.

Did you find medical professionals sympathetic and helpful?

No one has ever taken the time to try and help me from a medical standpoint. I did see a specialist last year who recommended dilators, but they just hurt, and I hated them. I know I should go back to trying them again, but I think the mental trauma has become so much now that I just don’t want to. Which of course is not great for my relationship. I’m stuck feeling awful and guilty and wanting it to change, but with no idea how to change it.

When you tried medical cannabis, can you describe how it was helpful for the pain you were experiencing? What conventional drugs have you tried and were there any unpleasant side effects? 

“I tried cannabis for my back pain. I had been on a cocktail of Tramadol, diazepam and codeine which had left me with terrible IBS, an addiction, and just feeling dazed and confused a lot of the time. Nothing got rid of the pain either , they just helped you not care and to relax. 

Cannabis medicines manage to help me relax when I am in pain, which in turn helps the pain reduce as you are less tense and worried. It means I can sit and chat to people without being too ‘stoned’ on something like tramadol and doesn’t cause any of the negative side effects like IBS.

When I have tried tinctures and topicals they have given me pain relief without any of the ‘stoned’ effects, so I can focus and work without issue. That’s probably the most important thing – to be able to focus and get my work done without making mistakes.  It also helps with sleep. I get terrible nightmares and sleep paralysis when I am on Tramadol which I just never get with cannabis medicines.

Why do you think talking openly and publicly about women’s pain is so important? 

Just knowing that you are not alone is so important. Women’s pain is still tied up with the old stereotype of ‘hysteria’ and women are often left to languish in pain without a diagnosis for years, which has a huge effect on your mental health, so you’re stuck in a catch-22 of being depressed because you are in pain and don’t know why, and then your depression is blamed as the cause of your pain. 

There is also a fundamental lack of joined up thinking when it comes to gynaecological symptoms with all your other symptoms, so co-morbidities are missed. I don’t know if this is just because of the spectacular lack of sex specific training that doctors go through, with the male medical body being the default body, or down to some belief that the two cannot ever be related? Or more simply – the patriarchy. 

I think we are also still shamed for talking openly about sex and our bodies as women. We don’t talk openly about periods, contraception, menopause, vulva’s. It’s still very taboo. Who sits around the table and says, ‘actually I rarely have sex as it feels like I’m being stabbed every time I do’? I remember seeing Vulvodynia represented on Sex Education on Netflix and just cheering – I had never seen that before. 

I also remember each time I had to tell a new partner about this before having sex , each time I would be so scared they would think it was a sexually transmitted infection (STI) or something. I thought they would think badly of me for having this ‘thing’ that ‘normal’ women didn’t have. And I think that goes directly back to the slut-shaming we all faced in our teenage years for daring to have sex and enjoy our bodies.”

 

Integro Medical Clinics Ltd always recommend remaining under the care and treatment of your GP and specialist for your condition, while using cannabis-based medicines, and the Integro clinical team would always prefer to work in collaboration with them.

 

If this article has been of interest, you are invited to join a free webinar on Wednesday 12 May at 7pm, exploring the role of cannabis medicines in women’s health.

Expert speakers Dr Sally Ghazaleh, Sarah Higgins CNS, women’s health lead for Cannabis Patients Advocacy and Support Services (CPASS) and endometriosis patient’s Abby Hughes and Jessica* of The Endomonologues will candidly discuss this new field of medicine.

The event is hosted by Cannabis Health, Integro Medical Clinics and CPASS, sign up for free here

Women's health

Cannabis legalisation not linked to adverse birth outcomes – study

Researchers studied the relationship between the liberalisation of cannabis laws and key indicators of child health

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Studies assessing the potential impacts of cannabis exposure during pregnancy are mixed.

Legalisation of cannabis in the US is not linked to any significant adverse outcomes for  child health, according to a recent study.

New data shows that changes in legal status of cannabis in US states is not associated with increases in adverse clinical birth outcomes.

Researchers at Purdue University studied the relationship between the liberalisation of state-level cannabis laws and two key indicators of child health – birthweight and gestational age.

Their findings were published in the journal Population Research and Policy Review.

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While the authors reported a trend which indicated a reduction in average birthweight and gestational age for some groups of women following the relaxation of cannabis penalties, they acknowledged that these changes were not linked to any “increases in clinically meaningful birth indicators associated with adverse child health.”

The findings are similar to those reported in a 2021 study which found “no statistically significant effect of medical cannabis laws on the proportion of newborn hospitalisations”. 

The authors concluded: “Our findings indicate that cannabis policy liberalisation may be contributing to lower average birth weights and reduced average gestational age, but not in a manner that has increased low birthweight (<2500 g) infants or preterm (<37 weeks) births. 

“These results indicate that while cannabis policies have not led to increases in adverse clinical birth outcomes overall, these trends are worth monitoring to ensure that increases in clinically relevant child health outcomes do not emerge as the nationwide trend toward liberalised cannabis policy persists. “

They added: “Although our study does not show substantial changes in adverse birth outcomes, policymakers should be attentive to opportunities to strengthen child health by considering policies that minimise consumption, particularly heavier forms of consumption, by prospective parents.

While the evidence base around the effects of cannabis use during pregnancy on perinatal is growing, studies assessing the potential impacts of cannabis exposure are mixed.

Some observational data has identified a link between exposure and low birth weight and/or an increased risk of preterm birth. However others have failed to substantiate these claims once adjusting for other factors, such as tobacco smoking.

The majority of the existing studies have been done on recreational cannabis, accessed through the illicit market, which tends to contain higher levels of THC than that in medicinal cannabis.

There have been very limited, if any, studies exploring the effect of prescribed cannabis on perinatal health, as advice from clinicians is that women should refrain from using cannabis medicinally or otherwise whilst pregnant or breastfeeding.  

 

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Can cannabis help with menopause?

Juicy Fields explores how cannabis could help women with some of the symptoms brought on by menopause. 

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Juicy Fields explores how cannabis could help women with some of the mental and physical symptoms brought on by menopause.

Menopause is one of the most challenging transitions women face as they go through dramatic physical, psychological, and vaginal/uterine changes.

The stage is characterised by symptoms such as insomnia, night sweats, hot flashes, pain, inflammation, and mood swings.

Although there are various medical alternatives to deal with the unwanted and uncomfortable symptoms, a study conducted in 2021 by the Canadian Institutes of Health Research showed that women experiencing menopause (perimenopause, menopause, and postmenopause) in Alberta were significantly using cannabis to relieve symptoms. Sixty five per cent of the participants had ever used cannabis to relieve menopausal symptoms, while 35 per cent of the group were using marijuana during the period the study was conducted. 

Another study presented to the  North American Menopause Society (NAMS) in 2020 had similar conclusions. In a sample of 232 women from Northern California, 27 per cent indicated using cannabis to manage hot flashes, night sweats, and insomnia.

Ten per cent of the participants expressed interest in using cannabis, while only 19 per cent utilised hormone therapy to combat menopause symptoms. From the studies, one can conclude that women are shifting from hormonal medication and switching to organic, natural alternatives, specifically cannabis. This piece explores everything about menopause and its symptoms and how cannabis can help alleviate these conditions. 

What is menopause?

Menopause is a period in a woman’s life that can stretch 10 or more years. During this period, their reproductive hormones go through a natural decline. This marks the end of the menstrual cycle and, consequently, their fertility. It is divided into three stages;

Perimenopause: this includes the years leading to menopause. Most women experience this during their early to mid-40s, although others can begin early during their 30s or late 40s. The woman will experience biological disturbances characterized by irregular menstrual cycles and varying hormone levels during this time. 

Menopause: this is when a woman stops having her menstrual period for 12 consecutive months. One will not know when they are experiencing menopause until the 12 months have gone by. Common symptoms during this stage include vaginal dryness, night sweats, hot flashes, and sleep issues. 

Postmenopause: this refers to the period after a woman has stayed 12 consecutive months or more without menstruating – after menopause. Symptoms like hot flashes and night sweats begin to fade or disappear entirely. 

Physical, psychological, and vaginal symptoms of menopause

As mentioned earlier, menopause is a life-changing transition with its fair share of problems. It is attached to a host of symptoms, which can be classified as either physical, psychological, or vaginal.

Physical: symptoms include fatigue, pain and inflammation, heart palpitations, headaches, dizziness, stiffness, insomnia, and chest discomfort.

Psychological: symptoms include anxiety, depression, lowered sex drive, lack of concentration, memory loss, and mood changes.

Vaginal/uterine: symptoms include dryness and pain during sexual intercourse.

The relationship between cannabis, the endocannabinoid system, and cannabis

Does cannabis help with menopause? To answer this question, we must first look into the endocannabinoid system. This is a system comprising endocannabinoids, receptors, and neurotransmitters. This cell-signaling system utilizes these components to support normal body functioning, aka homeostasis. It regulates and controls various immune system, cardiovascular, nervous, and reproduction (including fertility and menopause) functions. 

During menopause, the ECS is disrupted, which causes changes in various related biological systems. Cannabis interacts with the ECS on different molecular levels to support its function of maintaining homeostasis, thus relieving the menopause symptoms.

The research into how cannabis directly relieves menopausal symptoms is currently unavailable. However, cannabis is known to have potent analgesic, anxiolytic, antidepressant, appetite-stimulating, sleep-inducing, antiemetic, and muscle-relaxing properties that can play a significant role in managing symptoms like pain, inflammation, mood swings, depression, anxiety, and sleep issues. Below is a highlight of top menopause symptoms and how cannabis can help combat them. 

Hot flashes and night sweats

These symptoms are the primary reasons why women turn to cannabis. THC, the most abundant cannabinoid in cannabis, is associated with lowered body temperatures. The cannabinoid supports thermoregulation, which is handy for women experiencing hot flashes and night sweats. Ever heard of THC-induced hypothermia? This may happen when THC is taken in high doses. Identifying the right amount of cannabis to consume may help mitigate the disturbing hot flashes and night sweats. 

Mood swings, anxiety, depression, and concentration

Anecdotal and scientific evidence point out the effectiveness of cannabis’ mood-boosting and regulating, antidepressant, and focus-boosting properties. Its anxiolytic capability is dependent on various factors, such as the dose taken and the consumer’s tolerance level. These psychological issues affect most women undergoing menopause due to the numerous changes, discomforts, and uncertainties they go through.

Vaginal dryness and low sex drive

Cannabis can help with vaginal dryness and low sex drive in either of two ways; first, its calming, relaxing, and mood-boosting properties coupled with clear-headedness may support a return of the sex drive. Secondly, CBD lubricants have been known to decrease inflammation in the vaginal area, increase blood flow in the area, and support muscle relaxation. 

Pain and inflammation 

Cannabis is a powerful analgesic and anti-inflammation agent. It is utilised by numerous cannabis consumers to treat pain resulting from conditions such as arthritis, fibromyalgia, MS, sciatica, and headaches. Athletes have been known to incorporate cannabis in their pre- and post-workout regimes to combat muscle aches, pains, and injuries.  

Fatigue and insomnia 

Cannabis is a powerful muscle relaxant that, when consumed, melts all the tightness and tension away. It also promotes full-body relaxation and sleep. It helps restore one’s sleep pattern and promotes a regular sleep cycle. 

Take away

Although not directly, cannabis has been proven to help relieve menopausal symptoms such as hot flashes, pain, anxiety, inflammation, depression, sex drive, and insomnia. There is a need for more research to link the two together. This will facilitate the identification of proper cannabis strain genetics and dosage for managing perimenopause, menopause, and postmenopause symptoms. 

Leading crowdgrowing platforms like JuicyFields’, are making medical cannabis accessible for more and more people. You too can join the platform and start making profits with every harvest.

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Medical cannabis and endometriosis – “I can live a normal life”

Thirty-two-year-old Megan has lived with the symptoms of endometriosis since her teens.

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Megan was diagnosed with endometriosis in February this year.

Megan, an Australian medical cannabis patient living with endometriosis, shares how the plant has helped in managing her symptoms.

Thirty-two-year-old Megan has lived with the symptoms of endometriosis since her teens. At times she’s experienced such intense pain that she struggled to leave her house.

“I honestly believe I would have ended up suicidal within the next few months if I didn’t pursue and get approved for medicinal cannabis when I did,” she said.

During Endometriosis Awareness Month in March, Cannabis Health interviewed several patients across the globe who  live with the often-debilitating symptoms of the inflammatory condition.

US research programme studies cannabinoids in ovarian cancer

Endometriosis is present in about one in 10 women and non-binary people aged between 25 to 40 in the United Kingdom – but can affect people at any age.

Cells similar to those lining the womb grow elsewhere in the body, such as the bladder, ovaries, colon and rectum, and react to changing hormones in the menstrual cycle.

They grow thicker in the middle of the cycle and then break away and start to bleed before being slowly reabsorbed by the body. This process can cause inflammation, pain and new scar tissue.

Megan, who lives in Australia, explained that she was only officially diagnosed with endometriosis in February this year.

Lengthy diagnosis is common as the condition can mirror others and is widely misunderstood among many doctors – the average time from onset of symptoms is seven and a half years.

“I’ve always had painful periods – I just always thought they were meant to be painful,” Megan told Cannabis Health.

“I didn’t question it until early 2018 my periods stopped for about three months and when they returned it was like everything was turned up and the pain was excruciating.”

In early 2019 Megan was told she had adenomyosis, a condition in which the inner lining of the uterus breaks through the muscle wall of the uterus.

Symptoms can include lower abdominal pressure, menstrual cramps, bloating and heavy periods.

Her GP at the time suggested that she may have endometriosis as well, but it was not confirmed until surgeons performed a laparoscopy – keyhole surgery of the abdomen or pelvis.

Managing pain

People who have endometriosis often suffer from painful periods, painful sex, pain in the lower abdomen, pain on passing a stool and urinating, or lower back pain.

This can then lead to difficulty sleeping, an inability to focus on daily tasks, and in some cases a mental health decline.

Over the years Megan has tried NSAIDs, codeine and oxycodone in an attempt to manage the pain.

“I’m somewhat unlucky that I don’t respond to a lot of painkillers… so I was always ‘pushing through’ the pain and essentially burning myself with heat packs,” she said.

Meanwhile, she was using cannabis recreationally, but it took a comment from her partner to realise that it was also helping to dull the symptoms of her two conditions.

I was mid-flare about 12 months ago and we’d run out of cannabis. It was a long weekend in my city so all the dealers we knew were sold out,” she recalled.

“I was curled up in bed with my heat packs and my partner said then I should see if I can get into trials for medicinal cannabis or a prescription for it.

“He’d picked up that it was the only thing that would help my pain and being reliant on black market wasn’t ideal long term.”

She was initially nervous to make an appointment at a clinic, because she did not think she would get approved.

“Everyone downplays endo so much, I was worried I’d get the same kind of dismissal about my symptoms and pain that so many doctors had done in the past,” she said.

She finally applied for a prescription last summer, and because she was able to show all the painkillers she had tried that had not worked, the process to approval was fairly quick.

Among the methods she uses to take cannabis are ingesting CBD and THC oils, and cannabis flower to vape.

The CBD oil helps with overall symptoms – definitely reduces anxiety and nausea and has a huge impact on reducing pain,”  said Megan.

“THC oil I’ll use more on days when the pain is worse than my normal levels, or when I get a random flare up some days, it helps to take THC oil and flower together to get through it.”

Stigma

Despite how much it helps her, Megan has experienced some negative comments due to her use of cannabis, particularly before she was given a prescription.

I think a lot of people still just view it as this evil illegal drug and don’t understand that it’s such a powerful and useful plant and tool in treating people’s illnesses,” she explained.

However, after getting a prescription she said her friends and family had been “surprisingly supportive”.

She continued: “I’m not sure if it’s because it’s issued via a prescription that makes people more approving of it, or if it’s just because they can see the effect it’s had on me since starting it. Maybe a combination of both.”

Getting a prescription for cannabis made a huge difference to her wellbeing. 

“With cannabis I can live a pretty normal life,” she added.

But in the long term, Megan is worried for women who have endometriosis, and the dismissive nature of some doctors when it comes to the benefits of cannabis for pain.

“I’m scared for the next generation of endo warriors who are going to be pushed onto these incredibly strong medications,” she said.

I really struggle to comprehend how some doctors will be happy for their patients to be on really strong pharmaceuticals every day to manage their pain, but can still be so anti-cannabis.”

Alongside the cannabis, the laparoscopy – during which surgeons removed some of the offending cells – also helped to significantly ease the pain of the endometriosis.

She stressed that it is vital that more surgeons are trained in expert excision surgery as a more permanent solution for patients.

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