Endometriosis & Cannabinoids, the Science
Endometriosis is a gynecological condition that moderately to severely impacts a woman’s overall health and wellness. It affects 5-15% of women of reproductive age and is defined as the presence of endometrial glands/tissue in places other than inside the uterine cavity. This can include the ovaries, tissue lining the pelvis, and the tissue that separates the rectum and the vagina (rectovaginal septum). Not only is endometriosis the cause of pain in any/all of these regions, it impacts quality of life as it pertains to sexual and psychological health. Unfortunately, there are few effective treatments for this condition besides hormones to suppress the ovaries (and menstruation), non-steroidal anti-inflammatory medications (NSAIDS, like ibuprofen), and surgery. Another- commonly used but not great- treatment is the use of opiods (painkillers, which are addictive).
There have been several papers published in the past few years regarding cannabinoids and endometriosis. Our bodies’ own endocannabinoid system is actually quite important in both endometriosis development AND in pain management of this debilitating condition. This is because endometriosis causes pain in several different ways as it involves 3 different pain systems in the human body. All of these pain systems also overlap with our bodies’ endocannabinoid system. Please check out our post on the endocannabinoid system, phytocannabinoids and pain for more scientific details.
Briefly, women with endometriosis have amplified inflammation and oxidative stress and this overstimulation results in both acute (intense, short-term) and chronic (nagging, long-term) pain via the inflammatory pain pathway. Then, there’s nociceptive pain from endometriosis due to those rogue endometrial cells changing in size and what they secrete over the course of the cycle. We perceive this type of pain as intense pressure, stretching, heat, burning, etc. Endometriosis cells can infiltrate nociceptive nerve fibers leading to painful stimulation of this system. In addition, endometriosis cells can lead to production of other types of pain molecules in the system that can directly excite this part of the nervous system, amplifying endometrosis pain.
Finally, there is neuropathic pain which results from direct damage to the nerve cells (and fibers) themselves. This can also occur as part of inflammatory or nociceptive damage. Many people describe this type of pain as shooting or piercing as it travels along nerve fibers. Then, the brain gets involved, remembers and distorts the experience of pain, amps up anxiety about avoiding pain like this in the future, and a chronic pain pathway is born. The earlier in her life a woman begins to experience this type of pain the greater the CNS (brain) integrates it and distorts it. That’s why it is important to recognize and treat this type of pain in teens as much as it is in older women.
In endometriosis the pain from the condition itself is compounded by other concerns that arise such as fertility and painful sex. This worsens the anxiety, social withdrawal, poor sleep, and other factors which can negatively impact an individual’s overall mental health. Overall, this leads to a very challenging cycle. So how can the endocannabinoid system come to the rescue in this condition?
Expression of CB1 receptors is HIGH in the uterus and CB2 receptors are also expressed abundantly in the uterus, intestines, immune system, lungs, pancreas and skin. Over the course of a woman’s monthly cycle, CB1 and CB2 receptors are found in varying amounts. These amounts also differ between women who have endometriosis and those who don’t. Hormones such as progesterone, which is one of the main “directors” of the menstrual cycle, also increase or decrease endocannabinoid receptors during different parts of the cycle.
Because CB1 and CB2 receptors appear to play such a large role in the endometriosis “cycle,” some studies have gone as far as to describe endometriosis as an “endocannabinoid deficiency” syndrome. This is based on how much mismatch there can be between existing internal cannabinoids and the receptors that they act upon. In endometriosis, this mismatch apparently leads to endometrial cell overgrowth and to migration of these cells outside of the uterus. Therefore, one route that cannabinoids likely take to reduce endometriosis pain is via an “antiproliferative” effect- that is- they likely prevent the endometriosis cell overgrowth and migration outside of the uterus mentioned above.
We have formulated our Endo-Xo and Endo-Xv products with this science in mind to address all of the involved pain pathways activated by endometriosis and to reduce the damage from endometriosis at the root. Because endometriosis waxes and wanes with the menstrual cycle, daily use of the Endo-X products over the course of, at least, one cycle is necessary to determine whether this product is right for you!
Bouaziz, et al. “The Clinical Significance of Endocannabinoids in Endometriosis Pain Management.” Cannabis and Cannabinoid Research 2017, 2.1
http://online.liebertpub.com/doi/10.1089/can.2016.0035