Medical marijuana for urologic chronic pelvic pain It is generally acknowledged that many patients are not satisfied with the contemporary medical approach to the management of urologic chronic Pure Craft CBD offers CBD Oil 1000mg & 2000mg flavored CBD tinctures, CBD Gummy Bears, CBD Oil for Dogs and more! Discover Pure Craft CBD PURE CRAFT BLOG
Medical marijuana for urologic chronic pelvic pain
It is generally acknowledged that many patients are not satisfied with the contemporary medical approach to the management of urologic chronic pelvic pain syndrome (UCPPS). Many have turned to marijuana or cannabis because of its strong anecdotal reputation of providing benefit to patients with chronic pain. In a condition in which patients are struggling to cope, the marijuana story appears to offer hope.
What is marijuana?
Marijuana or cannabis contains hundreds of known compounds (421 chemicals and counting), including cannabinoids (more than 60). Delta 9-tetrahydrocannibinol (THC) and cannabidiol (CBD) are the most widely studied to date. THC (the psychoactive cannabinoid) stimulates appetite, reduces post-traumatic stress disease (PTSD) symptoms, and can be used as a sleep aid. CBD (the non-psychoactive cannabinoid) reduces inflammation, relieves anxiety, and reduces seizures. The combination of CBD and THC may act as a muscle relaxant, relieve spasms, reduce nausea, and relieve pain. At least that is the theory.
Painful lessons learned from the UCPPS clinic
We have been prescribing medical marijuana for a number of years and are slowly figuring out how to do this properly. We had no textbook, no manual, and no instructions. The literature did not help us. It was really trial and error, with our patients teaching us the optimal strategies for the use of marijuana in UCPPS. Herein, I share the seven most important lessons we have learned.
Lesson 1: Basic research supports the theoretical use of marijuana
If you prescribe marijuana for your patients with UCPPS, you can be reassured that there are many potential theoretical mechanistic pathways by which marijuana has shown possibilities for benefit in basic science research. These include theoretical analgesic, antiemetic, antispasmodic, anti-inflammatory, antibacterial, relaxant, and anxiolytic properties.
Lesson 2: Clinical research does not provide strong support for the use of marijuana in UCPPS
Unfortunately, there are sparse clinical research studies to support the use of cannabis in UCPPS. In fact, there is almost none and we have to rely on what little clinical evidence is available for the use of marijuana in other chronic pain syndromes. There is at least some literature attesting to the possible benefits of medical marijuana in spastic disorders, PTSD, irritable bowel syndrome, rheumatic diseases, anxiety, depression, sleep disorders, inflammation, and chronic pain. Unfortunately, there is just no solid, long-term data for UCPPS management. The available literature suggests that marijuana can reduce pain by 37%, or a total of 0.5 points on a pain scale of 0–10. Inhaled cannabis results in short-term reductions in chronic neuropathic pain for one in every 5–6 patients treated. But the use of medical marijuana is also associated with known adverse side effects, which include dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination.
Lesson 3: Marijuana is better than opioids
For patients who are having trouble coping because of pain that has not responded to the standard therapies outlined in this supplement, turning to opioids as the last resort is not usually the best approach. Opioids, at best, offer around a 30% improvement in pain and at worse, offer a paradoxical slow exacerbation in pain intensity. With even minor pain relief comes the possibility of physical or at least psychological dependence to opioids, with desire for further increasing doses with diminished returns. Marijuana has fewer downsides, with the possibility of similar pain relief, better psychological coping, and less chance for addiction and dose escalation.
Lesson 4: Recognize patients at risk
All patients with UCPPS are not candidates for medical marijuana management. Patients with a history of substance abuse, diversion risk, and mood disorders should never be prescribed cannabis as a treatment option. If they decide to use the substance on their own, then it will not be a medical error in judgement, but rather a patient-only decision.
Lesson 5: Patient education is the key to successful use of medical marijuana
Patient education should provide a clear understanding of the benefits (30–40% reduction in pain) and risks of medical marijuana ( Table 1 ). The different modes of administration (oral, smoking, vaporization), must be a part of the teaching process. The advantages and disadvantages of the various routes of administration are described in Table 2 .
CBD For Pelvic Pain
Pelvic pain — it’s a common condition among women, but men can suffer from it, too. Whether the pain is due to issues in your digestive, reproductive, or urinary system, it can be debilitating.
What’s worse is when you’re told that the pain’s all in your head, or that you just have to deal with it. But what if there was a natural way to ease the pain?
Many people suffering with chronic pelvic pain are taking their health into their own hands. And some are turning to CBD for relief.
Some swear by its ability to ease their pain. And it seems like science is catching up, too. Let’s take a look at how CBD may be able to help with pelvic pain.
Pelvic Pain: Causes, Diagnosis & Treatment
Pelvic pain is a broad term that is used to describe any pain that occurs in the pelvic region. A wide range of possible causes means that pelvic pain can be due to things like endometriosis, pelvic inflammatory disease, infection, or interstitial cystitis. The pain could also be constant or intermittent, slow developing or sudden.
Causes Of Pelvic Pain
Pelvic pain can happen due to a number of reasons. Some pelvic pain is caused by problems with the reproductive organs, such as endometriosis or ovarian cysts. Other reasons for pelvic pain could be an infection, such as a UTI.
Some common conditions that cause pelvic pain:(1)
- Menstrual cramps
- Reproductive tract cancers
- Uterine fibroids
- Ectopic pregnancy
- Pelvic inflammatory disease
- Urinary tract infection
- Ulcerative colitis
Diagnosis & Treatment Of Pelvic Pain
Pelvic pain-related conditions are diagnosed by a healthcare provider based on a person’s medical history and a physical examination. Sometimes tests like blood tests, diagnostic imaging, urinalysis, or pregnancy tests may be needed to pinpoint the cause of the pelvic pain.
Treatment will also vary depending on the cause of the pelvic pain. Some common treatments include over-the-counter or prescription medications, antibiotics, contraceptives, physical therapy, or surgery.
It often takes a combined approach of different treatments to find physical and emotional relief from pelvic pain.
CBD For Pelvic Pain: Does It Work?
The surveys are in — people are definitely using CBD to manage their pelvic pain symptoms.(2)
How does CBD fare? To see how CBD might help in the treatment of pelvic pain, we have to look at the different triggers of pelvic pain. Pelvic pain can be from vulvar/vaginal pain disorders, uterine diseases, urologic pain disorders, or other inflammatory conditions.
Let’s see how CBD might help with all of these different types of pelvic pain.
CBD For Vulvar & Sexual Pain Disorders
Sexual pain disorders are more common than you think. Many women struggle with pain during sex due to:
- Vaginismus: A tightening of the muscles around the vagina
- Vulvodynia: Chronic pain of the labia, clitoris, and vaginal opening
- Dyspareunia: Genital pain during intercourse
- Pelvic floor tightness: Pelvic muscles tighten and are unable to relax
Often, sexual pain is unexplained pain — meaning no one knows why it’s happening. Thus, it frequently goes undiagnosed. But, if you’re experiencing pain during sex be sure to find a doctor who won’t dismiss your concerns.
In addition to being medical issues, these conditions could be triggered by stress. Stress can cause the pelvic floor muscles to tighten and could contribute to sexual pain.
Some studies suggest that CBD might reduce muscle spasms.(3) This might help relax the pelvic floor muscles.
For more on CBD and sex, read: Does CBD Help. Sexually?.
CBD For Uterine Conditions
Endometriosis is a uterine tissue disorder that can cause a lot of pain. Patients with endometriosis report taking cannabis to self-treat their symptoms. The most common reasons reported include pain reduction, addressing gastrointestinal issues, and improving mood.(4)
There’s some good news too. There’s a clinical trial in the works to evaluate CBD for the treatment of endometriosis-associated pain.(5) Keep tabs on this one!
CBD For Urinary Tract Pelvic Pain
Urologic chronic pelvic pain syndrome (UCPPS) is a syndrome that includes several conditions that lead to pain and frequent urination. For those who aren’t responding well to standard therapies, doctors are starting to prescribe medical marijuana as a treatment for the management of UCPPS.(6)
CBD For Other Pelvic & Inflammatory Conditions
In pelvic floor dysfunction, the muscles and tissues that support the pelvic organs are constantly tightened. Your body is unable to relax those muscles, which can lead to painful and frequent urination, as well as constipation.
CBD might help to relax the pelvic floor muscles, which can lead to less pain and fewer bathroom trips.(7)
CBD Products For Pelvic Pain
Pelvic pain is a complex condition that often requires a multi-faceted approach to treatment. If CBD oil sounds like a part of that approach for you, here are a few product types to consider:
Tips On Choosing CBD For Your Pelvic Pain
Too many options? Not sure where to start? Here are a few pointers:
- Topical CBD is made for localized pain relief. It could be used on top of the skin around the pelvic area.
- CBD oil, tinctures, softgels, and gummies can be taken orally and provide more systemic relief.
- CBD oil, which is taken sublingually, skips the digestive tract. This means it may get to work more quickly than an edible CBD product.
- CBD suppositories are a newer product that may also help to provide cannabidiol near the pelvic floor muscles.
- No matter which CBD product you choose, opt for one formulated to have high bioavailability.
- Consider layering different types of CBD products for maximum relief from pelvic pain. Read our blog Layering CBD: How To Do It Safely & Effectively for tips.
Final note for those seeking pelvic pain relief: CBD is not an FDA-approved product for treating pelvic conditions. Research suggests that it might help ease pain, though it’s not approved to treat or prevent any pelvic infections, diseases, or conditions. Talk to your doc for more guidance on whether CBD is a good fit for your needs.
Can CBD Help With Pelvic Pain? Maybe!
There are many different types of pelvic pain — indeed dozens of conditions could lead to this type of discomfort. But whatever the source of your symptoms, CBD oil might be able to offer some relief.
If you’re experiencing chronic pelvic pain, chat with your doctor about whether CBD has a place in your pain management plan!