Can CBD Prevent Pelvic Pain?
The compound is certainly trendy, but the research is scant.
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I suffer from pelvic pain, specifically vaginismus. I’ve been reading about the benefits of CBD with pain. I was wondering if CBD salves or lubricants were safe to use internally? And if CBD will actually reduce the pain one experiences with vaginismus.
Vaginismus is a medical condition where the muscles of the pelvic floor (the muscles that support the bladder, vagina and rectum) have excessive tension. This can lead to both pelvic pain and pain with sex. There is no data to support using CBD vaginally (or by any other route) for this pain condition. There is some evidence linking cannabis use in the previous four months with increased vaginal yeast colonization, but CBD has not been studied independently.
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CBD, or cannabidiol, is a nonpsychoactive compound found in cannabis. CBD is “in” right now for many medical conditions, not just ones that are painful. The data supporting CBD use for most conditions is generally low quality or completely absent, so it is important to separate the fad from the facts so you can make an informed choice about your body.
CBD may play a role in reducing pain and muscle spasm for some conditions, but there are still a lot of unknowns. An oral spray with THC (tetrahydrocannabinol, which is the main psychoactive component of cannabis) and CBD is approved for use in other countries for muscle spasm caused by multiple sclerosis as well as for some kinds of chronic pain. However, it is not possible to directly translate this data to vaginal use or to apply it to a different medical condition.
We do not know how CBD would act vaginally since cannabinoid receptors in the vagina have not yet been studied. We also don’t know how much CBD would be absorbed into the bloodstream or if absorption is needed to produce an effect. (In this case, if the drug has to enter the bloodstream to work, there is probably no benefit to vaginal use).
We also don’t know what effect CBD could have on the pelvic floor muscles. There is one study that tells us natural endocannabinoids actually reduce during sexual excitement, so it is biologically plausible that CBD could increase pelvic floor muscle tone (meaning it would be very unhelpful for spasm). There is also some data that suggests cannabis use is associated with a higher rate of vaginal yeast colonization. We don’t know if this is from the THC, CBD or other cannabinoids.
Essentially, we don’t know what we don’t know about CBD and the vagina. I recommend that any woman (or man) with pelvic floor muscle spasm skip CBD and instead see an Ob/Gyn or urologist with expertise in that area, as well as a specialized pelvic floor physical therapist.
Dr. Jen Gunter, Twitter’s resident gynecologist, is teaming up with our editors to answer your questions about all things women’s health. From what’s normal for your anatomy, to healthy sex, to clearing up the truth behind strange wellness claims, Dr. Gunter, who also writes a column called, The Cycle, promises to handle your questions with respect, forthrightness and honesty.
CBD for Pelvic Pain, Sciatica & More: How Rectal Suppositories Could Help
If you’re reading this, there’s a good chance you’re aware of the growing trend of putting CBD oil and cannabis-infused suppositories where the sun don’t shine. For many of us, putting things up our butts is a rare — or nonexistent — experience, especially since there are plenty of other ways to take CBD or THC.
But if you’re looking for specific, local relief, don’t rule out taking a suppository rectally. Not only is the rectum part of the digestive tract (a system that can benefit from cannabinoids), it’s also very close to sections of your spine that control your lower torso — meaning that anal or rectal suppositories might benefit the lower half of your body in unexpected ways. And for people who are intrigued by the sensual possibilities of anal play (but maybe a bit intimidated), the power of cannabinoids to relax muscles and soothe pain could make offer an additional route for sexual enhancement.
When Did People Start Putting Weed in Their Butts?
For decades, people in the medical cannabis community have endorsed taking suppositories rectally — particularly for cancer patients whose chemotherapy-induced nausea prevents oral administration.
Foria was the first company to promote vaginal use of cannabinoids for sexual pleasure and menstrual relief (at least in the modern world) and the effectiveness of that route got us curious about other routes for pleasure and pain relief, leading to our anal play suppository Explore .
But humans like to experiment, so we’ve subsequently heard about all sorts of other reasons people take our suppositories rectally :
Which all makes sense, given that cannabinoids have a surprising number of benefits — including being potent anti-inflammatory compounds. And rectal therapeutics have been embraced by our ancestors for thousands of years for treating pelvic ailments: Egyptian scrolls from 1500 BC describe over 700 herbal medications that were applied rectally .
All this might leave you wondering whether you’ve been missing out if you haven’t explored the therapeutic upsides of going this route. So instead of leaving you to explore in the dark, we’re shedding some light on the science behind anal suppositories. Read on to learn about the many ways medicine — and CBD suppositories — can accomplish wonders when you let them in the back door.
Drugs in Your Derriere: What Happens?
When molecules enter your body via the back door, their final destination depends entirely on their chemical properties.
For instance, alcohol and very water-soluble medications can easily pass across rectal tissue into the bloodstream, which gives them very quick access to your body. This is why vodka-enemas and cocaine-smuggling can be incredibly dangerous — rectal delivery of toxic drugs skips over your body’s emergency eject function (aka vomiting).
However, not all molecules travel so efficiently — if at all — into your bloodstream. The larger the molecule and the less water-soluble it is, the more likely it will stick around locally and diffuse into the surrounding tissues, which are full of welcoming fatty lipids. Instead of circulating through your bloodstream and affecting the entire body, these larger molecules have much more localized effects in the pelvis.
That’s why, compared with oral drugs & medicines, most medical suppositories provide relief to the pelvic region and digestive tract while producing fewer full-body side effects . Anti-inflammatories, anesthetics and anti-tumor drugs are currently used in medical suppositories for:
CBD & THC: Why They’re Not Like a Vodka Enema
Cannabinoids like CBD oil and THC don’t dissolve into water (they’re hydro-phobic ). Instead, they dissolve more easily in oils (they’re fat-soluble ). This is the reason that cannabis & hemp extracts usually come in a fat like coconut oil, hemp seed oil, or butter — and why our CBD Suppositories are made with cocoa butter.
Despite their rich history and therapeutic potential, modern research into the behavior of rectally-delivered cannabinoids is lacking. To the best of our knowledge, only one study has tested whether or not cannabinoids from fat-based suppositories reach the bloodstream. When monkeys were given high doses of THC in an oil-based suppository, it only reached the bloodstream if it was first chemically modified (into THC hemisuccinate ).
However, the science is far from settled, and everyone’s body is unique. Cannabis doctors have told us about patients experiencing full body effects from rectal suppositories, and we’ve found that some of our customers report a full-body effect after using our suppositories, which only contain natural cannabinoids in organic cocoa butter.
Whether you experience this or not, current evidence suggests that rectal cannabinoids are mostly going to stay within the tissues of the pelvis. So, what’s in the neighborhood?
Quite a lot, actually.
The Anal Landscape
If you’re already familiar with anal anatomy, feel free to skip ahead, but this amazing transition zone between the internal and external world deserves a proper introduction.
The back door — your anus — opens into the anal canal. This narrow canal is typically 1-1.5 inches long and contains sphincter muscles that regulate what goes in and out.
Past the gates of the anal canal is the rectum, a stretchy passageway about 5 inches long. This section of the digestive tract serves as a temporary storage facility for whatever travels out of — or into — the back door.
When the rectum is full, the sensation of being stretched tells your body to either send the contents out through the anus or back up into the colon if possible. The colon is lined with sponge-like tissue that absorbs water (which is why a long-delayed bowel movements can lead to constipation).
Surrounding the anal canal and rectum are some very “sacred” parts of our bodies. The lowest region of the spinal cord is here — the sacrum — and it’s the root source of many sensations that occur in the pelvis and legs.
Directly opposite the sacrum (on the other side of the rectum) are organs that can bring us intense pleasure or pain: the vagina and uterus (for females), or the prostate and bladder (for males).
When you insert a little rocket-shaped suppository and let the cocoa butter slowly melt, the tissues lining your rectum and anal canal become coated with cannabinoid-packed oil. From this oil, CBD and/or THC slowly diffuse into and throughout the surrounding tissues. Where do these molecules end up, if not the bloodstream?
The nerves in the pelvic region carry a variety of signals & sensations. Not only do they carry signals from your anus to the decision-making headquarters of the central nervous system, they also carry messages back to the muscles and glands of the pelvic region, based on how your nervous system interprets these sensations.
Sensations experienced throughout the pelvis contribute to both “felt” sensations (tactile & structural), as well as subconscious perceptions of well-being. Many sensations felt in your anal canal & rectum can feed directly into your “fight-or-flight” response or its opposing “rest-and-digest” response (through the sympathetic nervous system or the parasympathetic nervous system, respectively). Together, these alert/relax signals help your body to coordinate when to get sexually aroused, when to digest — or when to temporarily halt these functions and panic .
Where cannabinoids fit in: It’s not so much that cannabis & hemp suppositories make you feel “good,” but rather they make you feel “not bad” — soothing the nerves that perceive pain. Research has found that both CBD and THC help decrease the sensation of pain through nerve receptors TRPV1 and CB1 , respectively. When bad sensations in your pelvis go away, it leaves room for you to feel more of what’s good.
The pelvic region is packed with important muscles that cannabinoids can influence.
Ringing your anal canal are two sphincter muscles — one that you control, and the other that is told by the parasympathetic nervous system when to “let go.” Further upstream, the puborectalis muscle tugs right where your anal canal and rectum meet, which creates another barrier between your rectum and the back door. (This is also why many people love squatty potties: when you squat, this muscle tends to relax!)
If you want things to painlessly enter or exit your rectum, the puborectalis muscle and both sphincters need to relax together. And because two of these muscles are controlled by your subconscious, you can’t simply will this relaxation to happen. This is why most tutorials on anal sex focus first on spending time fostering feelings of comfort & safety.
Looking at the bigger picture, these muscles belong to the pelvic floor — a group of muscles you might already be familiar with. Collectively, the pelvic floor supports pelvic organs and helps maintain continence. While kegel exercises focus on strengthening the pelvic floor, many people actually suffer from pelvic floor muscles that are too tight, which can cause painful sex, urinary problems, or even pinched nerves (as in some cases of sciatica).
Where cannabinoids fit in: Many people who try cannabis suppositories rectally are surprised by how relaxed their pelvic muscles become and — more specifically — how much easier anal play becomes or how much their period cramps subside . As discussed above, CBD and THC desensitize pain receptors, which could help your nervous system relax and ease muscle contractions. Additionally, when skeletal muscles (ie pelvic muscles) are bathed in cannabinoids, they’re physically unable to hold as much tension . Some men report that rectal suppositories help to increase penile bloodflow, helping with the ability to achieve and maintain an erection.
Immune Cells & Inflamed Tissues
For some of us, pelvic inflammation can ravage our daily lives. Hemorrhoids or digestive disorders often coincide with inflammation in the anal canal or rectum. Other sources of inflammation in the pelvis can include arthritis, physical injuries and the ups and downs of the menstrual cycle. And inflammation can actually pinch nerve roots within the spinal cord, setting off downstream health conditions like sciatica.
But most of your pelvic region is buried within your body, so how can you know if you suffer from inflammation? Stiffness or pain could be an indication that your immune system is working overtime. Temporary inflammation from injuries, overuse or painful periods can be treated at home, but if you suffer from chronic pelvic inflammation, consult with a medical professional. Why?
In addition to diagnosing potential conditions like endometriosis, a doctor can assess whether chronic inflammation should be treated to prevent future health problems. For instance, inflammatory bowel disease increases a person’s susceptibility to diseases like colorectal cancer .
A 2012 study on colitis (an inflammatory colon condition) showed that mice receiving rectal CBD experienced greater relief than with oral dosage.
Because internal inflammation and swelling are sensed by your subconscious (through the autonomic nervous system), don’t be surprised if you experience an overall increased sense of wellbeing.
CBD suppositories may also relieve pains you’ve been ignoring — it might be useful to tune in to how your pelvis feels once the CBD wears off. This practice could help you pinpoint trouble zones and muscular imbalances that a massage therapist or physical therapist could help you with in the future.
Rectal? Or Vaginal?
As a note to those with vaginas: You might want to experiment to see if Foria suppositories are more effective at relieving pelvic issues when taken rectally versus vaginally. For period cramps, the back door is a great option if you’re currently experiencing a flow and have… obstacles in the way.
If you’re using suppositories for sexual enhancement & relaxation, be aware that oil-based suppositories and lubricants are not compatible with latex condoms.
What to Expect
If this is your first time trying a cannabis suppository, there’s a chance you’re worried about potential cognitive side effects. Although most people who use our CBD suppositories do not experience a strong “high,” we do occasionally hear from people who end up feeling mildly “elevated” or deeply relaxed.
Because the release of cannabinoids from cocoa butter is low and slow, you might feel the effects for a day or more — which is almost universally regarded as an upside for CBD suppository users. Although Foria suppositories are molded for single-use application, feel free to experiment first with smaller doses by cutting off a small amount and re-shaping it (and then firming it in the refrigerator).
Do our suppositories help you with something we forgot to mention? We’d love to hear about it!
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