For millennia in eastern medicine the hemp plant has been used to treat women’s ailments; western medicine is discovering the cannabinoids pharmacology; women are more sensitive to cannabis, more susceptible to effects, abuse dependence and relapse. CBD in women life
This sexual dimorphic effect is related to estrogen secretion: gonadal hormones and the endocannabinoid system (ECS) are closely connected.
The ECS impacts the release of estrogens through down regulation of luteinizing hormone (LH) and gonadotropin releasing hormone (GnRH); CB1R expression is modulated by estradiol and anandamide is higher with a lower fatty acid amide hydroxylase (FAAH) activity
Anandamide is higher during the follicular phase and highest during ovulation and lower in the luteal phase.
The ECS plays a significant role in the regulation of the menstrual cycle and in fertility.
- Estrogen is calming anxiolytic and antidepressant through an ECS mechanism.
- Estrogen regulates the ECS, down regulates FAAH in uterus and immune cells.
- Estrogen and brain cannabinoids are major modulators of affect, emotions, social and sexual behaviors
- Estrogen modulates receptor activity production and degradation of endocannabinoids in the central nervous system and the ECS down regulates the production of estrogen by decreasing the release of gonadotrophins
Endocannabinoids control the release of neuropeptides, neurotransmitters and hormones at hypothalamus pituitary gonadal and adrenal levels.
Women through their whole life must endure some “natural sufferings”
When they are teen age girls
- starting to menstruate dysmenorrhea is very frequent and usual treatment includes antispasmodic and NSAID drugs
- acne (boys and girls) with production of male hormones
- antibiotics and absurdly prescribed for years on
- antiandrogens cyproterone with serious side effects like brain tumors
- synthetic estroprogestative drugs with side effects such as blood clots
- isotretinoin with serious side effects such as liver damage
When they are adults 20-50 years old looking for a companion, raising children, trying to be efficient in her work and controlling their fertility
- They may suffer from anxiety, emotion, depression, burn-out
- They may have immunity disorders with low thyroid and adrenals functions and chronic infections
- When they wish to have a baby it can be more difficult because the biological clock has reduced fertility potential
Their cycles and menses may be disturbing with dysmenorrhea menorrhagia. Fibromyalgia and endometriosis are feared diseases. Each pregnancy and delivery are significant stages in a woman’s life
Her usual drugs are
- oral contraceptives with the risk of blood clots, breast cancer
- sleeping pills, antidepressants
When menopause comes the wise lady must still fight:
- to avoid the dreaded risks of cancer
- to protect her bones: bisphosphonates treatment brings risk of osteonecrosis
- to protect her skin, her beauty, her libido
- to save her memories
- to avoid depression, arthritis pain
Hormone replacement treatment (HRT) which has been largely prescribed is not safe increasing breast and ovarian cancers
The load of estrogens from the birth control pill, xenoestrogens from the environment and hormone replacement therapy and lack of iodine is a matter of concern
Medical cannabis and CBD can be another paradigm of treatment and can provide a safer alternative.
Cannabis has a long history in gynecology and obstetrics and its reputation to treat efficiently dysmenorrhea, menorrhagia, urine disorders goes back from British and American physicians in 1840 -1940 to famous Arab and Chinese scholars of past centuries till Egypt and Sumer ancient times.
Certainly, clinician studies are required to assess their efficacy but nonetheless compared to all the serious side effects of the actual drugs and their limited efficacy it is worth considering.
- negative allosteric modulator of CB1R, GABAR
- partial indirect antagonist of CB2R
- acts on 5HTR, VR1R, A2AR, GPR55 & GPR18, TPVR, Dopamine R, Serotonin R
- potentiates glycine receptor, blocks TNF-alpha
- inhibits breakdown of anandamide and 2-AG
- prolongs effects of THC by blocking degrading enzymes, reduces intoxicating effects of THC
- appetite stimulant
- muscle relaxant
- promotes bone growth
Main indications of CBD
- epilepsy seizure control
- spasticity and pain of multiple sclerosis
- pain control of arthritis, cancer
- anxiety, depression
- inflammatory diseases: rheumatoid arthritis, irritable bowel syndrome, metabolic diseases diabetes
- anti-tumor activity, brain, breast, endometrium cancers
- disorders of cell migration endometriosis; psoriasis
- promotes bone growth osteoporosis, wound healing
- reduction of stroke risk, stimulates coronary blood flow
- opiods addiction and aid for tobacco alcohol addiction
- memory loss
- nausea vomiting
- inhibits lipid in sebocytes, acne treatment
- dysmenorrhea & menorrhagia
CBD FOR THE TEEN AGE GIRL
Primary dysmenorrhea is caused by uterine cramps
Medical marijuana has been prescribed for menorrhagia and dysmenorrhea since ancient times and in the beginning of the 20th century by British and American physicians
Sublingual drops of CBD 2,5%,3%,4%-5% starting 2 days before the menses and, if necessary, suppositories and massage of the pelvic area with a relaxing antispasmodic CBD based cream associated with magnesium sulfate.
This will help to relieve headaches as well.
No more NSAID no need for oral contraceptive when there is no need for birth control
For severe acne CBD drops or capsules 3%,4%% 2-5drops/day
CBD 3% ,4% directly on lesions
CBD for grown up women
We all live in a world full of environmental toxic exposures and women depending on their lifestyle from diets to beauty regimen are fully exposed to many endocrine disruptors. Oral contraceptives intrauterine devices and xenoestrogens increase this burden and their capacities for reproduction, emotion control and immunity precautions can be non-optimal.
Hormonal imbalances between estradiol progesterone and male hormones provide many symptoms:
- disturbances in the cycles: premenstrual syndrome with mood changes, headaches, menstrual cramps, breast tenderness, sleep difficulty, back ache, venous insufficiency.
Secondary dysmenorrhea causes are pelvic inflammation or infection, endometriosis, adenomyosis, uterine fibroids.
CBD sublingual 5% 5-10mg/day before bed
CBD oil 3% on breasts, on the pelvic area
- emotion, anxiety and depression associated with headaches, sleep disturbances less libido due to stress hormones are often the tribute behind success at work
CBD sublingual 5%-10%, 10-50mg/day, day and night
Suppositories rectal and vaginal
CBD cream for pelvic massage
Lubricating gel with CBD
Women may need different dosages of CBD depending on the different phases of their cycle.
A lifetime exposure to estrogen unopposed by progesterone increases chronic inflammation, pelvic inflammation, uterine fibroids, breast and endothelial cancer growth.
Breast cancer and endometrial cancers are hormone dependent and CB2R plays a role.
CBD induces cell death of estrogen receptor positive and estrogen receptor negative breast cancer cells.
CBD and endometriosis
There is a decreased expression of cannabinoid CB1R and CB2R in endometriosis and adenomyosis; for some researchers, endometriosis is a clinical endocannabinoid deficiency.
There is abnormal growth of endometrium and peripheral innervation causing dysmenorrhea, dyspareunia and risks of infertility.
CBD drops or capsules 10-30mg/day
CBD suppositories, ovules
CBD cream for massage
CBD and genital prolapse
Loss of pelvic support leads to descent of pelvic organs.
There may be a deficiency of the local endocannabinoid system and a disorder of collagen metabolism at the menopause phase
CBD drops or capsules 4%,5% 5-10mg/day
CBD ovules and tampons are an aid to increase muscle tone with physiotherapy before and after surgery
Sublingual CBD4% ,5% to ease stress, for better sleep and to avoid migraines.
Sublingual CBD 10% to improve energy, be resilient, improve
- ovules for cramps
- suppositories digestive issues
- creams for arthritis pain, vascular dilation, venous insufficiency
- cosmetic creams for psoriasis
- lubricating gels
CBD and pregnancy
The ECS is vital for fertility. There are components of the ECS in ovaries and the uterus
Low levels of anandamide (AEA) for implantation and pregnancy to term; increased level of AEA or agonist might induce higher risk of miscarriage
High levels of AEA facilitates labor process
Risks about fetus development and brains of newborns need to be evaluated
There is a lack of clinical studies, this implies that for precaution CBD is not recommended for pregnant and breastfeeding women, however many experienced physicians at the beginning of the 19th century have praised cannabis efficacy during labor for pain and hemorrhage related to delivery.
CBD and hormone dependent cancers breast, endometrium, ovaries
Women hormone drugs and CYP
CBD and Oral contraceptives
Substrates of CYP1A2: estradiol, éthinylestradiol
Substrates of CYP2C9: testosterone
Substrates of CYP2C19: progesterone
Substrates of CYP2D6: tamoxifen
Substrates of CYP3A4:ethinylestradiol , desogestrel, estradiol, progesterone, testosterone, hydrocortisone, medroxyprogesterone, norethisterone
Oral contraceptives are substrates and inhibitors of CYP 1A2 et 3A4
Progestins synthetic progesterones are substrates of CYP3A4
Contraceptive progestin desogestrel is substrate of CYP3A4
As CBD inhibits CYP2C9,2C19,3A4, serum levels of these hormones will raise therefore with a higher level of associated risks blood clots and cancer.
A woman, smoking tobacco, taking birth control pill and drinking some glasses of wine and taking CBD must be aware of this mixed danger
Hormone replacement therapy is:
Estradiol in subcutaneous patches and progesterone
Male hormones DHEA and testosterone
The conventional treatment with hormone replacement therapy has proven to be unsafe with the raise of breast and ovarian cancers
Women following hormone replacement therapy in pill form should be aware of its dangers which could raise with CBD inhibiting CYP, inform their doctors and ask for a change
Tamoxifen which is a selective estrogen receptor modulator(SERM) is a substrate of CYP2D6 and 3A4 and a prodrug which needs to be transformed after degradation to be active ; with CBD inhibiting CYP2D6 and 3A4 tamoxifen will stay longer in the serum and degradation will be delayed therefore there will be less of the active form of tamoxifen so less activity and less efficacy.
CBD and hormone dependent cancers (breast, endometrium, ovaries)
CBD has antitumor activity and may have indications for these pathologies besides actions for overall health for these patients
Added CBG which is cytotoxic at high doses for breast carcinoma is recommended
Ovaries are at rest.
There is a deficit of estrogen with a reduction in ECS signaling
Early menopause may be a clinical deficiency of the ECS
- hot flashes, anxiety, mood changes, poor sleep, weight gain
- dry skin, mucosa
- low libido
- loss of bone density
- memory loss
CBD can offer relief for all conditions suffered by aging ladies.
CBD for heart and vascular tension, blood pressure, reduction of stroke risk.
CBD associated with vitamin D for bone health, brittle bones and fracture risks
CBD love potion to increase desire, pleasure, sexual behavior
CBD for arthritis pain
CBD for insomnia, depression
CBD to prevent memory loss
Sublingual CBD 4%,5%,10%
Edibles are not yet available in many countries; their consumption will not be a cause of concern as with THC as 7-COOH-CBD is also not psychoactive.
Dosages can reach 50-100mg per day
Topical CBD for pain, for beauty care
Bath with CBD
The interplay between the ECS the Hypothalamus Pituitary Gonad (HPG) and the Hypothalamus Pituitary Adrenal (HPA) axes is extensive and impact women’s mental health and wellbeing.
Women need to be educated to be able to make wise health choices regarding lifestyles and cannabis use.
The hemp plant and its constituents, CBD in particular provide many benefits for women throughout the most important episodes of their life without harm in the short and long term.
Article written by Dr. Janine GASTON-NHAN
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