CBD for Vulvodynia and Endometriosis

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Over the past two years, thanks to the efforts of associations and individual activists, we've been hearing more and more about vulvodynia and endometriosis, two typically female conditions characterized by chronic pain.

Both conditions can seriously impact women's physical and psychological well-being. In this article, we'll explore the symptoms and causes of these silent diseases and review some scientific studies to understand how a CBD-based product might be helpful in supporting the bodies of those who suffer from them.

What is vulvodynia?

Vulvodynia, also known as the vulvovestibular syndrome, is a disorder that causes inflammation of the nerve endings in the vulvo-vaginal area.

According to a 2020 study, 8 to 10% of women of all ages suffer from this condition. It primarily manifests as chronic pain affecting the female genitals. The pain can extend to the entire vulva or be limited to a specific area.

We refer to vestibulodynia when the pain is confined to the entrance of the vulva. Clitorodynia is when the pain is localized in the clitoral area, and urethrodynia is when the pain is concentrated in the urethra area. Additionally, dyspareunia refers to pain associated with penetration before, during, or after sexual intercourse.

One of the main characteristics of vulvodynia is that its symptoms vary in intensity and duration from woman to woman. This factor, along with a series of socio-cultural components we'll discuss, makes it very difficult for women to receive a diagnosis, and vulvodynia is often confused with other conditions and consequently treated incorrectly.

In Italy, there's a significant awareness campaign underway, with associations, activists, and influencers fighting to urge the government and the National Health Service to finally recognize vulvodynia as a chronic and disabling condition, ensuring that those who suffer from it receive essential levels of care.

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What causes vulvodynia?

The causes of vulvodynia are still unclear. Some believe it may be caused by nerve damage in the vulvar area, others think it stems from chronic inflammation or hormonal issues, while some consider it a combination of both physical and psychological factors.

One of the main problems in managing this condition is the delay in diagnosis, which is due to limited research funding and insufficient training of specialized medical personnel.

At the root seems to be a socio-cultural issue: the notion that pelvic pain in women is normal, especially during sexual intercourse, and should be endured and "normalized".

This is not the case. Chronic pain is never normal. Women's pelvic pain is often misjudged and misunderstood. As a result, the condition is often accompanied by feelings of inadequacy, guilt, anxiety, and depression, particularly in the pre-diagnostic phase.

The long-term goal of those who fight daily to raise awareness about this disorder is to have vulvodynia recognized as a chronic disabling condition, ensuring that sufferers can access appropriate healthcare and treatments.

What are the symptoms of vulvodynia?

The main symptoms of vulvodynia include:

  • Vulvar pain and burning (widespread or localized) lasting more than 3 months
  • A sensation of pins and needles
  • A feeling of burnt skin
  • Sudden sharp pains
  • Discomfort/pain when wearing tight pants
  • Pain during sexual intercourse
  • Pain during urination
  • Pain/discomfort that worsens after sitting for long periods

All these symptoms can also occur with other conditions such as cystitis, candida, genital herpes, and many other infections affecting female genitalia. This is why it's crucial to rule out all other potential conditions through specific tests before discussing vulvodynia.

The diagnosis of vulvodynia, which should be made by a specialized gynecologist, is done by exclusion and through the Swab test.

The Swab test is a non-invasive examination that involves checking for pain in response to stimulation. This, along with chronic vulvar pain lasting more than three months, could be key elements for diagnosis.

How is vulvodynia treated?

Precisely because the causes are still unknown, there is no standardized therapy. Instead, treatment focuses on managing symptoms, which, as we've mentioned, can vary greatly from woman to woman.

Once diagnosed, the specialist will investigate the patient's lifestyle, habits, and possible other conditions to determine the most suitable treatment plan.

The gynecologist might choose a pharmacological therapy, a rehabilitative approach involving work on the pelvic muscles, or a psychological approach, which can be very helpful in some cases.

These three approaches are often combined for a more comprehensive treatment.

Most medications used for vulvodynia act on pain mediators and are also used for neuropathic pain.

What is endometriosis?

Endometriosis is a condition where endometrial tissue, which normally lines the inside of the uterus, grows outside of it. This can cause inflammation, pain, and interfere with the normal functioning of female reproductive organs.

It can develop from the first menstrual period, but can also affect women who have gone through menopause.

In Italy, 10-15% of women of reproductive age suffer from this condition. Approximately 3 million women have been diagnosed with endometriosis.

What are the causes and symptoms of endometriosis?

Opinions on the causes of endometriosis vary. The most plausible theory is that fragments of endometrial tissue travel from the uterus through the fallopian tubes and into the abdomen during menstruation.

However, this hypothesis doesn't completely rule out others. Interestingly, in extremely rare cases (about 20), endometriosis has even been diagnosed in men.

Compared to vulvodynia, significant progress has been made with endometriosis. It's now recognized as a chronic and debilitating condition, and standardized treatment protocols exist.

Research is ongoing, and a saliva test, already trialed in France, seems to be on its way to Italy, capable of quickly diagnosing the condition.

But what are the symptoms of endometriosis?

The most common symptoms of endometriosis include:

  • Dysmenorrhea - painful menstruation

  • Menorrhagia - heavy and prolonged menstrual bleeding

  • Metrorrhagia - bleeding unrelated to the menstrual cycle

  • Pelvic pain

  • Dyspareunia - pain during intercourse

  • Pain during urination

  • Infertility

To receive an endometriosis diagnosis, you should consult specialized centers or gynecologists. An ultrasound or MRI will be performed to confirm the condition.

How is endometriosis treated?

You can seek help from competent facilities and professionals who will determine the appropriate therapy. Treatments for endometriosis can vary, but typically involve hormone therapies, combined with anti-inflammatory drugs to reduce pain if necessary. In limited cases, surgery might be required.

With early diagnosis and proper treatment, the quality of life for those affected can significantly improve.

Endometriosis is a recognized condition included in the list of chronic and disabling diseases. In advanced stages, patients are entitled to follow-up visits with exemptions. In Italy, about 300,000 women benefit from these exemptions.

CBD for vulvodynia and endometriosis: what does science say?

A study on cannabis and vulvodynia symptoms suggests that therapeutic cannabis may significantly reduce pain and improve quality of life in women with vulvodynia.

This clinical research, which tested cannabinoids in cases of neurodegenerative diseases, pain, addiction, and anxiety, suggests the therapeutic potential of CBD both alone and in combination with THC or pharmacological therapy.

Here is another study highlighting how CBD can be effective for pelvic pain, intestinal disorders, and mood disorders.

During this research on cannabis and pelvic pain, a quarter of patients with pelvic pain associated with vulvodynia and endometriosis reported better sleep, less pain, reduced anxiety, and decreased irritability.

Finally, CBD can be a useful ally before and during sexual intercourse, used both orally and as an addition to a lubricant to calm pain and inflammation.

Cannabidiol (CBD) is an active compound produced by hemp plants. Unlike THC, which is always present in cannabis sativa plants, CBD does not cause psychotropic effects. Thanks to its interaction with receptors in our endocannabinoid system, it has been used for over a decade as a natural option to support the body in cases of numerous disorders, particularly chronic pain, anxiety, and stress.

It does not cause significant side effects, but it can interact with some medications. Here is more information on this topic. It's crucial to consult your doctor if you're on any medication. Additionally, CBD should not be used during pregnancy or while breastfeeding.

Who are the specialists for vulvodynia and endometriosis in Italy?

If you suspect you're suffering from vulvodynia or endometriosis, the first step is to consult your trusted gynecologist or alternatively, seek out gynecologists who specialize in vulvar conditions.

In cases of severe anxiety and stress, psychological support might be beneficial. For pelvic floor rehabilitation, you may find relief through working with physical therapists who specialize in chronic pelvic pain.

Additionally, for support and information, you can reach out to various organizations dedicated to raising awareness about vulvodynia and endometriosis in Italy, as well as patient advocacy groups. For example, the Italian Endometriosis Association, the Italian Vulvodynia Association, and the Italian Society of Gynecology and Obstetrics (SIGO).

Many women delay seeking help due to embarrassment, fear, or denial of their pain. However, in most cases, late diagnosis only worsens the situation.

Don't wait.

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