Chronic pelvic pain is a common problem. It affects approximately 1 in 7 women. The prevalence is similar to migraine headaches, asthma, and chronic back pain. Over 9 million American women may suffer from chronic pelvic pain today. However, 70% of women suffering from chronic pelvic pain – DO NOT seek medical care. Why is this the case?
Women are often not taken seriously.
When women have pain, they are told to suck it up, keep going, you have to go to work, take care of your children, partner, family, and just move on with life. And before you know it, the pain becomes “normal”.
We adapt to it.
Women with pelvic pain are some of the strongest women I know because they have been living with this underlying pain for so long.
Health practitioners routinely minimize women’s experience of pelvic pain, IBS, insomnia, and sexual dysfunction. These complaints are often dismissed as having a psychological rather than a physiological condition. Some women go undiagnosed for years, despite multiple trips to doctors and specialists—all the while being told that their symptoms could be stress-related.
For our recent HiVi Office Hours on cannabis and pelvic health, we were joined by Dr. Jennifer Pierre, ND, MPH a naturopathic physician specializing in Women’s Health. Dr. Pierre is an integrative physician who navigates research and science but prioritizes natural treatment protocols over pharmaceutical drugs. In her approach to medicine, she uses her research acumen and public health background to give you the best of both worlds. This includes functional medicine testing and diagnostics. By combining the best in natural medicine with modern technology, she gives her patients the best care. During our segment, Dr. Pierre shared integrative and natural tools on how to manage pain, inflammation, anxiety, insomnia, and digestive issues that surround women’s pelvic pain. Some of these include nutrition, homeopathy, acupuncture, and functional medicine.
Pelvic Pain in BIPOC Women
Common gynecologic conditions and surgeries may vary significantly by race or ethnicity. Uterine fibroids are more prevalent in Black women and Black women may have larger, more numerous fibroids that cause worse symptoms and greater surgical complications. Studies have found a higher prevalence of endometriosis among Asian women.
Race and ethnicity are also associated with hysterectomy rate, route, and complications. Overall, the current literature has significant deficits in identifying racial and ethnic disparities in fibroids, endometriosis, and hysterectomy. Interesting is that the majority of my new patient inquiries seeking cannabis care for pelvic pain are BIPOC women.
Individuals who suffer from chronic pelvic and abdominal pain also often present other complicating factors such as depression, anxiety, poor sleep, difficulty with work, and/or relationship issues. Pelvic pain is puzzling as it is a multi-system disorder, which includes sexual, bowel, urinary, gynecological, and musculoskeletal symptoms.
Chronic pelvic pain is an autoimmune disease with a high level of inflammation.
What is inflammation? It is our body’s own maintenance and repair system. When we scrape and cut ourselves, our body sends out an alarm; an inflammatory response. White blood cells (WBC) and our immune system are like troops of an army. Our immune system reacts by sending in troops to defend our body from infections and heal our damaged tissue. There is increased blood flow to the area and some swelling. The body normally responds by creating a scab, walling off the injured area. Eventually, when the crisis ends, the inflammation subsides, the troops dismantle their defenses, and everything goes back to normal function.
But what happens when the body doesn’t shut off this inflammatory response? What happens when these troops hang out longer than usual, when underlying organs, muscles, joints continue to swell and nearby and healthy tissue is compromised? What starts as a low level of inflammation is like embers of a fire burning. And this can easily become a blazing forest fire. This is how chronic inflammation stays in our bodies.
Cannabis is a complex plant medicine containing over 500 unique chemical compounds. This plant can help with many conditions such as chronic pain, appetite, sleep, anxiety, and inflammation. Cannabis is a potent anti-inflammatory. It can modulate pain signals, relax muscle spasm and reduce overall inflammation.
Women who use cannabis may find control over their health, enhance prevention and self-care; and enjoy a wellness pathway that leads to wholeness in body, mind, and spirit.
A major challenge for anyone looking to incorporate cannabis into their health routines or to use it to treat a chronic or acute condition is speaking to a healthcare provider about it. If you are on prescription medication, it is crucial to find reliable, medically responsible guidance around cannabis use. When you are supplementing with cannabinoids they can interact with meds and make their effects more powerful. The key is to integrate cannabis mindfully, creating a safe environment, and optimize your health and wellness journey.
Women who use cannabis may find control over their health, enhance prevention and self-care; and enjoy a wellness pathway that leads to wholeness in body, mind, and spirit.
Q&A:
1. Why does cannabis work for pelvic pain and sex?
Women with chronic pelvic pain (CPP) are at higher risk for sexual dysfunction than women without CPP. A recent study found that over 80% of women with chronic pelvic pain cope with sexual problems. In this study, women with CPP had lower scores of desire, arousal, vaginal lubrication, orgasm, and pain compared to the women without CPP. Depression, in particular, was associated with sexual problems in the CPP group. Depression may diminish sex drive, deplete energy, contribute to poor self-esteem, and lead to social withdrawal.
Cannabis can quickly reduce the sensation of pain when smoked, vaped, or ingested, but even more effective is a topical vaginal cream, spray, lubricant, or suppository containing a concentration of THC. Cannabis topicals or suppositories manufactured for vaginal use and applied to the vagina and in and around the vaginal canal can offer near-immediate pain relief, increase blood flow to the area, and enhance sexual pleasure. None of the topical or vaginal forms of delivery of THC should affect your brain or make you high, although the lower region of your body may feel very relaxed. In my clinical practice, patients report beneficial effects of cannabis on their sexual experiences by increasing sensitivity when touched and improving relaxation.
2. How does a Naturopathic Physician approach women’s health?
Naturopathic treatment of chronic pelvic pain is comprehensive, including dietary counseling, physical activity recommendations, nutritional/herbal supplementation, and often acupuncture. Some conventional, allopathic physicians are needlessly apprehensive about naturopathic medicine because they are not familiar with the various treatments.
Naturopathic doctors (NDs) are trained in both pharmaceutical interventions and herbal medicine, so they can present a holistic view of how naturopathic and conventional treatments may or may not work together. The good news is that we can explore multiple avenues to healing. Because pelvic pain is multifactorial, it is often advantageous to consult with multiple health care practitioners to figure out a treatment that works best for you.
3. How does nutrition play a role in pelvic health?
Focusing on an anti-inflammatory diet is key. Consume a diet rich in fiber, leafy greens, healthy fats, and lean protein. In particular, cruciferous vegetables like broccoli, cauliflower, and kale contain sulforaphane, substances that encourage the breakdown of excess hormones in the liver.
Beans contain fiber, protein and are a source of inositol, a nutrient that has yielded positive effects on blood sugar. Avoid saturated fats, dairy and red meat. If we must have dairy, choose organic and make sure the meat comes from grass-fed animals to avoid additional hormone disruption. Even some presumably healthy foods can raise insulin levels, so be sure to avoid high glycemic foods until hormone levels are under control.
In conjunction with exercise, there has been promising information concerning time-restricted diets such as intermittent fasting (IF). Studies show that IF can be effective in addressing obesity, reducing blood sugars and ultimately decrease chronic inflammation in the body.
I hope you can join me for the next month’s HiVi Office Hours!
Wishing you the Best in Health!
Dr. June Chin
Learn more about Dr. Chin and her practice here.
