How Cannabis Is Helping Endometriosis Patients

Dysmenorrhea, dyspareunia, ablation, laparoscopy. For the blessed many, these are vague, painful sounding terms, but for the one in ten women and transgender men living with endometriosis, these are everyday symptoms and procedures, keywords that mark an internal battle between their vital organs and the painful flesh growing around them.

Endometriosis is diagnosed when doctors find an overgrowth of endometrium – the tissue usually found within the uterus – growing outside the uterus. Typically this tissue growth begins in the pelvic region, and can spread to multiple organs and systems. According to The Endometriosis Network Canada, it generally takes seven to nine years and an average of five to seven doctors before a person with endometriosis is diagnosed. In the meantime, endometriosis patients suffer from a host of symptoms and related conditions, including tortuous periods, infertility and recurrent miscarriages, pelvic pain, bladder and bowel dysfunction, painful sex, depression and anxiety.

There is no cure for endometriosis and treatments focus on symptom management. Hormone therapy, anti-inflammatories and painkillers are the frontline treatments, and for some endometriosis patients, cannabis is emerging as a promising healing tool.

The impact of endometriosis

Last week, Hempster put out a call for sources who could speak to their experience using cannabis for endometriosis. Within minutes, we were overwhelmed with responses. In the end, we chose three women – Donna Hartt, 48, of Cranbrook, Maia Leggott, 30, of Toronto and Linn Groen, 33, of Winnipeg.

Although each told a unique story, many themes emerged. Every single one of them had been diagnosed, or misdiagnosed, with something else before the discovery of endometriosis. At some point in each journey, each woman felt dismissed. Groen and Hartt were both told their excruciating period pains were normal, while Hartt was told to “stop being a hypochondriac”.

The pain of endometriosis changed their lives in many ways. For Hartt, it was a factor in the dissolution of her first marriage over 20 years ago. More recently it forced her to abandon her dream job as a self-employed television personality, just after appearing on the CBC show, Canada’s Smartest Person. For Leggott, it meant a 45-lb weight gain, giving up normal activities like yoga and going out with friends, and a “virtually nonexistent sex life.” For Groen, constant pain meant missing out on time with her daughter.

Cannabis and endometriosis

None of the women we spoke to for this story are pain-free, but cannabis is helping them manage better, they say, than pharmaceuticals alone.

“B.C. (Before Cannabis) I often needed morphine to sleep when I was on my period,” says Leggott. “I was taking prescription-strength naproxen often multiple times a day. A.D. (After Dope) I might have to take one or two naproxen on the first day or two of my surgery, but I haven’t had morphine since my surgery recovery…I also noticed such a shift in my mood that I didn’t even realize I had faded out of taking my antidepressants.”

The discovery that cannabis may help with more than one aspect of a disease is common, says Dr. Vahid Salimpour, a medical cannabis specialist at Apollo Cannabis Clinic. “A patient with endometriosis mentioned to me during her follow up visits that not only is her pain far less severe, but she can sleep again,” he says. “These kind of ‘co-treatments’ are commonly heard at Apollo Cannabis Clinic. When pain decreases, overall quality of life improves because pain, stress and sleep are all connected, and cannabis can help with all three.”

Dr. Salimpour prescribes cannabis to endometriosis patients as a replacement or supplement for opioid painkillers, naproxen and other non-steroidal anti-inflammatories (NSAIDS). “Replacing hormone therapy with medicinal cannabis has been seen in a few cases, but this is rare.” Instead, his strategies focus on pain relief.

A dose of community helps the medicine go down

Cannabis is complicated medicine, and determining the right dose, strain and delivery method takes time. “Most of the challenges I face [in prescribing cannabis] are based on finding the correct dose,” says Dr. Salimpour.

The overwhelming majority of Canadian doctors do not prescribe cannabis, making the already-complicated process of dosing even more complex, as patients struggle to access resources. Years of prohibition and stigma mean that research lags behind anecdotal evidence – one of the reasons many doctors cite for passing on the pot prescriptions. For pain patients, studies can’t happen fast enough, and many turn to online groups for advice and emotional support, relying on community to step in where science and medicine have left off.

SheCann is one such group, a Canadian effort that began when founder Ashleigh Brown found other Facebook cannabis groups lacking. “There was a lot of hostility towards licensed producers and the legal side of cannabis in Canada,” she says. Moreover, she noticed that conversations tended to be dominated by men, and women’s questions were often greeted with dismissal or terse instructions to “just Google it.” By the time the “c-word” came up on one of the forums, Brown had had enough, and banded together with other female cannabis patients to create a safe space.

“Because SheCann is a female driven group, there is a lot more openness and honesty in discussing issues around sex and female health challenges,” says Brown, “including endometriosis and also of course PMS, polycystic ovarian syndrome, cramps and menopause.”

“SheCann saved my life,” says Groen, explaining how members helped her find a local clinician who had success treating endometriosis with cannabis, and continue to help by sharing their strain reviews and dosing strategies.

Raising awareness

“Often we are the last resort,” says Dr. Salimpour of cannabis-prescribing clinicians, “but hopefully this changes as the stigmas surrounding medical cannabis continue to decrease.” For women like Groen, Hartt, Leggott and the many others who offered to share their stories, simply being heard is essential.

“Endometriosis and adenomyosis come with pain that most people, after an hour of walking in our shoes, would throw it back,” says Hartt. “We are laughed at, treated like hypochondriacs, and dismissed, yet our physical experience is present. It is a full-time job trying to manage this disease, but eventually we get there. A lot of people get judged for marijuana use, but for some of us, it is the only thing we have left, and it is saving our lives.”