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The Entourage Effect is the theory that all compounds in cannabis work together and when taken together they produce a better effect.

How Cannabis Creates Space To Exist Beyond My Endometriosis Diagnosis

ally-schott-eir-club

Like one out of every ten humans with a vagina, I was diagnosed with Endometriosis, a whole-body disease, before I even turned thirteen. My diagnosis changed the course of my life in almost every way. 

It was that same year, that I was not-so-subtly told to “get pregnant” or consider a hysterectomy, by an OBGYN who believed these were the “cure” to a condition that, in reality, had and still doesn’t have a cure.

Over the following years, I would often bleed twenty days straight, regularly soak through extra-large tampons in an hour, have three laparoscopies, be put into a chemical menopause by an injectable medication, and try all kinds of insane treatments that promised an ounce of relief. Many nights, I’d barely fall asleep only to wake up to my parents bursting into my bedroom to comfort me, telling me I was screaming from the pain. 

You see, this is life with endometriosis. The unrelenting pain, surgeries, hospital stays, ravaged body, and invasive protocols – not to mention the endo belly, isolation, weakened immune system, depression, round-the-clock opioids, fatigue, and painful urination and bowel movements. 

At age nineteen, I had what I consider a life-changing laparoscopy with a miracle of a doctor, who has since, sadly, had her license revoked due to the advanced (not yet approved) surgical techniques she used. Endometrial and scar tissue, plus the hernias that I developed from bearing down in pain for so many years, were removed and repaired. By the time I was in my mid-twenties, I found a suppression method that stopped me from cycling, by preventing the monthly growth and buildup of endometrial tissue.  

While this protocol has allowed me to reclaim my life and keeps my severe symptoms somewhat at bay, I am by no means symptom-free. Far from it. 

I turned to evidence-based cannabinoid care to ease my endometriosis symptoms, in my early thirties, as I found myself craving medical independence, holistic control over my symptoms, and space to transform into the woman I’d never had the chance to become, up until that point. I wish cannabis had been available to me much earlier in my medical journey, but I stand in gratitude, every day, for the benefits the plant’s brought to my life.  

While we wait for more definitive answers surrounding the development of endometriosis and a cure, we know that the endocannabinoid system (the ECS) and cannabis work together to combat the disease in the following specific ways: 

  • Scientists have discovered a complicated interplay between endometriosis and the endocannabinoid system (the ECS) – a native system that controls cell-to-cell messaging in our bodies, including receptors in every organ system, responsible for maintaining a healthy body. For example, a properly functioning ECS will turn hormones up or down, depending on what our bodies require to maintain health, or homeostasis. 
The Endocannabinoid System

The ECS plays an integral role in the healthy function of the reproductive system, with plentiful receptors located throughout. Rapidly developing science shows us that endo pain may be caused by a disruption in CB1 receptors, however, the specifics are still unknown. Researchers also believe women with endometriosis have fewer CB1 receptors, signaling a potential endocannabinoid system deficiency (endo- indicating the cannabinoids our body makes naturally). Supplementing a deficiency with phytocannabinoids (cannabinoids from the cannabis plant) may control many symptoms in a variety of ways, at one time, which makes it a useful therapy.

  • We know various cannabinoids like CBD, THC, and CBG appear to decrease inflammation in a very similar way, or along the same pathway, as steroids and NSAIDS (Non-Steroidal Anti-Inflammatory Drugs, like motrin, ibuprofen, and high-dose aspirin). CBD fights pain by reducing inflammation, while THC contains 20x the anti-inflammatory potency of aspirin and twice that of hydrocortisone. We also see cannabis interacting with other mechanisms in the body to control pain, like altering pain-receptor messaging to the brain. 

Beyond the research, here’s how I address my endometriosis with cannabis:

  • I rely on CBD and THC suppositories when I sense my pelvic pain and inflammation building. The great thing about suppositories is you can insert them vaginally or rectally, delivering cannabinoids, terpenes, and oftentimes other soothing plant allies, directly where your body needs them most. When I’ve run out, or don’t have time to lay down and prop my hips up for 20 minutes to allow for absorption, I’ll insert a tampon heavily soaked in cannabis-infused serums or oils safe for internal use. 

Word of caution: Pay close attention to allergens and consult with a cannabis nurse, first, to make sure you’re a candidate for vaginal/rectal suppositories, as this method can be dangerous to some, especially oncology patients and those with weakened immune systems. It can be fatal for those that have low platelets or too few neutrophils, a type of white blood cells.

  • Terpene selection is at the top of my priority list when I’m buying cannabis flower. At one point, it was believed that terpenes, which are naturally occurring chemical compounds found in cannabis and other plants, were solely responsible for the flavor and aroma of cannabis, but more recent research has suggested terpenes may carry their own unique characteristics and medicinal benefits, through the entourage effect. My go-tos, that target pain and inflammation, include Myrcene, Beta-caryophyllene, Linalool, and Limonene-rich strains.
  • If I’m in extreme, acute pelvic pain, you’ll find me with a joint, pipe, or bong in hand, as  inhaled cannabis directly enters the bloodstream without going through the liver from the GI tract, allowing cannabinoids and terpenes to get into the bloodstream within 5-15 minutes. 

When my pain’s on the rise, I’ll pop an edible which can take 1-2 hours to peak in effects, as THC must first pass through the gut, then the liver, before finally being absorbed into the bloodstream. 

The beauty of cannabis is you can layer both, or other, consumption types to achieve your desired results – you’re in complete control. When used in combination, edibles produce Delta Hydrox 11, while inhalation produces Delta 9, creating a better therapeutic effort. One study shows that on average, women need 6-10 inhalations of cannabis containing THC to relieve endometriosis symptoms, but this varies widely depending on the product consumed, THC:CBD ratio, and lung capacity.  

  • Painful intercourse is very much a part of my life. I’ve found that a little prep work and a layered approach go a long way to truly connect my mind and body, while combating pain and inflammation. I like to identify my needs and wants before reaching for CBD or THC, or a combination, and determining which method of consumption is best for me in the moment. Both CBD and THC promote vasodilation, sending blood flow to the genitals, boosting sensitivity, enhancing natural lubrication and arousal, but they also help ease preemptive anxiety I have about a painful experience. 

If I’m already experiencing moderate pelvic pain, I’ll start by inserting an infused suppository 30 minutes prior to getting randy, followed by a microdose (2.5-5 mg) of inhaled cannabis, as cannabis use prior to sex been linked to perceived improvements in in overall sexual experiencs, sex drive, orgasm, and pain in women.

During intercourse, I integrate cannabis-infused oils and serums, internally and externally, for pain and inflammation management. Post-sex, I often get deep, debilitating, throbbing pain, which is only manageable with an additional suppository and another microdose of inhaled cannabis, plus deep breathing techniques. 

When my pain is low, I cut this protocol down to only the cannabis products I need to make sure I’m present and enjoying my body and partner. I’ve learned to trust that my body will tell me what it needs.   

  • Topicals are very safe to use in any amount, as they don’t get absorbed into the bloodstream and produce no psychoactive effects. I use salves, creams, oils and balms on my lower abdomen and, honestly, all over my body. The reason they’re so effective is because we have CB1 and CB2 receptors on the top layers of our skin, and other neurotransmitters that play into the ECS system that cannabis can help modulate. In pain medicine, blocking a pain receptor with a different sensation and alternating the cell messaging can help ease pain. This is why sometimes spicy-feeling capsaicin and cooling menthol work for pain control in other neurologic pain processes. 

The truth is, scientific evidence regarding how and why cannabis may relieve endometriosis symptoms is still in its infancy. My hope is that anecdotal accounts from individuals, like me and potentially you, will fuel future research, so we can have definitive answers in the near future. In the meantime, seeking the guidance of a cannabis nurse can help you navigate the intricacies of your body, endometriosis diagnosis and symptoms, and holistic cannabinoid care.

By Ally Schott, Founder & CEO, EIR Club

Medically reviewed by Rebecca Abraham, RN, BNS, Chief Nursing Officer, EIR Club

ABOUT ALLY: Ally Schott is the Founder and CEO of EIR Club, as well as a fierce plant medicine and human rights advocate, with a special passion for women’s health and equality. She turned to cannabis to aid in symptom relief and PTSD recovery, after enduring decades of chronic health conditions (Endometriosis and late-stage Lyme disease) not helped by traditional medicine and trauma inflicted by healthcare providers. Through EIR, Schott’s turned her deeply personal struggles into a mission to educate, support, and be of service to other women, as well as gender-minority individuals, interested in cannabis as an alternative tool for health, wellness and lifestyle benefits. She’s also deeply invested in cannabis legislation; equal access to the plant; the intersection of pain, gender and healthcare bias; as well as cannabis as a vehicle for social change. She currently lives in Denver with her partner and their dogs, Ruby and Hank.
ABOUT EIR: EIR Club is a community-based club for women and gender-minority individuals that offers personalized cannabis care plans, designed by cannabis nurses, tailored to each member’s unique body, symptoms, conditions, preferences, and lifestyle. For more information, or to connect with a cannabis nurse, please visit: eirclub.com.

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