June 09th, 2020
One of the most common questions I get from female patients is:
“Can I use medical cannabis while taking prescription psychiatric medication?”
This question is typically followed up with:
“I have so many side effects (insomnia, low libido) from my psychiatric medication, can I use medical cannabis to help relieve this?”
A major challenge for anyone looking to incorporate cannabis and CBD into their health routines or 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 using the plant. When you are supplementing with cannabinoids, they can interact with meds and make their effects more powerful.
Most Prescribed Psychiatric Drugs in the U.S. are:
At least 1 out of 4 women in America now takes a psychiatric medication, compared with 1 in 7 men. Women are nearly twice as likely to receive a diagnosis of depression or anxiety disorder than men.
For many women, the meds prescribed for their conditions significantly improve their lives. But for others, pharmaceuticals are not necessary or can cause side effects that can be as bad – or worse – than the underlying condition. The increase in prescriptions for psychiatric medications, often by doctors in other specialties, is creating a new normal that encourages more women to seek prescription meds. Whether a woman needs these drugs should be a medical decision and not a response to peer pressure or consumerism. Antidepressants are often used in the clinical management of anxiety disorders, chronic pain, and menopausal hot flashes. More than 90% of depressed patients complain about difficulties in falling asleep, sleep disruption or early morning awakenings.
In 2018, cannabis delivery service Eaze put out a report stating that the number of women buying cannabis products from them almost doubled in 2018, increasing by 92 percent. According to BDS Analytics, women now make up 38 percent of all cannabis consumers.
Cannabis and CBD can be effective in addressing myriad physical and mental health issues, both chronic and acute. Cannabis and CBD can also be used to optimize your overall feeling of well-being. The cannabis plant can provide your body and brain with beneficial cannabinoids and terpenes, each of which can have a positive impact on your health.
How can cannabis and CBD help me with sexual health and wellness?
Women report that cannabis helps with disrupted sleep, vaginal pain during sex, and low libido. These are listed as the top reasons for female cannabis self-care.
Sex involves a complex set of physical, mental, and emotional reactions that can be affected by cannabis or CBD. Most prescription antidepressants are part of a drug family called SSRIs (selective serotonin reuptake inhibitors). By raising levels of serotonin in the body, the person taking the drug experiences a feeling of calm and less anxiety. However, that same sense of calm and stability can lower our libido.
Cannabis can promote the following, all of which could enhance your sex life:
▶ Increased relaxation
▶ Reduced anxiety
▶ Lowered inhibitions
▶ Increased hormone production
▶ Increased sexual arousal
▶ Increased sensitivity in your erogenous zones
▶ Enhanced creativity
Think of the endocannabinoid system, or ECS, as a system that interfaces with all of the other systems throughout your entire body. The ECS regulates movement, pain sensation, and immune responses, and mental functions, like perception, mood, and memory.
The endocannabinoid system modulates hormones related to stress.
When you’re sick, your body’s internal endocannabinoid system jumps into gear to help put things back in order. The ECS comes into play when we eat, sleep, relax, exercise, and have sex, as well as during pregnancy, while giving birth, and even when nursing a baby.
Estrogen interacts with your Endocannabinoid System, and so do cannabinoids in cannabis. CBD binds to the estrogen receptor. Apigenin, a phytoestrogen in cannabis, also binds to the estrogen receptor. THC can increase luteinizing hormone levels in perimenopausal women.
ANANDAMIDE is Sanskrit for “Bliss.”
Also known as the Bliss Molecule. One of our own internal cannabis molecules, anandamide, helps us temper stress and balances our nervous system, so we are not spiraling out of control on a high sympathetic nervous system overdrive.
Anandamide levels fluctuate throughout the menstrual cycle, peaking during ovulation. This may help to explain how great most of us feel mid-cycle (Days 12-16).
During ovulation, our estrogen levels are also high, we feel sexy, attractive, and we feel like we can conquer the world. Estrogen increases anandamide signaling, keeping us calm, cool, and level-headed. Because of the female hormone, estrogen, women are more sensitive to the effects of the chemical compounds within cannabis – cannabinoids and terpenes in particular. Uterus, fallopian tubes, ovaries, vagina, and vulva are all extremely dense in endocannabinoid receptors. Our breast milk also contains cannabinoids. Interestingly, the cannabinoid receptors are critical in priming the muscles in the infant’s mouth- necessary for suckling and latching on properly for breastfeeding in newborns.
These are some of women’s health issues that might get in the way of sexual wellness.
1) Painful or irregular periods. Women can have such bad cramping, bloating, spasmodic pelvic muscles, and tense muscles in the abdomen and pelvic floor.
2) Endometriosis is a chronic inflammatory disease caused by tissue that lines the uterus growing outside the uterine cavity on to other organs in the pelvis. This can cause a variety of symptoms, including chronic pelvic pain, infertility, and pain during menstruation or sexual intercourse. These symptoms may contribute to anxiety, depression, loss of working ability, and affect your quality of life.
3) Vulvodynia is a condition involving painful burning and irritation of the vulva. Women experience chronic, unexplained pain in the area around the opening of the vagina. It is a condition that can be so uncomfortable that some activities can feel unbearable, such as sitting for long periods or having sex. Symptoms include burning and rawness in the genital area. It can even hurt to wipe after urinating.
4) Vaginismus is a condition involving a muscle spasm in the pelvic floor muscles. It can make it painful, difficult, or impossible to have sexual intercourse, to undergo a gynecological exam, and insert a tampon.
5) Interstitial cystitis can cause urinary frequency, urgency, recurring pain in genitals, back, abdomen. It can feel like you have a UTI all the time. Diet seems to have an effect on flare-ups.
The vicious cycle of pelvic pain.
A disorder anywhere in the pelvic floor can have an impact on all of the pelvic floor functions. For example, if you have endometriosis, interstitial cystitis, or a bladder infection, this can cause terrible pain in your low back, bloating, and can lead to sexual dysfunction. If you experience pain in and around your vagina, when the inflammation heats up, it can cause all of your pelvic muscles to tighten. It can result in constant spasms, increase scarring of tissue, decrease mobility misalignment of your hips, sacrum, gluteal muscles, low back, etc. It can feel like there are a ton of bricks weighing down your pelvis, and it’s in muscle spasm. Any little thing can trigger the spasm, even sitting on the toilet. This can all lead to sexual disorder, and the cycle of pain and immobility repeats.
Why does cannabis work in the bedroom?
People may experience sexual health issues at different stages of their lives. This may include people going through perimenopause or menopause or those who have entered menopause prematurely from illness or hysterectomy. A substantial proportion of patients will experience some disturbance of sexual function while taking antidepressants. Another connection to sexual dysfunction is vaginal pain during sex.
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. 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 THC delivery 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 the beneficial effects of cannabis on their sexual experiences by increasing sensitivity when touched and improving relaxation.
Lack of estrogen due to a disorder, removal of ovaries (hysterectomy), or after menopause leads to an absence or end to healthy reproductive cell activity resulting in atrophy and cell death. Cannabis can also help address conditions such as perimenopausal insomnia and hot flashes.
Are CBD or CBD/THC infused sexual lubricants any different from regular lubricants? I’m post-menopausal, and being less dry will help me enjoy sex more.
Women who have had pain issues during sex should always use a lubricant, even if it begins to subside. Experiment with a variety and find one that suits you best.
Avoid Propylene Glycol because it tends to burn. Look for paraben-free formulas. Parabens are used in preservatives in many cosmetic and personal hygiene products and mimic estrogen. They may contribute to the growth of tumors on the breast. Also, look for formulas that are safe to use with condoms.
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. Cannabis-infused lubricants can help dilate blood vessels in your vagina, increasing blood flow, and promoting elasticity and also may provide pain relief caused by friction on thinning vaginal walls. Essentially, cannabis sexual lubricants can help with dryness, vaginal friability- thinning, sensitive skin, and pain with sex.
What other integrative therapies should I consider ?
1. Acupuncture : Dry needling into the trigger points has been demonstrated to be most beneficial.
2. Pelvic Manual Treatment: External and internal manual therapy including: myofascial release and trigger point release, visceral manipulation, connective tissue manipulation, and cranial osteopathy, biofeedback, electrical stimulation, and transcutaneous electrical nerve stimulation (TENS)
3. Yoga has been shown to be very helpful calming the nervous system and relaxing the pelvic floor
4. Natural supplements such as Omega 3 Fish oils, Turmeric Curcumin, Probiotics and Magnesium.
5. Therapeutic wand for intravaginal treatment. Please contact a pelvic floor specialist for a full evaluation before performing at home treatments.
6. Anti-inflammatory diet for your pelvic floor , eliminating and foods that may cause flareups.
I keep hearing that women need to take charge of their health. What does this mean?
Health practitioners routinely minimize women’s experience of pain, 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, while being told that their symptoms could be stress-related.
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.
Nourishing your endocannabinoid system can be the missing link in your overall quest to live a better, healthier life or simply feel good. Being in good health makes everything you encounter in life seem more manageable.
As always, consult your health care provider before making any changes to your prescription medication.
Wishing you the best in health!
Dr. June Chin