The compound is certainly trendy, but the research is scant.
We also don’t know what effect CBD could have on the pelvic floor muscles. There is one study that tells us natural endocannabinoids actually reduce during sexual excitement, so it is biologically plausible that CBD could increase pelvic floor muscle tone (meaning it would be very unhelpful for spasm). There is also some data that suggests cannabis use is associated with a higher rate of vaginal yeast colonization. We don’t know if this is from the THC, CBD or other cannabinoids.
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Essentially, we don’t know what we don’t know about CBD and the vagina. I recommend that any woman (or man) with pelvic floor muscle spasm skip CBD and instead see an Ob/Gyn or urologist with expertise in that area, as well as a specialized pelvic floor physical therapist.
It is generally acknowledged that many patients are not satisfied with the contemporary medical approach to the management of urologic chronic pelvic pain syndrome (UCPPS). Many have turned to marijuana or cannabis because of its strong anecdotal reputation of providing benefit to patients with chronic pain. In a condition in which patients are struggling to cope, the marijuana story appears to offer hope.
What is marijuana?
For patients who are having trouble coping because of pain that has not responded to the standard therapies outlined in this supplement, turning to opioids as the last resort is not usually the best approach. Opioids, at best, offer around a 30% improvement in pain and at worse, offer a paradoxical slow exacerbation in pain intensity. With even minor pain relief comes the possibility of physical or at least psychological dependence to opioids, with desire for further increasing doses with diminished returns. Marijuana has fewer downsides, with the possibility of similar pain relief, better psychological coping, and less chance for addiction and dose escalation.
Lesson 4: Recognize patients at risk
All patients with UCPPS are not candidates for medical marijuana management. Patients with a history of substance abuse, diversion risk, and mood disorders should never be prescribed cannabis as a treatment option. If they decide to use the substance on their own, then it will not be a medical error in judgement, but rather a patient-only decision.