CBD and Uterine FIbroids

July is fibroid awareness month so let's dive into how CBD and Cannabinoids may help manage symptoms associated with this condition. Uterine fibroids are non-cancerous growths that occur in the uterus, often affecting women in their childbearing years. They can cause heavy menstrual bleeding, pelvic pain, and infertility. In this post, we'll explore how cannabis products, particularly CBD, can help manage the associated symptoms of uterine fibroids. Interesting side note, a uterine artery embolization on a African American woman with multiple leiomyomas (scientific term for fibroids) was my first procedure during my Interventional Radiology rotation in medical school. If I hadn't decided to become a cannabis "guru" (ha!) I'd be doing that for a living. Although I'm not doing procedures, I'm still able to help people through the type of medicine I practice now 🙂

What are Uterine Fibroids?

Uterine fibroids are non-cancerous growths that develop in the uterus and are estimated to affect up to 80% of women by the age of 50 (1).They are made up of muscle and fibrous tissue and can vary in size from as small as a pea to as large as a grapefruit.

The most common symptoms of uterine fibroids (leiomyomas) are heavy menstrual bleeding, pelvic pain and pressure, and infertility. Other symptoms may include constipation, frequent urination, and lower back pain (2). While there are several conventional treatments for uterine fibroids, such as medication, surgery, and hormone therapy, some women have turned to cannabis products, particularly CBD, to manage their symptoms.

Many women have uterine fibroids, but they often go undetected as they don't cause any symptoms. However, when symptoms do occur, they can be severe and affect a woman's quality of life.

Symptoms of Uterine Fibroids

The symptoms of leiomyomas can vary from woman to woman, and some may not experience any symptoms at all. However, the most common symptoms of uterine fibroids include:

- Heavy menstrual bleeding

- Painful periods

- Pelvic pain and pressure

- Frequent urination

- Difficulty emptying the bladder

- Constipation

- Lower back pain

- Infertility

High Risk Populations

African American women are disproportionately affected by uterine fibroids. They are more likely to develop fibroids, have more severe symptoms, and undergo surgery for fibroids than white women. Examples:

• Incidence: African American women are two to three times more likely to develop uterine fibroids than white women.
• Symptoms: African American women are more likely to experience severe symptoms of fibroids, such as heavy menstrual bleeding, pelvic pain, and pressure on the bladder.
• Surgery: African American women are more likely to undergo surgery for uterine fibroids than white women.

There are a number of factors that may contribute to the higher incidence and severity of fibroids in African American women. These factors include:

• Genetics: There may be a genetic predisposition to fibroids in African American women.
• Hormones: African American women have higher levels of certain hormones, such as estrogen, which may contribute to the development of fibroids.
• Lifestyle: African American women are more likely to be obese, which is a risk factor for fibroids.
• Access to care: African American women may be less likely to have access to quality healthcare, which can delay diagnosis and treatment of fibroids.

Conventional Treatment Options for Uterine Fibroids:

1. Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help manage pain associated with uterine fibroids. Hormonal medications such as birth control pills or a progestin-releasing intrauterine device (IUD) can also be used to regulate menstrual bleeding and reduce the size of fibroids. However, these medications do not eliminate fibroids and may have side effects (7).

2. Surgery: Myomectomy is a surgical procedure that involves removing fibroids while leaving the uterus intact. Hysterectomy is a more invasive surgery that may involve removing the entire uterus and cervix. While surgery can be effective in treating fibroids, it may also have risks and side effects, including infection, bleeding, and damage to surrounding organs (8).

3. Uterine Fibroid Embolization (UFE): UFE is a minimally invasive procedure that involves blocking the blood vessels that supply blood to the leiomyomas, causing them to shrink and die. While UFE is effective in treating fibroids, it may also have risks and side effects, including pain, fever, and infection (9).
4. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS): MRgFUS is a non-invasive procedure that uses focused ultrasound waves to destroy fibroids. While MRgFUS is a less invasive option compared to surgery, it may not be suitable for all types of fibroids, and it may not completely eliminate fibroids (10).

Each treatment option for uterine fibroids has its own pros and cons. The choice of treatment depends on various factors, including the size and location of the fibroids, the severity of symptoms, the woman's desire to preserve fertility, and overall health. It is important for women with uterine fibroids to discuss their options with their healthcare provider to determine the best course of treatment for their specific situation.

CBD as a Treatment

Studies show that approximately 60% of women suffering from fibroids use over the counter medications to help manage the condition. Approximately 50% of women use hormone therapy (contraceptives) and a third of women use a combination of lifestyle modifications: diet, exercise, meditation, etc. About 25% of women use holistic/ natural remedies including herbs as treatment, amongst African American women that number goes up to 37%.

CBD, or cannabidiol, is a non-psychoactive compound found in the cannabis plant. CBD has been shown to have several therapeutic properties, including analgesic, anti-inflammatory, anxiolytic, and antidepressant effects (3, 4, 5). CBD has also been shown to regulate hormones, including estrogen (6). These properties make CBD a potentially useful tool for managing the symptoms of uterine fibroids.

How Cannabidiol May Help

Pain Management: One of the most common symptoms of uterine fibroids is pelvic pain. CBD has been shown to have analgesic properties, making it effective for managing pain. A study published in the Journal of Pain found that CBD reduced pain in patients with neuropathic pain (3).

Inflammation: Uterine fibroids are associated with inflammation, and CBD has been shown to have anti-inflammatory properties. A study published in the Journal of Clinical Investigation found that CBD reduced inflammation in animal models of multiple sclerosis (4).

Anxiety and Depression: Women with uterine fibroids may experience anxiety and depression related to their symptoms. CBD has been shown to have anxiolytic and antidepressant properties. A study published in the Journal of Psychopharmacology found that CBD reduced anxiety in patients with social anxiety disorder (5).

Hormone Regulation: Uterine fibroids are influenced by hormones, particularly estrogen. CBD has been shown to regulate hormones, including estrogen. A study published in the Journal of Steroid Biochemistry and Molecular Biology found that CBD reduced the growth of breast cancer cells by regulating estrogen levels (6).

Conclusion

Leiomyomas are a common condition that can cause a variety of symptoms. While there are several conventional treatment options available, some women have turned to CBD to manage their symptoms. CBD has been shown to have several therapeutic properties, including analgesic, anti-inflammatory, anxiolytic, and antidepressant effects, as well as the ability to regulate hormones. However, more research is needed in this area, and women with uterine fibroids should consult with their healthcare provider before using CBD or any other cannabis products.

CBD is available in a variety of products, including oils, capsules, edibles, and topical creams. When choosing a CBD product for uterine fibroids, it's important to choose a high-quality product from a reputable company. Look for products that are third-party tested and have a certificate of analysis (COA) to ensure that they contain the amount of CBD advertised and are free from contaminants.

Take Home Points: 

• The dosage of CBD that is effective for treating uterine fibroids is not yet known.
• CBD may interact with certain medications, so it is important to talk to your doctor before taking it.
• CBD is not a cure for uterine fibroids, but it may help to manage the symptoms.
• There are a variety of CBD products available, so it is important to choose one that is high quality and from a reputable source.

Remember, it’s important to speak with a healthcare provider before using CBD, particularly if you are taking any medications or have any other underlying health conditions.