“Weed”ing Out Menstrual Cramps

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When most women are asked what helps alleviate their monthly menstrual cramps, common answers include Midol, ibuprofen, and hot water bottles.  One of the last remedies expected would be…marijuana.  Until now.

Foria Relief, a vaginal suppository which contains cocoa butter and medical cannabis (60 mg of THC (tetrahydrocannabinol) and 10 mg of CBD (cannabidiol)) has recently been used in California, Washington, and Colorado to treat dysmenorrhea (menstrual pain).  According to the National Health Service (NHS), menstrual cramps are the result of contraction of the muscular wall of the uterus.  This in turn compresses the surrounding vascular system and restricts blood flow.  The suppository addresses these issues by acting on the nerve endings surrounding the uterus, the ovaries, and the cervix which in turn decreases pain and inflammation.  In particular, THC interferes with pain pathways while still keeping pleasure pathways open, and CBD reduces inflammation by acting on the immune system.

Foria Relief is not the first product manufactured by Foria.  In 2014, The California based company (founded by Mathew Gerson) first gained consumer attention when it produced a THC-enhanced lubricant, Foria Pleasure spray, to help improve sexual satisfaction.  Ever since then, Foria has been colloquially (and appropriately) referred to as the “weed lube” company.  The product’s success caught the attention of many, including urologist Dr. Jennifer Berman, who has also appeared on The Doctors.  Gerson and Berman joined forces to investigate the potential benefit of cannabis in treating pelvic pain, inflammation, endometriosis, and menstrual cramps.  According to Berman, “When a woman experiences menstrual cramps, the uterus is contracting.  The muscle goes into spasm, and it releases inflammatory mediators that exacerbate pain. Cannabis, in general, works to relieve muscle spasms by increasing blood flow and decreasing muscle contractions. When you increase blood flow, you help to restore oxygenation to the tissue, thereby decreasing inflammation and lessening discomfort.”

Women who have used Foria Relief reported that cramps decreased shortly after inserting the suppository and that the benefits were long lasting.  They also reported that the product worked locally, and the chemicals did not affect their ability to function as they normally would have (i.e. they did not feel high).  Despite these promising subjective reports, both Foria products are not yet approved by the US Food and Drug Administration (FDA).  Furthermore, it goes without saying that two of three ingredients in Foria Relief are illegal in most states.  Finally, clinical studies investigating these products have not yet been performed.  As a hard core scientist, anecdotal evidence does not compare with tried and true evidence based research.

It will be interesting to see how law intersects with science in the coming years.  The current relationship between the courts and the laboratories effectively tie researchers’ hands behind their backs to an extent.  Treatments can only be manufactured as long as their ingredients are legal.  How will the scene of medicine change in response to legal decisions and changes?  What exactly constitutes “medicinal purposes” and how far will the concept extend?  Only time will tell…and I am eager and excited to see what the future holds.

Dare to Fail

Thomas Edison failed 1,000 times before he created the first successful light bulb
 

My avid blog readers will recall a post from June 2015, entitled “Transplant-astic””, which was about the first successful uterine transplant in Sweden (October 2014).  On February 24, 2016, The Cleveland Clinic attempted to replicate Sweden’s success; a uterine organ transplant was performed by Dr. Andreas G. Tzakis and her team on 26 year old Lindsey, the organ recipient.  The surgical team was initially positive about the transplant, which they hoped would be the first of ten successful uterine transplants.  Unfortunately, a simple fungal infection to Lindsey’s immunosuppressed system resulted in post-surgical blood loss and subsequent transplant failure.

Shortly after Lindsey’s media debut, which was greeted with initial excitement at the prospect of success, she began experiencing tachycardia (increased heart rate), dizziness, and decreased blood pressure.  She was brought back to the Cleveland Clinic where it was determined that she required emergency surgery to remove the uterus.  Apparently, candidiasis, a Candida albicans infection, had developed at the attachment site of the transplanted uterus.  According to the Centers for Disease Control and Prevention, Candida albicans is the most common of the 20+ species of candida yeasts which can infect humans.  Candida yeasts typically reside on mucous membranes and skin without causing infection, however proliferation of the fungus can create organ specific symptoms.  For example, overgrowth in the vagina results in a yeast infection, overgrowth in the mouth/throat results in oropharyngeal candidiasis (thrush), and overgrowth in the bloodstream is referred to as invasive candidiasis.  In Lindsey’s case, the infection resulted in blood loss and the other aforementioned symptoms.  Fortunately, Lindsey is in good medical condition, however she will not be an appropriate candidate for a repeat surgery in the near future.

I chose to highlight this medical milestone in today’s blog.  And yes, I refer to it as a “milestone” despite the fact that others might prefer to call it a “failure.”  The reason I have chosen to do so is because medical research follows the same principal as the one taught to many children learning to tie their shoelaces for the first time.  Namely, “If you don’t succeed at first, try, try again.”  Many successful medical advancements come on the heels of previous unsuccessful attempts.  Confucius has aptly stated, “Our greatest glory is not in never failing but in rising every time we fail.”  Similarly, Thomas Edison, inventor of the light bulb, failed 1,000 times before he finally succeeded.  When asked how it felt to fail 1,000 times, Edison responded, “I didn’t fail 1,000 times.  The light bulb was an invention with 1,000 steps.”  On that note, I give much credit to the Cleveland Clinic, who is already planning for future transplants with modified protocol to decrease the chance of future similar occurrences.  In addition, I applaud Lindsey for boldly going where no American woman has gone before.  May all her hopes and dreams regarding family planning come to fruition in a safe and satisfying manner.

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