Can CBD Prevent Pelvic Pain?

I suffer from pelvic pain, specifically vaginismus. I’ve been reading about the benefits of CBD with pain. I was wondering if CBD salves or lubricants were safe to use internally? And if CBD will actually reduce the pain one experiences with vaginismus.

— Anonymous

Vaginismus is a medical condition where the muscles of the pelvic floor (the muscles that support the bladder, vagina and rectum) have excessive tension. This can lead to both pelvic pain and pain with sex. There is no data to support using CBD vaginally (or by any other route) for this pain condition. There is some evidence linking cannabis use in the previous four months with increased vaginal yeast colonization, but CBD has not been studied independently.

[Have a question about women’s health? Ask Dr. Gunter yourself.]

CBD, or cannabidiol, is a nonpsychoactive compound found in cannabis. CBD is “in” right now for many medical conditions, not just ones that are painful. The data supporting CBD use for most conditions is generally low quality or completely absent, so it is important to separate the fad from the facts so you can make an informed choice about your body.

CBD may play a role in reducing pain and muscle spasm for some conditions, but there are still a lot of unknowns. An oral spray with THC (tetrahydrocannabinol, which is the main psychoactive component of cannabis) and CBD is approved for use in other countries for muscle spasm caused by multiple sclerosis as well as for some kinds of chronic pain. However, it is not possible to directly translate this data to vaginal use or to apply it to a different medical condition.

We do not know how CBD would act vaginally since cannabinoid receptors in the vagina have not yet been studied. We also don’t know how much CBD would be absorbed into the bloodstream or if absorption is needed to produce an effect. (In this case, if the drug has to enter the bloodstream to work, there is probably no benefit to vaginal use).

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.

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.


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