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Vaginal marijuana for menstrual cramps: the grass isn’t always greener

foria-menstrual-reliefForia wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD.

Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible?

THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e. high) from marijuana is believed to be due to the THC, which can relax muscles and also cause euphoria and sedation as well as anxiety, paranoia, and dysphoria. Cannabidiol can stimulate receptors in the brain, reproductive, endocrine (hormone), gastrointestinal, and vascular systems. Some research suggests CBD may attenuate THC-induced tachycardia, euphoria, and anxiety (i.e. the bad parts of a high), but it’s not clear if that is really the case clinically. We have a lot to learn about these receptors and their role in pain and inflammation. Basically, we don’t know what we don’t know.

It is always hard to substantiate any claim about marijuana products due to the limited research. There is no study on THC and/or CBD for menstrual cramps or pelvic pain or endometriosis. If fact the few studies on the reproductive tract are on rat uteri. If that doesn’t reassure you I don’t know what will.

So what can we infer from the available research and general body of knowledge?

Oral and mucosal delivery of THC is different from smoking. Mucosal delivery (like vaginal suppositories or an oral spray) is a slower reveal to the brain than smoking. With edibles it is about 30-60 minutes for the drug to reach the brain.

We know a fair bit about mucosal delivery. Canada and the United Kingdom (and other countries) have the drug Sativex, a 1:1 ratio of THC and CBD to treat the muscle spasm associated with multiple sclerosis and pain from cancer. Each spray contains 2.7 mg delta-9-tetrahydrocannabinol (THC) and 2.5 mg cannabidiol (CBD). Eight sprays spread out throughout the day is very well-tolerated with no psychoactive effects.  A dose of 8 sprays over 20 minutes, so 21.6 mg, showed abuse potential. After Sativex is administered the THC and CBD appear in the blood stream within 15 minutes. The maximum recommended dose is 12 sprays a day or 32.4 mg.

Absorption from the vaginal mucosa would likely be somewhere between the oral spray and ingestion, so between 15 and 60 minutes.

With oral administration many people consider 10 mg of THC to be one dose.

The dose of 60 mg of THC in the Fiora suppositories is significantly have higher than the recommended 32.4 mg maximum daily dose of Sativex.

It’s high doses of THC, much more common with modern strains, that takes people to the emergency department.

 

 

What about Foria’s claims?

The company says it’s product won’t get you high because “the medicine is administered as a vaginal suppository.” This makes no sense. Medications are absorbed from the vagina into the bloodstream and then from the bloodstream they go to the uterus and the brain and everywhere else that blood goes. This requires only a rudimentary knowledge of physiology. Medication doesn’t crawl up the vagina to the uterus and then just hang out avoiding circulation.

Fiora also claims the uterus has “more cannabinoid receptors than any part of the body except the brain.” I can find no study to support this assertion. Also, just because we have a receptor doesn’t mean that stimulating it produces a medicinal and safe effect. Opioids stimulate the all kinds of receptors and of course there is good and bad in that. Keep in mind that the role of endocannabinoid signaling in the human reproductive system is still largely not understood.

What Other effects could it have?

Vaginal THC and CBD could affect the vaginal ecosystem (the good bacteria).Again, untested. One study has linked marijuana use with colonization of the vagina with yeast.

So…

Technically there is more than enough THC in Foria Relief vaginal suppositories to get you very high and even send you to the emergency department, although as vaginal absorption of THC is totally unstudied who really knows? Also, you are taking their word that this is the actual dose. The product might also contain not much of anything.

Why they decided to go with such a high dose is unknown as much lower doses can produce analgesia (pain relief), unless of course it’s not about the cramps after all.

If Foria Relief really does contain 60 mg of THC and absorption is between 15 and 60 minutes it’s hard to believe the goal isn’t to leave you paralyzed on the bed thinking menstrual cramps aren’t so bad after all.

I was going to suggest Maureen Dowd try them out and report back, but given all the unknowns and the dose I can’t recommend anyone use them. Not even for the New York Times.

 

 

 

 

 

 

Discussion

15 thoughts on “Vaginal marijuana for menstrual cramps: the grass isn’t always greener

  1. Dr. Jen Gunter, you are my latest heroine (not heroin). Your knowledge and common sense, and your writing are all fantastic! I hope you are reaching lots of women in your efforts to counter the rampant BS in reproductive health in the media!

    Posted by Leslie R. Schover, PhD | January 28, 2016, 10:41 am
  2. Possibly important note: My email client (Microsoft Live Mail) interpreted this most recent email post as a phishing attempt. I read through it and clicked the links, and couldn’t figure out why this was so, but thought you should have the heads-up. All the best, Lauren

    Posted by Lauren Sarno | January 28, 2016, 11:24 am
  3. Why didn’t I get a chance to try this or know about this … instead I had a hysterectomy for my chronic, longstanding painful dysmenorrhea! Oh, and I don’t live in a state where you can have “medical marijuana” either … reposting this to https://hysterectomy4dysmenorrhea.wordpress.com

    This was really interesting … and I wouldn’t have tried this anyway had it been available because I’m sure I would have had ALL the negative side effects. Very sure.

    Posted by elizabetcetera | January 28, 2016, 4:56 pm
  4. Reblogged this on da Vinci Total Hysterectomy and commented:
    Look what the amazing Dr. Jen Gunter has to share again! The idea of marijuana via vaginal suppository is quite interesting. At times, I’m sure I would have been very desperate to try such a thing, but today is the first I’ve ever heard of this … plus I don’t live in a state that allows medical marijuana.

    Anyway, if anyone tries or has tried this, please let me know — I’d really like to know how well it worked! But it’s not like I’m going to go get a uterus transplant so I can try it myself! My dsymenorrhea (painful periods) are a thing of the past — and it was all done legally!

    Posted by elizabetcetera | January 28, 2016, 5:00 pm
  5. I heard a couple of years ago about Foria, in a spray for sexual enhancement. I almost ordered some, just to try it out. I am interested to see what might actually come about with this. I take nabilone currently and I’ve often wondered what else its doing?!

    Posted by thescarlettside | January 28, 2016, 9:15 pm
  6. People are just falling all over each other to make the vagina the port of entry for all sorts of stuff. I knew about girls soaking tampons in vodka and inserting them, and that is disconcerting at the very least, but really what is this fascination?
    I am enjoying and still being horrified by your posts about all these vaginal intruders and renovations. Please continue to educate, and help protect girls and women from these evildoers. Thanks.

    Posted by Carole (@buhcula) | January 30, 2016, 3:09 pm
  7. Hi Dr. Gunter. I’m a writer working on an article that I’d love to interview you for. Would you please let me know the best email to reach you at? Thank you!

    Posted by Paige Greenfield | February 5, 2016, 7:16 am
  8. The Dr. Green Seeds blog actually has a ton of great info related to policy. It’s actually pretty handy. http://drgreenseeds.com

    Posted by S. Dean Robert | April 11, 2016, 10:53 am
  9. There are more cannabinoid receptors in the uterus and also the placenta compared to many other organs outside of the brain. They also develop in the fetal brain within the first few days of life and within the uterus cannabinoid receptors are actively involved in implantation. but, yes, THC in the bloodstream is THC in the bloodstream.

    Ref: Editors, Emmanuel S. Onaivi, Takayuki Sugiura, Vincenzo Di Marzo, Endocannabinoids: The Brain and Body’s Marijuana and Beyond, (Taylor & Francis Group, 2006, Florida),

    Posted by Jennifer Depew | April 13, 2016, 5:30 pm
  10. I purchased this product (Foria Relief suppository) legally in California and used it. It was simple, discrete and honestly was the only thing to help with my debilitating cramps (I am not interested in opioids which nauseate me). I wish I had been able to use it for the past 15+ years that I’ve been unable to leave my house, doubled over with cramps, unable to function. It’s been a blessing. For someone who is not a recreational drug user, this product really changed my mind about the use of cannaboid (sp?) medication. I was extremely nervous to try it, but willing to take a chance to do so since I had nothing to lose and again, had obtained a medical marijuana card and talked to my GP about this. I am so glad I did. Life-changing, truly. My 10 cents.

    Posted by BLB0723 | July 14, 2016, 3:42 am

Trackbacks/Pingbacks

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