As more and more states make various cannabis products that were previously off-limits readily available to consumers, we’re only beginning to unlock the full potential ways the plant can be used to benefit our health and wellness. Despite countless brands having a CBD-this or a THC-infused that and more high-profile folks loudly and proudly embracing the cannabis market (hello, Martha Stewart!) , it can be hard to decide what to buy when you don’t fully know what you’re paying for — as mainstream research still needs to catch up with the products on the market.

From the reproductive and vulva-owning person’s health perspective, one area that’s super interesting to cannabis connoisseurs and healthcare experts is the potential cannabis has for the vagina — particularly in how it can benefit people going through menopause and perimenopause or experiencing chronic reproductive health conditions. After all, our vaginas, like the rest of our bodies, change as we age and grow and finding ways to balance out and feel comfortable as we go through those changes has a lot of appeal.

“Cannabis helps the body right the ship and restore balance.”

Patty Pappas and Carrie Mapes, co-founders of Cannabis Vaginal Suppository start-up Hello Again, both came to personally appreciate the benefits of cannabis when they were going through menopause themselves — and it was that hunt for a perfect product that would address their needs that lead them to creating their business.

“Cannabis is a multi-faceted plant with a reputation for psycho-activity, but a long history of providing wellness and balance.The hundreds of cannabinoids in cannabis, as well as the particular terpene profile in each strain are partly responsible for user experience. Equally important is the method of delivery into the body. Low (THC) dose products will generally deliver less psycho activity than high dose.  But, if the cannabis enters the body through a vaginal suppository, THC does not deliver the same psycho-active high as the edible or smoking/vape options,” Pappas and Mapes tell SheKnows. “This makes a cannabis vaginal suppository (we call it a vagitory!) an ideal way to address the biological chaos that happens during menstruation and during menopause.”

You had us at biological chaos. But, like, what does it actually do for you and your body (especially when you’re going through hot flashes, pain, mood swings, dryness during sex, etc.)?

Spoiler alert: It’s all about regaining balance, baby!

“In each case, shifts in hormones throw the body’s systems off balance. Sleep systems, mood systems, energy, cognition all take a hit,” they tell SheKnows. “When the plant’s cannabinoids combine with the body’s cannabinoid receptors (and there are plenty in the female reproductive tract!), the biological response is equilibrium. Cannabis helps the body right the ship and restore balance.”

CBD vs. THC — What does it mean and who should use what?

SheKnows also caught up with Chief Medical Officer at Cannabis Doctors of New York Dr. Kenneth Weinberg M.D. to get a little more insight into what we know (and don’t yet know) about cannabis’ health potential. As someone who works with patients of all walks of life, Weinberg says he has seen a lot of anecdotal evidence of cannabis’ benefits, but does clarify that its history as a schedule one drug has greatly delayed the quality of research we have on the plant — and its potential to help people.

While Weinberg says he wouldn’t recommend cannabis-use to people who are pregnant or nursing because the lack of research and the knowledge that cannabis does cross the placenta and into breast milk, there’s more data available to show the benefits for non-pregnant or nursing people who are living with endometriosis, dealing with extreme menstrual discomfort, pelvic floor issues or those going through perimenopause or menopause. While there’s a lot to be understood about the whole plant, he points unpacks two of the most common cannabinoids you’ve probably heard about — THC (Tetrahydrocannabinol) and CBD (Cannabidiol) — and what they can do for the body.

“There are several things that go on certainly both THC and CBD and other minor cannabinoids,” Dr. Weinberg says. “In New York state, We’re really just looking at CBD and THC. But if you’re using the whole plant, then you’re getting all the minor cannabinoids and the terpenes all of which have have their own effect. But if we just stick the THC and CBD, which I am forced to do as a as a cannabis doctor in New York state, THC is a very, very good pain reliever. It also is very good for muscle spasticity. And if you think about it, any of these conditions where there is a chronic pain or an acute pain, your body tends to involuntarily hold itself in certain ways and [you have] tightened up muscles. And so a lot of times the muscle tightness and spasticity adds to these pain syndromes and THC very good for muscle spasticity mean. Incidentally. I have a lot of patients with multiple sclerosis where muscle spasticity is the major issue that they’re dealing with. And a lot of them use high THC, just for that reason.”

Meanwhile, CBD (which has exploded all over the market in many states that don’t have recreational cannabis legalized) is all about fighting inflammation: “Then CBD, it’s main benefit is the anti-inflammatory benefit,” Dr. Weinberg says. “So in all of these situations inflammation is such a major contributor that CBD is very helpful. It’s also very good as a pain reliever as well. It’s a good anxiety medicine. And as I’m sure you can imagine anxiety and psychological issues very quickly become intertwined with any ongoing or even acute medical condition.”

Utilizing the vaginal suppository to deliver cannabis in the proper dosing can address all kinds of localized pain and systemic imbalances.”

So for symptoms like hot flashes, brain fog, anxiety, changes in energy or sleep patterns, there’s some clear ways that a high-quality cannabis product might be a fit for a person going through menopause — particularly using the vaginal suppository application method that allows the product to reach directly where the discomfort is coming from without experiencing any high (and, to be clear, this product doesn’t smell like weed.) Pappas and Mapes said that creating their suppositories came from the goal of getting back to feeling normal (like themselves again) and restoring some of that internal homeostasis — so their product really focuses on addressing what needs addressing in the most comfortable and efficient way possible.

“Since we launched our Hello Again suppositories for menopause, we have received great feedback from women of all ages who are using the products for endometriosis pain, menstrual cramps, arthritis, bursitis, and fibromyalgia,” Pappas says. “Utilizing the vaginal suppository to deliver cannabis in the proper dosing can address all kinds of localized pain and systemic imbalances. This is why it’s no surprise to us that Hello Again is helping women of all ages with a variety of challenges. We definitely formulated for menopause, but are so happy to be helping women of all ages.” 

Other benefits they found (which we talk about around here fairly often) include how using cannabis products have helped their customers in the sex lives.

“Women in perimenopause, menopause and post-menopause often struggle with vaginal dryness. Many are experiencing painful sex for the first time in their lives and can revitalize their sex life by bringing personal lubricant into the bedroom,” Mapes says. “There are many cannabis-based lubricants and for good reason. The THC is a vasodilator, bringing blood to the area and CBD helps relax muscles, like the pelvic floor. Cannabis can also enhance the sense of touch and put a person out of their head and into their body. “   

Overcoming decades of stigma

When it comes to cannabis and reproductive health (menopause, particularly) there’s sort of a meeting of two deeply stigmatized spaces on the mend. Our cultural attitudes about what it means to be perimenopausal, menopausal or even a menstruator have changed astronomically in the last ten years and we’ve seen similar changes in attitudes about what it means to be a person who uses cannabis. 

But that’s one area where Pappas and Mapes have seen opportunity, allowing people to drop their preconceived ideas of both and embrace a time of their life (that until very recently hasn’t been considered a time to embrace) and take advantage of the full wellness benefits of a plant that has also been given a pretty bad rap over the years.

“We often talk to women in their 40s who describe to us their hot flashes, sleeplessness, irritability  and brain fog, but insist they are not in menopause. We get it. Women resist identifying with something they associate with aging,” Pappas says. “We definitely have some friends who are convinced that they cannot try a cannabis product because they had a bad experience with pot in high school. The cannabis in products today is so different from the bag of weeds and sticks they remember smoking. The cannabis industry is highly regulated for consumer protection. Our products go through rigorous testing for both potency and purity. An organic apple or standard tea bag wouldn’t pass the standards required for cannabis.”

A version of this story was published August 2021.

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