What is infertility?
The definition of infertility is the inability to get pregnant after trying to conceive for more than 12 months, or difficulty maintaining pregnancy. Many women experience infertility issues today, and according to the CDC, about 13% of women have trouble getting pregnant. Of those cases, 35% are found to also have a male fertility issue contributing. In some cases, the underlying reason for infertility cannot be determined. Many other cases find disorders such as endometriosis, PCOS, pelvic inflammatory disease or anovulation to be the cause. In all cases, there is stress and confusion related to the difficulty in planning and growing a family.
Naturopathic Understanding of Infertility
The naturopathic approach to disease and health issues looks at the body as a whole. When there is an imbalance, whether from an outside source or internal, the main goal is to identify the cause. With infertility these causes can be inflammation, toxic exposure, hormone imbalance, chronic stress or a combination of these. As each person is unique, so are the reasons for infertility. The first step to proper fertility support would be uncovering which specific areas need to be addressed.
What is CBD?
CBD, also known as cannabidiol, is a plant-based chemical from the Cannabis sativa plant also known as marijuana or hemp. Unlike delta-9-tetrahydrocannabinol (THC), CBD is not psychoactive but has many potential health benefits.
How does CBD work?
CBD works on a system in our body know as the endocannabinoid system or ECS for short. This is a complex cell signaling system made up of receptors known as CB1 and CB2 receptors. These receptors are found everywhere in your body including your brain, immune cells and even in your organs, including the testes and the ovaries. Traditionally, endocannabinoids, or the natural cannabinoids our body produces, work on these receptors and two major forms have been found: anandamine (AEA) and 2-arachidonoylglyerol (2A-G). CBD has been shown to affect AEA and 2A-G levels which both affect the ECS receptors. All of that to is to say, CBD helps balance the ECS affecting digestion, mood, stress and fertility.
How is the ECS related to infertility?
The ECS receptors can be found in the entire female reproductive system including the ovaries, the fallopian tubes and the uterus. It is vital to egg development and growth, movement of the egg through the fallopian tubes and in proper implantation. Studies have found that AEA levels are higher in the endometrium, or uterine lining, than any other reproductive tissue. Throughout the menstrual cycle, our levels of natural cannabinoids and number of receptors fluctuate. This is important because it means the ECS has a strong relationship with hormones. Recently, more studies have found that changes to the ECS caused changes in the reproductive organs. In one study altered CB1 receptor function led to a decrease in egg cell development. Altered levels of endocannabinoids led to delayed embryo development prior to implantation. Another study found proper functioning of cannabinoid receptors was necessary for fallopian tube contractions. These contractions propel a fertilized egg to the uterus for implantation. Lower receptor activity led to a decrease in contractions and led to ectopic pregnancies in mice. All of these studies show the intricate relationship of the ECS to women’s fertility.
What can Cause ECS Dysregulation?
The simple answer is; many things. The ECS can be easily imbalanced by both internal and external factors. Dysregulation means that the system is no longer functioning optimally. The receptors “malfunction” and are either are overactive, blocked from functioning or their numbers have been reduced. This can cause increased sensation of pain, digestive issues, anxiety or problems with sperm or egg development and even implantation. Since the ECS is everywhere in the body, the symptoms of ECS dysregulation can seem hard to pinpoint. This is where a health professional with experience in this area can be crucial. Stress, inflammation, and chemical toxins are a few of the major factors that can alter the proper working of the ECS. Identifying what that cause is key to getting proper support with CBD.
How Does Stress affect ECS?
Chronic stress has been shown to greatly alter the ECS system. The ECS helps us maintain normal balance in our bodies or homeostasis. When something imbalances us, stress for example, the ECS works quite effectively with the adrenals to help relax the body. Unfortunately, long term or chronic stress can weaken the ECS system, not just in its stress response but in overall function. Studies have found that long-term stress can lead to lower levels of endocannabinoids in our system. These are the vital signals that maintain the ECS, so lower levels mean lower ECS function, including in our reproductive organs.
How Does Inflammation Affect the ECS?
Inflammation is our body’s response to some kind of invader or damage. When we have chronic inflammation occurring our immune system can become overactive. This overactivity can unfortunately then begin to damage other areas of our body. Since our ECS is so large, it can be easily affected and damaged by chronic inflammation. Inflammation can come from autoimmune disorders, chronic allergies, or even from food we eat. Sugar and alcohol being the most well-known inflammatory foods. Outside of this, even foods we are “sensitive” to can cause big problems. Over time, these foods can damage the lining of our intestines and escape in to our bloodstream. Once there, it has access to everything including the ECS. Recently, a study showed that in patients with irritable bowel syndrome, IBS, there was a decrease in their ECS response. The issue lays in the fact you don’t have to have a full-blown autoimmune disease to have high levels of inflammation.
How do Chemical Toxins Affect ECS?
Chemical toxins or environmental toxins are not necessarily what or where you expect. Some of these toxins include things like parabens, estrogen-like substances, and phthalates. Unfortunately, these compounds are not as rare as you might think. They can be found in skin care products, plastics, flame retardants and pesticides. The problem is that they decrease the ECS receptors response. This means they make the receptors less responsive to signals from the body’s natural cannabinoids.
How Does CBD Help?
CBD, in the right cases, shows evidence of being a beneficial tool. It promotes normal function and balance in the ECS. In studies, CBD has been shown to help reduce inflammation, reduce stress and support repair in the ECS. Because infertility can be strongly impacted by these issues, CBD has a lot of potential in this area. If fertility has been affected by ECS dysfunction, CBD can be a supportive supplement, coupled with other lifestyle and nutritional changes. Many new studies have been propelling the research forward on CBD and its potential benefits, but still much is unknown. Fertility represents an exciting new territory for CBD and ECS research to explore.
About the Author
Dr. Preston is a Naturopathic Physician licensed in the state of Connecticut and with a Masters in Acupuncture. She currently works out of both Michigan and Connecticut. She obtained both her Naturopathic Doctorate (ND) degree and Acupuncture degree at the University of Bridgeport in Bridgeport, Connecticut where she also received her Bachelor of Science in Biology with specialized research in toxicology and clinical studies at St. Vincent’s Hospital.
While in school, she went on to research and write her thesis on prenatal massage and its benefits to mother and child. She continued her counseling training with Mind-Body techniques while in school to help with dealing with emotional and physical stress.
Dr. Preston specializes in prenatal and postpartum care, pediatrics, and women’s hormonal health. You can find her at https://www.cbdplaza.com/drpreston/.
Fertility CDC Stats: https://www.cdc.gov/nchs/fastats/infertility.htm
Correa, F., Wolfson, M., Valchi, P., Aisemberg, J., & Franchi, A. (2016). Endocannabinoid system and pregnancy, Reproduction, 152(6), R191-R200. Retrieved Feb 26, 2021, from https://rep.bioscientifica.com/view/journals/rep/152/6/R191.xml
Cacciola, Giovanna, et al. “Cannabinoids and Reproduction: A Lasting and Intriguing History.” Pharmaceuticals, vol. 3, no. 10, 2010, pp. 3275–3323., doi:10.3390/ph3103275.
Luschnig, Petra, and Rudolf Schicho. “Cannabinoids in Gynecological Diseases.” Medical Cannabis and Cannabinoids, vol. 2, no. 1, 2019, pp. 14–21., doi:10.1159/000499164.
López‐Cardona, Angela Patricia, et al. “CB1 Cannabinoid Receptor Drives Oocyte Maturation and Embryo Development via PI3K/Akt and MAPK Pathways.” The FASEB Journal, vol. 31, no. 8, 2017, pp. 3372–3382., doi:10.1096/fj.201601382rr.
Morena, Maria, et al. “Neurobiological Interactions Between Stress and the Endocannabinoid System.” Neuropsychopharmacology, vol. 41, no. 1, 2015, pp. 80–102., doi:10.1038/npp.2015.166.
Almogi-Hazan, Osnat, and Reuven Or. “Cannabis, the Endocannabinoid System and Immunity—the Journey from the Bedside to the Bench and Back.” International Journal of Molecular Sciences, vol. 21, no. 12, 2020, p. 4448., doi:10.3390/ijms21124448.
Forner-Piquer I, Santangeli S, Maradonna F, Rabbito A, Piscitelli F, Habibi HR, Di Marzo V, Carnevali O. Disruption of the gonadal endocannabinoid system in zebrafish exposed to diisononyl phthalate. Environ Pollut. 2018 Oct;241:1-8. doi: 10.1016/j.envpol.2018.05.007. Epub 2018 May 21. PubMed PMID: 29793103.
Endocrine disruptors and toxic exposure to certain chemicals alters proper ECS function. – Pomatto V, Palermo F, Mosconi G, Cottone E, Cocci P, Nabissi M, Borgio L, Polzonetti-Magni AM, Franzoni MF. Xenoestrogens elicit a modulation of endocannabinoid system and estrogen receptors in 4NP treated goldfish, Carassius auratus. Gen Comp Endocrinol. 2011 Oct 1;174(1):30-5. doi: 10.1016/j.ygcen.2011.08.001. Epub 2011 Aug 10. PubMed PMID: 21855545.
Suglia A, Chianese R, Migliaccio M, Ambrosino C, Fasano S, Pierantoni R, Cobellis G, pChioccarelli T. Bisphenol A induces hypothalamic down-regulation of the the cannabinoid receptor 1 and anorexigenic effects in male mice. Pharmacol Res. 2016 Nov;113(Pt A):376-383. doi: 10.1016/j.phrs.2016.09.005. Epub 2016 Sep 15. PubMed PMID: 27641926.