Chapter 10: Reproductive Health and Gynecological Disease


Human Reproductive System

The reproductive system is comprised of internal and external organs that operate together and serve several functions. These organs serve the purpose of pro-creating and facilitate sexual pleasure.

The female reproductive system consists of external parts that include the clitoris, labia majora, labia minora, and Bartholin’s glands. Internally the major organs are the vagina, uterus, and ovaries that produce the female’s ova. The vagina is appended to the uterus through the cervix, and the womb is connected to the ovaries via fallopian tubes. Hormonal changes trigger the release of one ovum or egg. The egg is released through the fallopian tube; this process is ovulation. If the ovum is not fertilized, it is discharged through menstruation.


There are two major parts in the male reproductive system, the testes, and penis. The testes, produce sperm and are located in an external pouch called the scrotum. The testes are placed here to be kept slightly cooler than the body, in case they become too cold, they are drawn closer to the body for warmth, or further in case of cooling is required.1, 2

Genetic influences, environmental factors and stressful lifestyles all affect sexual behavior and health. Disorders affecting the reproductive health are directly related to CB1 and CB2 receptors located throughout the system.3 – 5

Role of CBD in Reproductive Disorders and Diseases

Since the discovery of the endocannabinoid system, research and studies have shed light on the significant role of endocannabinoid signaling in several reproductive-related issues. These issues amongst others include Sertoli cell survival, spermatogenesis, fertilization, preimplantation embryonic development, implantation placentation, and postimplantation early growth. This has created new perspectives in clinical applications that point towards the likely effect of cannabinoid in improving infertility and promoting the overall reproductive health.3, 6


Endometriosis is when the tissue that  forms the uterine wall (the lining of the womb) is present on other organs in the body, Endometriosis is a painful, inflammatory disease that usually transpires in the inferior abdomen, or pelvis, but can also appear anywhere in the body. Women with endometriosis often have lower abdominal pains, pain during periods, or even during intercourse, and may even report a difficulty getting pregnant. Endometrial tissue can increase due to hormonal changes resulting in intra-abdominal bleeding and adhesion development.7

There is no single reason for developing endometriosis but is commonly associated with retrograde menstruation. Endometriosis is an idiopathic autoimmune clinical endocannabinoid deficiency (CECD), where CB2 receptor receptivity is affected. The endocannabinoid system adjusts hormonal imbalance in the reproductive system.

Surgical and hormonal intervention are both used against endometriosis, yet it can still cause chronic pain and disability. Cannabidiol administration has shown the ability to modulate bloating and pain associated with endometriosis. CBD oil has anti-inflammatory and analgesic properties as well as the ability to improve CB2 anandamide binding.8

Endometrial Cancer

Endometrial adenocarcinoma is a common intra-abdominal malignancy in women. Early detection is often associated with improved prognosis; however, treatment is still limited to radiation and chemotherapy; their aggressive side-effects are well documented. Clinical endocannabinoid deficiency (CECD) associated with endometrial adenocarcinoma is idiopathic autoimmune that affects CB2 receptors. The endocannabinoid system has a protective role against several types of cancers. Research has shown the effectiveness of cannabidiol (CBD) in inhibiting the metastasis in both in vitro and in vivo studies, Despite the limited human studies, CBD has analgesic benefits and is warranted as an adjunctive malignancy therapy.9-11

Prostate Cancer

Prostate cancer is a malignancy that transpires in the prostate; a small gland in men that originates the seminal fluid that nourishes and transports sperm. Millions of men are affected by prostate cancer, and if detected early, it is usually curable. The tumor commonly grows slowly and is confined within the gland, here it is unlikely to cause harm. However, due to the low number of men receiving prostate examination and PSA screenings the detection is delayed, risking a poor prognosis.

At early stages of prostate cancer, there might be no signs or symptoms, but as it advances symptoms that appear include, trouble urinating, blood in semen, discomfort in the pelvic area and even erectile dysfunction. It is not clear what causes prostate cancer, and the clinical endocannabinoid deficiency (CECD) associated with it is idiopathic autoimmune. The CECD in prostate cancer affects mostly CB2 receptors.

Cannabidiol promotes apoptosis in cancerous cells and inhibits the development and metastasis of the tumor as shown by clinical studies. The therapeutic administration of CBD in the early stages of prostate cancer has shown a promising effect, and also as a preventative therapy to maintain a healthy prostate.8, 12-24

Testicular Cancer

Cancer of the testicle is one of the least common forms of cancer that usually affects men between the ages of 15 and 49. Typically the symptoms are painless and appear in as swelling or lump in one of the testicles, or even as a change in form or texture of the testicles.

Testicular cancer is life-threatening, and due to its closeness to the lymph system, it makes it harder to manage unless detected early. It is associated with an idiopathic immune CECD, where cannabidiol has previously demonstrated effectiveness in inhibiting metastasis and spread of malignant cells.12-14


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