What is Endometriosis?
Endometriosis is a chronic inflammatory condition that causes tissue similar to that found in the lining of the uterus to grow outside of the womb. It affects around one in ten women of reproductive age, causing pain, infertility and gastrointestinal symptoms.
Women often report difficulty in getting pain and associated symptoms under control, despite medication or even surgery.
One in ten Australian women suffering from endometriosis reported using cannabis as a means of managing their pain and other symptoms.
What the Research Says
484 women with surgically diagnosed endometriosis were asked about what self-management strategies they used to treat their pain and associated symptoms.
Of the respondents, aged 18-45, 76% reported using self-management techniques in the past 6 months. This included the use of heat packs (70%), dietary changed and exercise, and cannabis (13%).
Cannabis was rated as the most effective for managing pain according to those surveyed.
Women who reported higher levels of pain were more likely to use cannabis than those with milder symptoms. This could be due to the fact that other relief measures did not help their symptoms enough, n
Respondents who used cannabis also reported improvements in other symptoms including gastrointestinal problems, nausea, anxiety, depression and sleep.
Mechanism of Action
The Endocannabinoid system (ECS) is a complex regulatory system comprised of various receptors, chemicals and enzymes. It helps maintain homeostasis in our bodies and is important in regulating a wide range of actions, including metabolism, inflammation and immune function.
The ECS is found throughout most organs in the human body, but is most abundant in the central nervous system, the immune system and the female reproductive systems.
Chemicals found in cannabis, like THC and CBD have the ability to interact with the ECS and other receptors in the human body. This suggests the mechanism through which cannabis can help relieve pain.
There is a lot of emerging research showing that medicinal cannabis can help with a number of conditions, including chronic pain and chemotherapy-induced nausea and vomiting.
Why Resort to Cannabis?
Both surgical and pharmaceutical treatments are commonly used for endometriosis. Surgery can reduce pain in the short and medium-term.
There have been reviews that have found hormonal treatment options to be effective at managing pain, but these are often avoided due to significant and unwanted side effects of their own, like headaches, mood swings and depression.
Non-steroidal anti-inflammatories like ibuprofen don’t seem to be effective at alleviating pain associated with endometriosis. In the US, opioids like oxycodone and codeine are often prescribed, but the risk of opioid dependence and overdose are rife.
Women with endometriosis report a lot of side effects that interfere with their daily lives, from having to reduce social activities to not being able to study or go to work. It can also cause poor mental and emotional health.
While studies have shown that cannabis reduces pain associated with endometriosis, the survey responses were self-reported and therefore may be subject to recall bias, or an overestimation of benefits or harms.
Well-designed clinical trials are urgently needed to determine how effective and safe quality controlled medicinal cannabis could be in treating endometriosis and its associated side effects.