Endometriosis is a chronic, inflammatory condition in which tissue similar to the tissue that normally lines the inside of your uterus (the endometrium) grows outside the uterus. Endometriosis commonly involves the ovaries, fallopian tubes and the tissue lining the pelvis. It affects around one in ten women of reproductive age.
With endometriosis, the endometrial-like tissue acts like regular endometrial tissue. It thickens, breaks down and bleeds with each menstrual cycle, but because this tissue has no way to exit the body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions – abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
Endometriosis can cause pain, sometimes severe, especially during menstrual periods. Fertility problems also may develop. Fortunately, effective treatments are available, among which medical cannabis has been identified as an effective remedy for the often very painful symptoms of endometriosis.
Pain is the primary symptom of endometriosis, the most common observations being:
- pain in lower stomach or back (pelvic pain) – usually worse during period
- period pain that prevents normal activities
- pain during or after sex
- pain when urinating or defecating during period
Cannabis has a fairly well investigated value for treating chronic pain, and some healthcare regulators do now allow for the prescribing of CBMPs for pain conditions.
Of the 240 respondents from an Endometriosis Association survey, 77 (32.1%) reported having tried cannabis, with the majority of these participants (52 of 77, 67.5%) reporting cannabis to be very or moderately effective.
Studies do validate the observational reports of cannabis’ efficacy. A 2017 study review concludes that, “Pain management for patients with endometriosis needs to be more effective, target the hormonal and immunologic environment, downregulate proliferation while enhancing apoptosis, and normalize the invasive mechanisms and neuroangiogenesis processes. ECS modulation appears to be a good therapeutic strategy by potentially combining all these factors.”
The mechanisms of action involved include:
- Stopping cell proliferation
- Preventing cell migration
- Inhibiting lesion vascularization (blood vessels)
- Inhibiting lesion innervation (nerves)
- Blocking synthesis of inflammatory prostaglandins
- Modulating the immune response
- Desensitizing nerves that transmit pain
As ever, further research into this area may uncover more effective and targeted cannabis medicines that could be deployed within clinical pharmacopeias and not just within self-treatment regimes. Special attention and further investigation are needed to evaluate the impact of the potential therapeutic side effects, especially on fertility and pregnancy outcomes.
For more information on studies around cannabis and endometriosis, take a look at our evidence base, a ground-breaking systematic review of the history of research in this area and a global first-of-its-kind searchable database for clinical referencing.
For more information on how medical cannabis can help with the management of chronic pain conditions, take a look at our in-depth course on this subject.
The rest of our comprehensive resources on medical cannabis are available on our website. We urge anyone considering the use of medical cannabis products to consult with a trained medical professional prior to beginning use.