Lena Yannella

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The Problem: No research has been done on the use of medical cannabis in patients with chronic pelvic pain (CPP).

 

Why do this study?  This study seeks to evaluate medical cannabis as a potential treatment for CPP in terms of pain reduction, side effects, and opioid use.

 

The study: Between 2012 and 2018, a daily dose of 3 grams of medical cannabis was prescribed to 135 women with CPP who were 35.4 years old on average. Sixty percent of participants had previously tried opioids to relieve pelvic pain. The method of cannabis use was recorded for 38 patients. Of these, 25 used cannabis oil, 10 ingested edibles, 9 used vape devices, and 6 smoked. There were 82 patients for whom a change in pain was recorded, and of these, 79 reported reduced pain. Thirty-nine of the 79 women who reported reduced pain also reported reducing their opioid use. A total of 9 women recorded experiencing side effects, the most common of which was a headache.

 

Conclusions: This study found medical cannabis to be a safe treatment option for CPP that yields minimal side effects and a potential reduction in opioid use. It also calls for further research in optimal CPP treatment.

 

Funder: None

 

Author conflicts: None

 

Commentary (David Casarett MD): This study has the potential to be very clinically useful because it describes the potential benefits of cannabis on a condition that can be very difficult to manage.  Chronic pelvic pain can be caused by many conditions, including endometriosis, surgical adhesions, cystitis, and irritable bowel syndrome.  Challenges of diagnosis make this syndrome difficult to treat for many women, so the appeal of a single, widely effective symptomatic treatment is considerable.  Although it’s very interesting, this study has significant limitations, one of the most important of which is that it only includes women who used cannabis over a long period of time—presumably because it was effective and well-tolerated.  So we can’t conclude that most women will find relief from cannabis.  Nevertheless, even if the true rate at which women experience relief is only a fraction of the figure reported in this study, that’s enough to warrant further study of cannabis as a therapy for this difficult to manage syndrome.