Dhivya Ramalingam, Ph.D. 

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Tags:  Medical cannabis; Endometriosis; Pain management

 

The problem:  Endometriosis is a disease that is common among women of child-bearing age and involves the growth of endometrial tissue outside of the uterus. This results in reduced fertility and often in severe pelvic pain. Currently, pain management for endometriosis requires use of analgesic medications and/ or surgical procedures.

 

Why do this study?   The survey was given to endometriosis patients to estimate their usage of cannabis and cannabidiol (CBD) for endometriosis-related pain management. The study also aimed to understand the prevalence of medical cannabis among women with endometriosis.

 

The study:  This was an online REDCap survey completed by 137 clinic patients with an endometriosis diagnosis and 347 patients from the Endometriosis Association (EA). The survey consisted of 55-75 questions (depending on the population) about pelvic pain history, demographics, and experience with marijuana or CBD for management of pelvic pain. Among respondents, 32.1% (77/240) of EA participants and 46.8% (58/124) of clinic patients reported having tried cannabis. Within these groups, 67.5% (52/77) of EA participants and 75.9% (44/58) of clinic patients reported that cannabis was very or moderately effective. In addition, 27.8% (67/240) of EA participants and 46.0% (57/124) of clinic participants reported having tried CBD. Of these, 50% (34/67) of EA participants and 64.9% (37/57) of clinic participants reported that CBD was very or moderately effective. Cannabis was most likely to be reported as very effective (40.2% of EA participants, 53.4% of clinic participants), while CBD was most likely to be reported as moderately effective (31.4% of EA participants, 36.8% of clinic participants).

 

Conclusions:  The study found that cannabis and CBD use for pain relief was common among women with endometriosis. While both cannabis and CBD provided pain relief, cannabis was perceived as being more effective than CBD.

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What does this study add?  Analgesic medications and surgery are often prescribed for pain management with endometriosis. Unfortunately, these come with a variety of side effects. This study shows that women frequently turn to cannabis/ CBD as natural alternatives for pain relief.

 

Funder:  Not available.

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Author conflicts:  None.

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Commentary: Recent studies have shown that the endocannabinoid pathway in the body plays an important role in the healthy functioning of female reproductive organs. Hence, there is a lot of interest in cannabis (and its derivatives like CBD) for pain management with endometriosis. Controlled cannabis use can alleviate pain and does not have the side-effects often reported with opioid analgesics. The mechanism of how cannabis offers relief is still unclear, and evidence is still anecdotal. Based on this study, marijuana appears to have an edge over CBD, with over 65% of respondents stating that it offered relief of symptoms. So, it is likely that other components in cannabis (e.g. THC) play a role in this process.