Is Cannabis an Effective Treatment for Endometriosis?

Endometriosis is a condition that causes tissue similar in composition to the uterus lining to grow in other parts of the body. The disease can impact people from all walks of life, affecting 1 in 10 women ages 12 to 52—an estimated 200 million women across the globe.

For these women, it is a brutally painful disorder that affects the reproductive system and parts of the digestive and endocrine systems within the pelvic area. It causes heavier flow during monthly periods, debilitating back pain and cramping, and the very real possibility of infertility.

Most physicians recommend pharmaceutical treatment and pain management techniques to ease the pain of endometriosis. Surgery is often a last resort option, however even a hysterectomy will not definitively cure endometriosis, and growth can recur.

Given the thrust toward less invasive means to treat conditions like endometriosis, research points to one possible—and controversial—long-term solution: cannabis, specifically cannabinoids derived from the raw material.

The Barcelona study

The use of cannabis or cannabis derivative products to relieve the symptoms of endometriosis was initially seen as a last hope by women who were frustrated with the short-term relief given by surgery and standard prescription medication.

In a 2020 study of 240 patients with endometriosis, nearly one-quarter of the women surveyed were taking CBD oil or edibles and found these products more effective over time. Findings showed cannabis was reported effective in terms of pain relief and the alleviation of related issues, such as digestive disorders, anxiety, depression and sleep disorders.

Yet, physicians continue to caution patients against the use of cannabinoids, citing their adverse impact on mental health and motor function. Despite this opposition, research currently being conducted at the University Pompeu Fabra in Barcelona, Spain, has shown the noted benefits of cannabinoids for women with endometriosis may far outweigh the risks.

A unique physical reaction

According to Professor Rafael Maldonado, whose team is doing the Barcelona study, chemicals in cannabis—specifically CBD and another cannabinoid known as tetrahydrocannabinol (THC)—interact with a complex regulatory system known as the endocannabinoid system (ECS.)

The ECS is made up of numerous receptors and enzymes that keep the body in a state of balance known as homeostasis, regulate metabolism, reduce inflammation of the internal organs and connective tissues, and boost immunity.

Current findings reveal the interaction between cannabinoids and the ECS and other receptors in the body enhances their functions. Thus, in the case of women with endometriosis, cannabinoid use may reduce inflammation in affected tissues and organs. This may well be the reason why some people living with endometriosis experience lasting relief whenever they use CBD oils, supplements or e-cigarette inserts.

Chronic pelvic pain, one of the most telling symptoms of endometriosis, has been shown to decrease in some cases of CBD use (in any form). Similarly, CBD has been shown to significantly reduce the severe anxiety and depression many endometriosis patients suffer throughout their monthly cycle.

Beyond endometriosis, cannabinoids are already being used in the treatment of neurological conditions, such as spastic multiple sclerosis and intractable epilepsy, and as digestive relief for those suffering from post-chemotherapy nausea. It is also touted to increase sexual libido.

The verdict is still out

Because of the limited research on the link between cannabis and endometriosis, it's still too early to draw any conclusions.

On a practical note, the legality of cannabis in any form is still heavily regulated, and the sale of such products is limited except in states where cannabis use and distribution for medicinal purposes are permissible.

Given the promising results of recent studies, however, it's best not to discount cannabis as a possible lasting, and hopefully more effective, treatment for endometriosis.