Photo Credit: Jeff W
Scientific Frontline: "At a Glance" Summary: Medicinal Cannabis for Endometriosis and Pelvic Pain
- Main Discovery: Cannabidiol oil, used alone or combined with dried cannabis flower, effectively reduces pain, improves sleep quality, and lowers anxiety in individuals suffering from endometriosis and related pelvic pain.
- Methodology: Researchers conducted a three-month prospective observational cohort study involving 28 participants diagnosed with endometriosis and/or pelvic pain. Participants were prescribed cannabidiol oil or a combination of the oil and dried cannabis flower, recording weekly pain scores on a 0-to-10 numerical scale and completing health profile questionnaires before and after the 12-week trial.
- Key Data: Overall pelvic pain scores decreased from an average of 5.4 to 3.7 out of 10. The severity of the worst pain experienced by participants dropped from an average of 7.6 to 5.3 out of 10, marking a clinically meaningful improvement in health-related quality of life.
- Significance: The study provides evidence for a well-tolerated, non-opioid alternative for managing complex endometriosis symptoms. The secondary benefits of reduced anxiety and improved sleep contributed to patient quality of life as significantly as the direct reduction in physical pain.
- Future Application: Large-scale clinical trials are required to establish standardized dosing, evaluate long-term safety, and identify specific patient profiles that will benefit most from medicinal cannabis as a primary or adjunct therapy for inflammatory pelvic conditions.
- Branch of Science: Gynecology and Pharmacology.
- Additional Detail: Participants reported that medicinal cannabis presented fewer and more manageable side effects compared to traditional opioid-based analgesics like tramadol, which frequently caused nausea, dizziness, and fatigue without providing consistent pain relief.
Medicinal cannabis could provide a new treatment option for those with endometriosis, with a study led by the University of Otago, Wellington showing it reduced pain, improved sleep and lowered anxiety.
The study, led by Dr Claire Henry from the Department of Surgery and Critical Care, involved 28 people with endometriosis and/or related pelvic pain who were prescribed cannabidiol (CBD) oil alone or in combination with dried cannabis flower for three months.
The participants recorded weekly pain scores on a numerical scale, with 0 being no pain, and 10 being the worst pain imaginable. They also completed an endometriosis health profile questionnaire before the trial started and at the end of the 12 weeks. Seventeen were interviewed about their experiences at the end of the study.
Dr Henry says overall pelvic pain among the group dropped from a level of 5.4 to 3.7, and the level of the worst pain dropped from 7.6 to 5.3. There was a clinically meaningful improvement in their health-related quality of life scores.
The study is the first prospective cohort study of medicinal cannabis for endometriosis-related pain in New Zealand. The findings are published in the international journal BMC Complementary Medicine and Therapies.
Dr Henry says while CBD did not work for everyone, for some of the impacts were life changing.
One of those in the study talked about preparing to re-enter the workforce after three years out, while another said they were “in such a good place health wise [they were] starting to try to have a baby”.
The benefits of their sleep and anxiety had an almost equal effect on their quality of life as the reduction in pain.
It is estimated that as many as one in nine people assigned female at birth have endometriosis, an inflammatory condition where endometrial-like tissue grows outside the uterus. Symptoms include severe and debilitating menstrual pain, non-cyclical pelvic pain, fatigue and reduced fertility.
Dr Henry says current treatment includes pain management, hormonal medications, and laparoscopic surgery.
“However, medical management of endometriosis is often associated with side effects, and patient satisfaction with these treatments can be limited.”
Those in the trial were using personalized combinations of analgesic, contraceptive, and holistic medication as well as lifestyle modifications to self-manage their pain.
Several of the participants reported previously using opioid-based analgesics, including tramadol, but said they provided limited or inconsistent relief and were often accompanied by undesirable side effects, including nausea, dizziness and fatigue.
There were few side effects reported from CBD use, with participants perceiving it as a gentler alternative that could still offer effective symptom relief.
The research project was supported by funding from endometriosis support group Endo Warriors Aotearoa.
The founder, Yessenia Sandoval, says the study highlights the need for accessible, evidence-informed care pathways for endometriosis.
“Those with endometriosis find it really difficult to find medications that work, that are affordable, and that don’t come with unmanageable side effects.”
Dr Henry says large-scale studies and clinical trials are needed so the safety, efficacy and long-term effect of using medicinal cannabis to treat endometriosis-related pain can be further evaluated.
“In particular, it is important to understand how medicinal cannabis treats pain and for who it would work best.
“Endometriosis pain management is often complex and individualized, and while CDB had benefits in terms of pain relief and improved sleep for many of our participants, we still need to understand how it works and what the long-term effects from its use might be.”
Published in journal: BMC Complementary Medicine and Therapies
Authors: Claire Henry, Lily Cooper, Hannah Adler, Justin Sinclair, Alexander Martin, Alex Semprini, Antonina Mikocka-Walus, and Mike Armour
Source/Credit: University of Otago
Reference Number: med031126_01
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