the chronicThe use of self-management strategies, especially non-pharmacological practices, in chronic illnesses is common. Patients with endometriosis often feel frustrated at the lack of effective medical treatments and therefore turn to self-management as one of the coping strategies to manage their condition. Patients with endometriosis often feel disempowered, and self-management strategies may help them feel a sense of agency and empowerment.- Self-management Strategies Amongst Australian Women with Endometriosis: A National Online Survey
Self-management techniques are commonly used by endometriosis patients and can play a key role in endometriosis care. Self-management can be self-care and lifestyle choices that mitigate symptoms, reduce stress and pain, manage side effects from medications, or treat endometriosis. A popular self-management strategy is cannabis.
Cannabis is a flowering plant that is harvested for various uses including potential medicinal applications. Parts of the cannabis plant have psychoactive, or mind-altering properties. This includes the flowers which are also known as marijuana. Derivatives of the cannabis plant are hemp and CBD oil, which do not have psychoactive properties.
Patients with endometriosis self-report that cannabis use is an important and beneficial treatment. Cannabis was the most highly-rated in terms of effectiveness in pain reduction of all the strategies assessed. Cannabis was also reported to result in the greatest reduction in medication usage. Due to the pain reduction, 56% of patients reported that they were able to reduce their pharmaceutical medication by at least half. An additional 27% of patients were able to reduce medication usage by 25-50%.
The greatest improvements from cannabis were reported in sleep, nausea, and vomiting. Few adverse effects were reported and the ones reported were minor. These included side effects like anxiety, drowsiness, and fast heart rate, which were reported by one in ten cannabis users.
When patients were asked about the effect self-management had on their need for medications needed to manage their endometriosis symptoms, the most effective was cannabis. Fifty six percent of cannabis users reported being able to reduce their endometriosis-related medication by more than 50% and another 27% percent of users reported being able to reduce medication by 25–50%.
Hemp and CBD oil were also rated highly in terms of effectiveness in pain reduction. A third of CBD or hemp oil users reported being able to reduce their endometriosis-related medication by 50% or more. This survey highlights the potential efficacy, but further clinical research is needed to determine the effectiveness of cannabis in managing endometriosis symptoms.
A recent study found that THC, the main psychoactive compound of cannabis, limits the development and symptoms of endometriosis in an experimental model. They also found that THC may have a protective effect on the memory of those with endometriosis. It highlights the need for conducting further research to ensure the safety and beneficial effects of this treatment.
The Endocannabinoid System
The endocannabinoid system is responsible for mediating the psychoactive effects of cannabis as well as many physiological processes, including pain sensation. The endocannabinoid system is a regulatory system that includes cannabinoid receptors, ligands, and enzymes which are located throughout the body. They are the most prevalent in the immune system, central nervous system, and the female reproductive system.
The endocannabinoid system interacts with mechanisms that play an important role in endometriosis-associated pain and in the establishment of the disease, its maintenance, and recurrence. It also contributes to mechanisms underlying the peripheral innervation of the abnormal growths. Studies suggest that approaches targeted at the endocannabinoid system may serve as a promising new method for treating endometriosis-related pain.
The endocannabinoid system has emerged recently as an important factor in endometriosis development, maintenance, and pain mechanisms. These new revelations suggest that the endocannabinoid system may potentially serve as a pharmacological target for endometriosis treatments, including pain management, and have a role in immune intervention and antiproliferative and antifibrotic effects.- The Clinical Significance of Endocannabinoids in Endometriosis Pain Management
Several studies have described endometriosis as an endocannabinoid deficiency condition. The growth of endometriosis tissue and more severe pain are potentially related to reduced endocannabinoid function. Patients with endometriosis have been found to have lower levels of certain endocannabinoid receptors in their endometrial tissue.
Various interactions between the endocannabinoid system and pain-associated mechanisms in endometriosis patients occur. These include involvement of neuropathic and inflammatory pain, changes in central and peripheral neural system, and the expression of cannabinoid receptors. Modulating the endocannabinoid system appears to be a beneficial therapy for addressing these various components and reducing pain. Cannabis may relieve endometriosis-related pain by interacting with the endocannabinoid system with its chemicals, including tetrahydrocannabinol (THC) and cannabidiol (CBD). More studies are needed to further our knowledge of the endocannabinoid system and to learn more about the potential side effects of cannabis for endometriosis treatment.
Resources
The following resources provide more information on cannabis use for endometriosis:
- Weed And Vagina Problems: The Story Of Lara Parker, Cannabis And Endometriosis Activist looks at the role cannabis plays in an endometriosis patient's treatment.
- Lara Parker's Instagram addresses endometriosis, vaginal problems, body positivity, and medical marijuana.
- The New Breakthrough for Endometriosis: Cannabis? provides a deeper look at the endocannabinoid system and how cannabis works in the body.
- 1 in 10 Women with Endometriosis Report Using Cannabis to Ease Their Pain discusses the results of a survey of endometriosis patients.