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Endometriosis is a Disease of Chronic Inflammation

Dragana Komnenov PhD
cannabis, medical cannabis, recreational cannabis, women's health, endometriosis, legalization, pain, estrogen, hormones, health benefits, health risks

New research has begun on how cannabinoids stop the progress of endometriosis, and treat its symptoms of inflammation and pain.

The pain of endometriosis can be debilitating at the time of menstruation; cannabis has a solution for that. Endometriosis is a painful condition that affects 200 million women worldwide, with an estimated 1 in 10 (in the US) remaining undiagnosed.  Pain that is specific to women tends to be under-represented in research. Endometriosis is no different, and as such, many women seek alternative treatments; cannabis has proven to be effective in treating the symptoms of endometriosis.

What is Endometriosis?

Endometriosis occurs when the uterine lining grows outside the uterus, such as onto the ovaries, cervix, bladder, and any other pelvic organs. When the lining breaks down, during menstruation, that blood has nowhere to go, leading to severe pain, cysts, and infertility. Women also experience pain during intercourse and severe cramping. For some, the pain is as strong as if one were having a heart attack.

Endometriosis advocates urge medical experts to take women’s pain more seriously, and treat this as an issue deserving of research.

How is Endometriosis Treated?

Well, unfortunately, when research is lacking, so too are treatments. Many women face a litany of “try this” before being permitted the option of surgery. Some women, like Lena Dunham, end up having a hysterectomy after struggling with untreated endometriosis.

Doctors often prescribe opioid medications to relieve the pain. Many women end up going through a trial and error process to find the right one, sometimes never finding one that fully relieves their pain while still allowing them to function in their life. On top of this, they fight seemingly endless side effects. All while they battle the symptoms of their condition, and also face addiction.

Opioids solve one problem (pain) by creating mass risk for another (addiction). With the opioid epidemic sweeping across North America, it’s no wonder that women are hesitating to resort to this medicine, even when over-the-counter pain killers can’t cut it.


How Does Cannabis Help?

Cannabis helps women return to a higher quality of life. CBD-rich strains, in particular, reduce the pain caused by endometriosis as CBD is a powerful anti-inflammatory, the key source of pain for endometriosis patients.

You can vape CBD flower, use medibles, take a tincture, or even use a full spectrum oil derived from a strain that is  high in CBD.

If the pain is persistent, add in a higher concentration of THC. CBD and THC have a synergistic effect on pain.  Strains like ACDC, Ringo’s Gift, Stephen Hawking Kush, Canna-Tsu, and Harlequin are all high in CBD but also possess a nice ratio of THC (ideally 1:1).

Cannabis is a viable option if:

  • you are concerned about the side effects or addiction issues of opioids
  • other treatments have not been effective.

Visit a cannabis physician that can help you figure out which strain and method of consumption is right for you.

Woman with pain in her uterus


More Research on Cannabis for Endometriosis

A leading Israeli research group announced that it will investigate the therapeutic potential of cannabis in endometriosis treatment.  Research is significantly lacking in this area. Over the last decade, some have come to suggest that cannabinoids inhibit the abnormal growth common with this condition. Some researchers believe they restore the balance between cellular growth and cell death, programmed activities of the cell under normal conditions.

Given that the current medical treatments are marginally successful in relieving only some of the symptoms associated in endometriosis (i.e. pain), there is an unmet need for novel, successful therapeutic strategies. The etiology of endometriosis includes inflammation, cell proliferation and cell survival.

The first question arising when considering any treatment is whether the receptors for that substance exist in the target tissue. Fortunately, both CB1 and CB2 receptors (and the enzymes that participate in endocannabinoid turnover) are expressed by many cell types in the human endometrium.

Additionally, the uterus contains a high concentration of anandamide, an endocannabinoid.  This tells researchers that cannabinoids from the cannabis plant will also engage with tissues in the uterus.

Cannabinoids as Anti-Inflammatory Agents

Equally important are the studies that have been published describing the role of cannabinoids as anti-inflammatory and anti-proliferative agents. Both of these properties will help treat the symptoms endometriosis.

These studies have also demonstrated that THC has a biphasic effect, a phenomenon that seems to be repeating. At low concentrations (nanomolar range) it has pro-proliferative effect, and at higher concentrations (micromolar range) it has inhibitory effect on cell-proliferation.

Therefore, it is in these higher concentrations that THC would potentially be beneficial in endometriosis. It would inhibit abnormal endometrial cell proliferation. In fact, one study addressed the role of cannabinoids in the proliferation of endometrial cells and showed that treatment with CB1 and CB2 agonist compound both in vitro and in vivo in a mouse model had anti-proliferative effect.

cannabis, cannabinoids, CBD, THC, endocannabinoid system, endometriosis, hormones, research, women, anandamide

How Cannabis might help Endometriosis

Since endometriosis is a chronic inflammatory disease, it is tempting to speculate that the anti-inflammatory effects of cannabinoids would be highly successful as a therapeutic strategy. Women suffering from endometriosis have elevated levels of circulating cytokines and other inflammatory markers. These constitute a risk for development of autoreactivity (i.e. autoimmune disease).

Immune cells express CB2 in abundance and much less CB1, and it seems that the activation of CB2 receptors is central to the immunosuppressive effects of cannabinoids . This would be beneficial in case of endometriosis. Especially when the inflammation is rampant and out of control.

Granted, under specific conditions cannabinoids can also kick start the immune response, but this seems to be mediated via CB1 receptor activation. Therefore, we need to develop cannabis-based modulators that are CB2 specific.

Research into the potential therapeutic benefit of cannabis-based medicine in endometriosis is only beginning. Since cannabinoids can bind to different cannabinoid receptors. Alternatively, they will bind to non-cannabinoid receptors. Further, they have a dose-dependent effect. Because of these factors, the road to discovery is likely still  long. Nevertheless, studies over the past decade have paved the way for future research.

Dragana Komnenov
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