Managing endometriosis pain with cannabis

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Women with endometriosis seeking pain relief may want to consider cannabis or cannabidiol (CBD), according to a recent study presented at the 2019 American Association of Gynecologic Laparoscopists (AAGL) Global Congress in Vancouver, Canada. The survey aimed to identify the prevalence of medical cannabis use among endometriosis patients as well as the effectiveness of both cannabis and cannabidiol in their pain management.

Methods
The online REDCap survey invited participants through email and contained 50 to 75 questions based on branching logic. The questions focused on pelvic pain history, demographics, and experience with cannabis and CBD for management of pelvic pain. Participants were identified through an ICD-10 code for endometriosis diagnosis at a clinic or from the mailing list of the Endometriosis Association.

Anna Reinert, MD, the presenting author noted “Our participation was very different between our two groups. The invitation stressed that this was an anonymous survey, but I think there’s still a lot of taboo around this topic. For the Endometriosis Association, only 1.4% of participants replied, which is much lower than the participation rates for other surveys that were being sent out around the same time frame. From our clinic population, we had about 16%.”

Findings
Of the 240 respondents from the Endometriosis Association, 77 (32.1%) reported having tried cannabis, with the majority of these participants (52 of 77, 67.5%) reporting cannabis to be very or moderately effective. Of the 124 clinic respondents, 58 (46.8%) reported having tried marijuana, with the majority of patients (44 of 58, 75.9%) reporting cannabis to be very or moderately effective.

Sixty-seven respondents from the Endometriosis Association reported having tried CBD, with 50% (34 of 67) reporting CBD to be very or moderately effective. Fifty-seven clinic respondents reported having tried CBD, with 64.9% (37 of 57) reporting that CBD was very or moderately effective in pain reduction.

In terms of effectiveness, participants from both groups were more likely to report cannabis as very effective (40.2% of Endometriosis Association participants, 53.4% of clinic participants) on a Likert scale. CBD was more likely to be reported on a Likert scale as moderately effective in both groups (31.4% of Endometriosis Association participants, 36.8% of clinic participants).

Looking ahead, Dr. Reinert said, “Further research is needed to explore the potential benefits and clarify the limitations and risks of the use of cannabis for the management of chronic pelvic pain and endometriosis.”