Cannabis could help millions of women suffering from endometriosis combat the pain associated with this debilitating disease.
Endometriosis is a chronic disease that affects 6.5 million women in the United States. It causes extreme pain during menstruation and sexual intercourse, as well as chronic pelvic pain, abdominal bloating, nausea, and infertility.
Currently there is no cure and treatment, aimed at controlling symptoms, includes invasive surgery.
Research has suggested that the microbiota (a collection of bacteria in the gut) and neurons called endocannabinoids bind to receptors in the central nervous system that play a role in the development and progression of endometriosis.
Endocannabinoids, as well as cannabinoids, which come from external sources such as ingesting marijuana, have analgesic effects that suppress the processing of pain signals to the brain.
The gut constitutes part of the endocannabinoid system (ECS), which has been found to influence pain levels, making it a promising target for the treatment of chronic pain associated with endometriosis, the researchers said.
An imbalance of these three things can trigger inflammation and increase the presence of bad bacteria in the body, contributing to worsening endometriosis.
The condition affects women of all ages and can cause pain, heavy periods, nausea and diarrhea. It is also a cause of infertility: between 30 and 50 percent of women who struggle to get pregnant have endometriosis (file image)
The uterus is lined by endometrial tissue called the endometrium. The body creates new endometrium with each menstrual cycle to prepare for a fertilized egg, but in cases of endometriosis, that tissue grows on the outside of the uterus.
In the female reproductive organs, endometrial tissue called the endometrium lines the uterus. The body creates new endometrium with each menstrual cycle to prepare for a fertilized egg. But in people with endometriosis, that tissue grows outside the uterus.
As tissue builds up, the risk of painful cysts, scarring, inflammation, and tissue that connects organs and holds them together increases.
This buildup of tissue can block the fallopian tubes (the tubes that eggs travel down to reach the uterus) or form scar tissue, making pregnancy difficult.
There is currently only one trial investigating the use of cannabis for endometriosis pain, specifically with CBD (which is not high) and vaporized THC, the psychoactive substance in cannabis.
The latest study by researchers in Australia and New Zealand builds on findings from more than 140 journal articles that have suggested that circulating levels of endocannabinoids in the blood are correlated with the pain of endometriosis, with low levels of endocannabinoids associated with greater pain.
Some researchers have described endometriosis as an “endocannabinoid deficiency.” In people with endometriosis, too low levels of CB1 receptors have been linked to alterations in the ECS and appear to affect the regulation of pain associated with endometriosis.
Activating specific receptors in the brain (CB1 and CB2) with endocannabinoids found in the body or cannabinoids from elsewhere when smoking or vaping THC can reduce the brain’s perception of pain signals and initiate a pain-relieving effect. .
Experimental models of endometriosis studied in mice have found that repeated exposure to cannabis interferes with the growth of endometrial tissue outside the uterus.
A similar study showed that exposing mice to CBD decreased the diameter, volume, and area of uterine lesions, demonstrating an ability to counteract free radicals in the body that can damage cells.
Therefore, researchers suggest that cannabis use could help women manage the pain levels associated with this serious disorder.
But the evidence on whether cannabis can actually reduce pain is conflicting.
Marijuana advocates claim the drug has countless health benefits, including the ability to relieve aches and pains.
But a U.S. government-backed analysis of 25 trials concluded that there is “very little scientifically valid research” supporting marijuana as an effective pain reliever.
The authors of the latest report from researchers in Australia and New Zealand said: “These promising findings highlight the potential therapeutic benefits of CBD and THC for endometriosis-associated pain, justifying the need for human studies.”
His report was published in the Journal of clinical medicine.
While more than 176 million women suffer from endometriosis worldwide, many struggle to obtain a diagnosis even though the pain interferes with daily life.
There are three types of endometriosis, depending on its location.
The most common is superficial peritoneal endometriosis, which affects the peritoneum or the thin membrane that lines the abdomen and pelvis. This is found in 80 percent of diagnosed women.
A second type of endometriosis also affects the ovaries and causes endometriomas. These are dark, fluid-filled cysts, or “chocolate cysts,” that are most commonly found on the ovaries and affect 17 to 44 percent of patients.
Deeply infiltrative endometriosis, which causes extreme pelvic pain in between one and five percent of endometriosis patients, refers to endometrial tissue that has penetrated organs such as the bowel and bladder. It can become nerves, typically the sciatic nerves, that run through each leg.
It is possible to have more than one type of endometriosis, and it is not clear if they all behave the same way.
Doctors aren’t entirely sure what causes endometriosis, but some believe genes play a role, as does a condition called retrograde menstruation, in which menstrual blood containing endometrial cells passes through the fallopian tubes to the pelvic cavity, where it attaches to the organs.