Consuming cannabis can help alleviate the painful symptoms endometriosis, and Canadians are using legal weed to manage them, new research shows.
A study released Tuesday in PLOS One, looked into the effectiveness of Canadians using regulated cannabis to treat a variety of symptoms linked to endometriosis, including chronic pelvic pain, fatigue, period pain (dysmenorrhoea), painful sex (dyspareunia), painful bowel movements (dyschezia) and pain related to urination (dysuria).
“Cannabis appears to be effective across all reported symptoms, with a noted propensity for inhaled delivery due to the potential increased speed of onset of effects versus the slower onset of oral products, particularly for pelvic pain,” reads the study.
It’s estimated that 5–11 per cent of reproductive-aged people are impacted by endometriosis — about 176 million people worldwide. Endometriosis can also affect those who have gone through menopause, accounting for about 2–5 per cent of cases.
Co-morbid anxiety or depression is frequently reported by people who suffer from endometriosis, and the disease can cause “a noteworthy cost of illness burden to the economy, mostly due to lost productivity,” researchers said.
Previous research had shown promise in using illicit cannabis to treat endometriosis pain and co-morbid symptoms. But since those findings relied solely on self-reported data, and couldn’t reliably be used to determine the effectiveness in terms of dosage, different modes of consumption and other determining factors, this study sought to investigate regulated products.
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Archival data shows cannabis helps manage symptoms
Using archival data from the Strainprint smartphone app, which tracks usage of regulated medical pot, researchers were able to look at varieties of cannabis, dosage and changes in symptom severity over time in 252 users with endometriosis.
Before consuming weed, participants opened the app, entered their age and gender and identified the medical condition or symptoms they were treating with cannabis.
After symptoms were rated on severity, and weed products and dosages were entered, users set a time period (20 minutes if inhaling cannabis and 90 minutes if ingesting) to reevaluate symptoms.
The mean age of participants was 35 years old. Inhaling cannabis accounted for 67.4 per cent of all dosage forms, and orally-ingested accounted for 32.3 per cent. Chart via ‘Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms’
Most participants (42.4 per cent) used cannabis to treat pelvic pain, followed by gastrointestinal distress (15.2 per cent) and cramps (14.9 per cent). Nausea and depression were noted too, at 13.9 per cent and 13.2 per cent respectively.
Read more: Cannabis eases severe morning sickness: study
Researchers found consuming weed had a positive effect on managing pain associated with endometriosis symptoms.
Whether cannabis was ingested orally or inhaled, both ways are “similarly efficacious,” and researchers pointed out that there was no difference between the two methods when treating pelvic pain.
But it’s noted that the app accounted for the difference in speed both methods take to kick in, so the effectiveness doesn’t show the whole picture of onset for pain relief.
A microscopic image of endometriosis in the fallopian tube. The dark blue areas indicate the presence of endometrial glands, one of three criteria to diagnose the disease via microscopic analysis. Photo by Ed Uthman via Wikimedia Commons
The difference in speed could help because patients with endometriosis have both chronic and acute pain, often called endometriosis “flares.”
“Such sudden-onset pain events require a fast analgesic onset for immediate symptom relief and may explain the prevalence of the inhaled route for dose delivery,” reads the research.
While close to half of participants used weed for pelvic pain, the largest effect was seen for gastrointestinal symptoms.
Ingesting cannabis seemed “superior” compared to inhaling it for less commonly reported mood or gastrointestinal issues.
Whether inhaled or ingested, the effectiveness of treating symptoms seemed to increase with age, but researchers aren’t exactly sure why.
They said it could be an increased sensitivity to medication and drugs that comes with age-related changes to organ function, or changes in pain perception that happened over time in people with endometriosis.
THC and CBD levels varied widely, with inhaled cannabis typically having a higher THC-to-CBD ratio, while edibles tended to be the opposite.
“There was no evidence of a difference in efficacy according to the ratio of THC to CBD between topical and inhaled treatments.”
However, ingested cannabis with particularly high THC levels was found to be slightly less effective than comparable inhaled cannabis.
Read more: Nearly half of US breast cancer patients use cannabis medically, but don’t tell their doctor: study
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