By Dr. Deborah Herchelroath, FACOOG
Endometriosis is a gynecologic condition in which the lining of the uterus, know as the endometrium, is located outside of the uterus. These cells and clusters of cells can be found on the ovaries, the bowel, the peritoneum (the lining of the abdomen and pelvis) and even in distant locations like the lung. This abnormally located endometrium still behaves like typical endometrium, responding to cycling hormones, becoming inflamed and even bleeding. This, in turn, can cause issues such as pain with periods, scarring of the pelvis, pain with sex, infertility and the need for medical, hormonal or surgical treatment. Unfortunately, endometriosis is a chronic, often debilitating disease due to severe pain with limited options (with many adverse side effects) to help treat it.
Medical marijuana (MMJ) has been legalized in many states, including Pennsylvania. There are over twenty diagnoses that PA has included in the MMJ program, including chronic pain. There have been several successful studies evaluating medical marijuana for endometriosis pain.
Our bodies have cannabinoid receptors present in them. This system is call the endocannabinoid system (ECS) and is composed of CB1 and CB2 receptors. In one study, it was found that CB1 agonists (stimulate the receptor) decrease endometriosis-related pain while CB1 antagonists (block the receptor) increase endometriosis-related pain. We can infer that using CBD oil, known for it’s anti-inflammatory and analgesic properties, will decrease endometriosis pain. We can also infer that MMJ, with the addition of THC and it’s analgesic properties, will also decrease endometriosis pain.
I have personally treated patients who have successfully used both CBD oil and MMJ to manage and treat their endometriosis-related pain and avoid surgical intervention. This is a win for both younger patients who want to avoid surgery to maintain their fertility and older patients who just want to make it to menopause, when endometriosis typically calms down due to the change in hormonal status.
Now that MMJ is legal in many states, we should see many more studies confirming the safety and efficacy of cannabinoid use in treating many ailments, including endometriosis.