A new study on the use of marijuana to treat endometriosis finds that women who consumed cannabis rated it as “the most effective self-management strategy to reduce symptom intensity” of the often painful inflammatory disease.

“Results suggest that Cannabis has become a popular self-management method for treating endometriosis-related symptoms,” authors wrote, “leading to substantial symptom improvement.”

The study, published this month in the journal Gynecologic Endocrinology and Reproductive Medicine, analyzed survey responses from 912 adult endometriosis patients in Germany, Austria and Switzerland. Of those, 114 patients (17 percent) reported using marijuana to help manage the condition, a chronic inflammatory disease related to cell growth in the uterus that can cause an array of pain symptoms.

Endometriosis affects between 2 percent and 20 percent of women of reproductive age, the study says. On average, respondents said it took them about nine years to receive a diagnosis.

Large majorities of cannabis users reported improvements in pain and other symptoms. And although some survey respondents reported increased fatigue related to marijuana use, side effects were otherwise minimal.

“The greatest improvement was observed in sleep (91%), menstrual pain (90%), and non-cyclic pain (80%),” results of the German-language survey showed. “Apart from increased fatigue (17%), side effects were infrequent (≤ 5%).”

“Additionally, ~90% of the participants were able to decrease their pain medication intake.”

Moreover, about 90 percent of participants reported decreasing their pain medication intake as a result of marijuana use.

“Cannabis use resulted in a significant improvement in symptoms, going beyond just pain management, and a majority of users were able to reduce their pain medication intake,” the report says. “Adverse effects were found to be rare. Nevertheless, more research is required to determine the best route of administration, dosage, THC/ CBD ratio, potential side effects, and long-term effects of cannabis use.”

“The study indicates that there is a significant interest and demand for additional therapeutic options,” it adds, “and cannabis can potentially become an important part of a multimodal therapy approach for treating endometriosis.”

Notably, cannabis users were also more likely to have tried different pain medications in the past. Generally, results indicated that people who used marijuana also experienced more severe pain and perceived pain medication to be less effective.

Some patients also reported that the chief side effect of cannabis use—fatigue—actually provided some benefits, though feelings varied across the group.

“Regarding the side effects of cannabis, some individuals find the occurrence of fatigue pleasant, leading to fewer sleep problems in the evening and at night,” the report says. “However, for others, this fatigue becomes a significant disadvantage, primarily limiting its use in the morning.”

The study was conducted by a four-person research team from the Department of Gynecology with the Center of Oncological Surgery at the Endometriosis Research Center Charité in Berlin, Germany.

“At the time of the study,” authors noted, “Cannabis consumption was still illegal in Germany, Austria, and Switzerland, with medical cannabis being rarely prescribed due to complex requirements.”

Nevertheless, they pointed out that existing therapy options “do not always provide sufficient pain relief and often cause unpleasant side effects.”

Prior research was limited and suggested cannabis may not be particularly effective, the team wrote, but “cross-sectional surveys with endometriosis patients from Australia, New Zealand, Canada and the US showed that self-management strategies are very common in those patients and that cannabis and cannabis products are among the most effective at pain reduction.”

“Thus, we aimed to determine, for the first time, the Cannabis use prevalence, self-rated effectiveness, and the possible reduction in medication in German-speaking countries,” the study says.

Authors said that in light of their findings, further research is needed to shed more light on how marijuana might help manage endometriosis, which would better facilitate “official recommendations to patients and healthcare providers.”

Regarding the need for further research, one of the takeaways from the team's findings is that “experiences related to the psychological effects of cannabis vary widely”—something that could be exacerbated by existing legal and social obstacles to cannabis use.

“While some users report 'reduced anxiety/despair' and improvements in mental health, others have observed a worsening of these conditions,” the study says. “However, almost all responses focused on structural issues: cannabis is challenging to obtain, physicians are poorly or not informed at all, cost coverage by health insurance is laborious and partially unsuccessful, dosages vary significantly, and there are few alternatives in terms of administration methods.”

“Additionally,” it adds, “concerns exist regarding stigmatization in the workplace and personal environment, impaired driving ability, and the potential for dependency.”

Findings that cannabis might help manage endometriosis symptoms, however, “closely align” with the results of some past studies, for example, one conducted in Australia that surveyed 484 people.

“The proportion of use of self-management strategies is similar,” authors of the new research noted, “but the percentage of cannabis users in our study is slightly higher (13% vs. 17%).”

In Canada, where marijuana was legalized nationally in 2018, the team added of other research, “prevalent use of 54% was determined among endometriosis patients.”

“It has been shown by various research groups that Cannabinoids can have positive effects on patients with endometriosis,” the study says. “However, to verify these findings, clinical trials with a defined dose, application form, and frequency are required. It is important to focus not only on symptom improvement but also on side effects. Since most endometriosis patients are young women of childbearing age, it is critical to thoroughly investigate other possible consequences, such as the development or intensification of psychoses or influences on the embryo in case of pregnancy.”

Separate research published earlier this year found that CBD appeared to alleviate menstrual-related symptoms such as irritability, anxiety, stress and other measures when compared to participants' baseline measures. Depression scores, however, did not change.

An earlier study similarly called CBD-infused tampons a “promising option” to treat menstrual pain.

Meanwhile, a number of U.S. states are considering adding female orgasmic disorder (FOD) as a qualifying condition for medical marijuana in what supporters say is a response to a growing body of research suggesting marijuana can improve orgasmic frequency, ease, and satisfaction in people with FOD.

A 2020 study in the journal Sexual Medicine found that women who used cannabis more often had better sex.

Because past findings indicated women who have sex with men are typically less likely to orgasm than their partners, authors of a study in the Journal of Cannabis Research said marijuana “can potentially close the orgasm inequality gap.”

Written by Ben Adlin for Marijuana Moment | Featured image by Gina Coleman/Weedmaps