(Photo credit: Marie Jeanne).
Women with endometriosis experienced significant reductions in pain, painkiller use and several other symptoms after three months of treatment with oral marijuana extracts containing THC and CBD, according to a new study published yesterday in PLOS One.
The prospective pilot study included 30 premenopausal women between the ages of 18 and 45 with confirmed endometriosis and chronic pelvic pain. Twenty-seven completed the full three-month treatment period.
Participants received standardized oral cannabinoid-based medicinal products containing a balanced ratio of THC and CBD. Researchers assessed pain intensity, number of pain days, use of analgesics, fatigue, anxiety, disability, central sensitization and quality of life before and during treatment.
Significant improvements were apparent after the first month and generally continued through the three-month study period.
Pain intensity declined significantly over the course of treatment, with researchers reporting a p-value of 0.0004. Participants also experienced fewer days with pain and significantly reduced their use of conventional pain medications.
That reduction included nonsteroidal anti-inflammatory drugs such as ibuprofen and diclofenac as well as opioid painkillers including tramadol, tilidin and oxycodone. The overall reduction in analgesic use was statistically significant at p<0.001.
Researchers also documented significant improvements in fatigue, anxiety, central sensitization and disability. Scores on the Endometriosis Health Profile-30, a questionnaire designed to measure the condition’s impact on quality of life, improved as well.
Anxiety showed one of the strongest statistical changes, with researchers reporting p<0.0001. Central sensitization — an increased responsiveness of the nervous system that can contribute to persistent pain — and disability also improved at p<0.0001.
The treatment was generally well tolerated. Reported side effects were predominantly mild and temporary and occurred most often while participants were gradually adjusting their doses. Adverse effects became less frequent as treatment continued.
The researchers said the results provide preliminary evidence that oral cannabinoid preparations could serve as an adjunct treatment for women experiencing endometriosis-related chronic pain and other symptoms.
However, the study was small, conducted at a single center and did not include a placebo or untreated comparison group. Because of the observational design, the findings establish an association between treatment and improvements but cannot prove that the cannabinoid extracts were responsible for the changes.
The researchers called for larger randomized controlled trials to confirm the findings, assess longer-term treatment and determine optimal THC and CBD dosing strategies.
The study, “Evaluating the impact of cannabinoid extracts on chronic pain and quality of life in endometriosis patients — a pilot study,” was conducted by researchers associated with Charité – Universitätsmedizin Berlin and its Endometriosis Research Centre.
