Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms

Summary & key facts

Researchers looked back at records from a phone app where people with self-reported endometriosis logged their cannabis use and symptom ratings from April 2017 to February 2020. Two hundred and fifty-two people logged about 16,000 use-sessions. Overall, users said cannabis reduced pelvic pain, gut symptoms, and low mood, but how well it worked depended on how it was taken: inhaled cannabis seemed better for pain and oral cannabis seemed better for mood and stomach problems. The data came from users’ own reports, so it can’t prove cannabis causes the improvements. The authors say controlled clinical trials are needed.

Key facts:

• The study used app records from 252 people who said they had endometriosis and who logged about 16,000 cannabis use sessions between 2017 and 2020.
• About two-thirds of the sessions involved inhaling cannabis, such as smoking or vaping.
• Around 60% of sessions were recorded as treating pain, making pain the most common reason people used cannabis in the app.
• Gastrointestinal complaints, like stomach pain or nausea, made up about 15% of sessions but showed the biggest self-reported improvement after cannabis use.
• Inhaled cannabis was reported to work better for relieving pain, while oral cannabis products were reported to work better for mood and gastrointestinal symptoms.
• Typical inhaled use in the app had a median of about 9 puffs per session. Oral products in the app had a median concentration around 1 milligram per millilitre.
• The balance between THC and CBD in products showed a small effect on how much symptoms improved, and this effect varied by how the cannabis was taken.
• All data were self-reported from an app and looked at after the fact. That means the study can show associations but cannot prove cannabis caused the symptom changes.
• The authors say randomized clinical trials, which test cannabis under controlled conditions, are urgently needed to know if cannabis is safe and truly effective for endometriosis symptoms.

Abstract

BACKGROUND: The use of cannabis for symptoms of endometriosis was investigated utilising retrospective archival data from Strainprint Technologies Ltd., a Canadian data technology company with a mobile phone application that tracks a range of data including dose, mode of administration, chemovar and their effects on various self-reported outcomes, including pelvic pain. METHODS: A retrospective, electronic record-based cohort study of StrainprintTM users with self-reported endometriosis was conducted. Self-rated cannabis efficacy, defined as a function of initial and final symptom ratings, was investigated across the included symptom clusters of cramps, pelvic pain, gastrointestinal pain, nausea, depression, and low libido. Cannabis dosage form, dose and cannabinoid ratio information was also recorded. RESULTS: A total number of 252 participants identifying as suffering endometriosis recorded 16193 sessions using cannabis between April 2017 and February 2020. The most common method of ingestion was inhalation (n = 10914, 67.4%), with pain as the most common reported symptom being treated by cannabis (n = 9281, 57.3%). Gastrointestinal symptoms, though a less common reason for cannabis usage (15.2%), had the greatest self-reported improvement after use. Inhaled forms had higher efficacy for pain, while oral forms were superior for mood and gastrointestinal symptoms. Dosage varied across ingestion methods, with a median dose of 9 inhalations (IQR 5 to 11) for inhaled dosage forms and 1 mg/mL (IQR 0.5 to 2) for other ingested dosage forms. The ratio of THC to CBD had a statistically significant, yet clinically small, differential effect on efficacy, depending on method of ingestion. CONCLUSIONS: Cannabis appears to be effective for pelvic pain, gastrointestinal issues and mood, with effectiveness differing based on method of ingestion. The greater propensity for use of an inhaled dosage delivery may be due to the rapid onset of pain-relieving effects versus the slower onset of oral products. Oral forms appeared to be superior compared to inhaled forms in the less commonly reported mood or gastrointestinal categories. Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.

Topics

Cannabis and Cannabinoid Research Endometriosis Research and Treatment Ion Channels and Receptors

Categories

Health Sciences Medicine Reproductive Medicine

Tags

Abdominal pain Cannabis Depression (economics) Economics Endometriosis Gastrointestinal function Ingestion Internal medicine Macroeconomics Medicine Mood Nausea Pelvic pain Psychiatry Retrospective cohort study Surgery

Substances

Cannabis

Conditions & symptoms

Chronic Pain Depression Chronic pain Sadness or low mood