Is cannabis the next endometriosis drug? Unfortunately, clinical trials testing the herb’s potential to heal or manage symptoms of the condition are lacking. However, pre-clinical experiments and research on women with the condition point out the great potential of cannabis medicines. Here’s what the studies say about cannabis and endometriosis.
What is endometriosis?
Endometriosis is a condition which affects women and girls. Tissue that lines the uterus begins to proliferate and develop outside of the organs. This tissue is called endometrium, and it is the same tissue that is shed during the monthly menstrual cycle.
The excess tissue responds to the menstrual cycle just like normal endometrial tissues does. Lesions consisting of misplaced endometrial tissue begin to slough during a woman’s regular period, causing extreme pain, cramping, internal bleeding, scarring, and inflammation.
The main symptoms of endometriosis include:
- Pain, especially before and during periods
- Painful sexual intercourse
- Pain during urination and bowel movements
Unfortunately, there aren’t many effective options for managing endometriosis. Pain medication is often prescribed to manage some of the most debilitating symptoms of the condition.
The most common treatment is hormonal birth control and other forms of hormone therapy. However, these treatments can cause mood swings, hot flashes, weight gain, and fatigue.
In severe cases, surgery may be required to remove excess tissue.
Endocannabinoids and endometriosis
The exact cause of endometriosis is unknown. However, recent research suggests that the endocannabinoid system (ECS) may be involved.
The ECS is a large network of cell receptors and corresponding agonists, called endocannabinoids. Just as a key fits into a lock, endocannabinoid agonists fit into specific sites on the surface of a cell.
Once connected, endocannabinoids give a chemical signal to the cell. This signal tells the cell what to do. The ECS controls many basic functions in the body, including mood, metabolism, sleep, reproduction, movement, pain and immune response.
Some researchers think that an imbalance of the ECS contributes to endometriosis. Cannabinoid receptors are present in the endometrium itself. During different times of the month, these receptors are more abundant in the tissue than at other times.
This is partly due to the fact that endocannabinoids are controlled by sex hormones, which also determine the various stages of a woman’s menstrual cycle.
Cannabinoids and the cause of endometriosis
As mentioned above, no one knows the exact cause of endometriosis. However, there is some strong evidence that environmental factors are to blame. Some of the most compelling research revolves around the environmental toxin, dioxin, and the disease.
Dioxin is a carcinogenic chemical pollutant that can be found in polluted drinking water, at old Superfund sites, garbage burning sites or operations, and in some forms of clay. They are also found in pesticides and are released during the paper bleaching process.
According to the U.S. Environmental Protection Agency (EPA), dioxins are incredibly toxic and can cause reproductive issues, cancers, developmental problems, hormone problems, and problems in immune function.
Recent research has linked dioxins with both the development of endometriosis and with endocannabinoid deficiency. A study conducted by the Endometriosis Association looked at the impact of dioxin on monkeys.
They found that 79% of monkeys exposed to dioxin developed endometriosis. The greater the dioxin exposure, the worse the disease condition.
In 2012, a landmark study published in Fertility and Sterility discovered the link between dioxin and poor endocannabinoid function. In fact, the study authors were the first to figure out that acute dioxin exposure disrupts endocannabinoid signaling, causing both an endocannabinoid imbalance and perhaps endometriosis.
This is a great sign that cannabinoid therapy may help those either exposed to dioxin or who have been diagnosed with endometriosis.
Does cannabis treat endometriosis?
Unfortunately, there are no cannabis-specific studies in endometriosis research. However, the evidence that some sort of cannabis therapy may help the disease is pretty promising.
A study published this year  found that women with endometriosis had more endocannabinoids (keys) in circulation than they had cannabinoid receptors (locks) during the secretion phase of the menstrual cycle.
The secretion phase is when the endometrial tissue begins to shed. This is when the most significant pain and abdominal cramping occurs.
To the researchers, too many keys and too few locks may contribute to the intense pain experienced by patients with endometriosis.
Further, an earlier 2010 study found that activating the CB1 receptor decreased the hypersensitivity to pain that most endometriosis patients experience.
Yet, things may be even more complicated than they seem.
A recent article, published online ahead of print, found that activation of the cannabinoid receptor 1 (CB1) may contribute to endometriosis in rodent models. The CB1 receptor is the binding location for the primary psychoactive in the cannabis plant, tetrahydrocannabinol (THC).
The researchers treated mice with a compound that engaged the CB1 receptor. Mice that received the treatment had larger lesions and greater accumulation of endometrial tissue than their untreated counterparts. However, this study was conducted in mice, and may or may not apply to human manifestations of the disease.
While the outcomes of these studies may seem confusing and contradictory, all endeavors agree that medicines which target the endocannabinoid system may provide a novel and much-needed future treatment for the disease.
4 additional benefits of cannabis
Inflammation plays a major role in endometriosis. In fact, hormone imbalances and a lack of proper endocannabinoid tone may contribute to excess inflammation in those with the disorder. This excess inflammation is associated with pain and uncomfortable cramping.
Cannabis compounds are potent anti-inflammatory agents. In fact, a 2014 study found that psychoactive THC may influence the expression of genes that ultimately control inflammation, causing an anti-inflammatory reaction.
Nonpsychoactive CBD may have an impact as well. The anti-inflammatory and immuno-modulatory effects of the compound are well-recorded. CBD engages with the body’s immune system, improving endocannabinoid tone and reducing pain and inflammation.
2. Cell growth and death
Interestingly, the anti-tumor properties of the cannabis plant may help treat endometriosis. In pre-clinical trials, cannabis had an anti-proliferative effect in cancer cells. Turns out, the herb may have the same effect in endometriosis.
In 2010, researchers discovered that cannabinoid treatment reduced the growth of endometrial tissue in mice. The mice had been implanted with human endometrial tissue. The authors ultimately concluded that cannabinoid treatments may have an impact on the proliferation of the disease.
Compounds in the herb also triggered a process known as apoptosis. Apoptosis is cell-suicide. Normally, cells undergo apoptosis, a form of programmed cell death, when they are damaged or diseased. In cancer cells, however, tumor cells stop self-destructing. Instead, they continue to proliferate.
Research from the past decade has shown that THC treatment may cause tumor cells to commit suicide in cell line and animal models.
Endometriosis is another disorder in which cells begin to grow and migrate in an irregular manner. While more research is sorely needed, it is known that cannabinoids have a major effect on the growth and death cycles of cells.
3. Pain relief
The analgesic properties of cannabis are quite famous. It is often used to manage chronic pain after injury and is recommended to patients undergoing chemotherapy. New reports have shown that many patients in medical cannabis states choose the herb over opioid pain treatments for dealing with chronic pain.
For more information on cannabis and pain, see the full article here.
4. Anti-nausea and diarrhea
Nausea and diarrhea are two of the lesser discussed symptoms of endometriosis. Fortunately, the anti-emetic properties of cannabis are well-known. Cannabis-like pharmaceutical drugs are already available to cancer and HIV/AIDS patients who experience intense nausea and appetite loss.
The herb can also ease intestinal cramping and slow intestinal motility. While this many not be ideal for those who struggle with constipation, diarrhea doesn’t stand a chance against cannabis.
This is perhaps one reason why the herb is so popular among those with irritable bowel syndrome.
For more information on cannabis and the gut, see the full article here.
High-CBD strains for endometriosis
There is not enough total research on cannabis treatments for endometriosis to determine whether or not cannabis is a helpful treatment. However, those interested in using the herb for symptom relief may be interested in cannabis strains high in cannabidiol (CBD).
CBD is nonpsychoactive and can provide pain and inflammation relief for a variety of different conditions. For those unfamiliar with cannabis, CBD is a great place to start. Some strains include:
Many patients self-medicate with cannabis to control symptoms of PMS, PMDD, and endometriosis. However, no formal trials of cannabis treatments have been conducted. This means that patients are taking a risk should they choose to use cannabis as medicine.
Always talk to your doctor before making any changes to your treatment plan.