It is estimated that between 5 and 30 percent of women of reproductive age struggle with endometriosis, which translates to approximately 180 million women worldwide (including approximately 1 million Polish women). The pain and other ailments associated with the disease negatively impact patients' quality of life, their psychological well-being, and their satisfaction with life. Diagnosing and treating endometriosis are complex and lengthy. Research into the potential use of CBD and other cannabis cannabinoids in patients with endometriosis has been ongoing for years. Results from studies involving patients confirm the beneficial effects of CBD in endometriosis.

What is endometriosis?

Endometriosis is a chronic, autoimmune disease that involves the presence of cells from the lining of the uterus – the endometrium – outside the uterine cavity, where they should not be physiologically present.

The endometrium is the lining of the uterus. It grows during the menstrual cycle, creating a favorable environment for a fertilized egg to fertilize. If fertilization doesn't occur, it sheds during menstruation. In some cases, menstrual blood, along with endometrial cells, leaks into the abdominal cavity and begins to grow elsewhere in the body.

Abnormal endometrial cells form cysts in the ovaries, ovarian fossa, and uterosacral ligaments. They can also occur in other pelvic locations, such as the intestines, stomach, and bladder, and, less frequently, in distant sites within the woman's body, such as the pleura, pericardium, orbit, and brain.

In some patients, in parallel or independently of endometrial cysts outside the uterus, a specific form of endometriosis develops – adenomyosis, which involves the formation of endometrial foci in the muscular layer of the uterine wall. This leads to a disruption of its structure, its "clumping," and is associated with pain in this organ.

Growing, infiltrating endometrial cysts can lead to serious health complications, both physically and mentally, such as:

fusion of internal organs, which may lead to impairment of their functioning,
inflammation digestive system,
chronic, severe pain that causes disturbances in the functioning of the nervous system, which leads, among other things, to hyperreactivity to pain signals,
mental problems (depression, anxiety).

Symptoms and diagnosis of endometriosis

Endometriosis is a complex, heterogeneous disease whose symptoms vary in severity among patients. Symptoms are often nonspecific, endometriosis can be confused with other diseases, and diagnosis is usually lengthy, requiring patients to consult with multiple specialists and undergo various tests to rule out other conditions.

Obtaining a diagnosis often takes a significant amount of time (even several years), which, as the patients themselves report, negatively impacts their mental health and is often associated with the progression of the disease if left untreated. Patients describe years of "bouncing back and forth between doctors" and experiencing their symptoms being downplayed or "psychiatrized.".

The most common symptoms of endometriosis are:

extremely painful periods,
heavy menstrual bleeding,
pelvic pain (during ovulation or throughout the menstrual cycle),
digestive system complaints (intestinal pain, stomach pain, flatulence, digestive problems, inflammation of the digestive system, bacterial and inflammatory bowel diseases, constipation, diarrhea),
frequent or chronic headaches,
feeling of pressure on the bladder, frequent urination,
numbness of the lower limbs,
joint pain,
painful intercourse,
painful defecation and urination,
feeling of weakness, lack of energy.

Endometriosis treatment

Currently, there is no cure available for endometriosis. The most common treatments offered to patients include: therapy Hormonal therapy and surgical treatment. Urogynecological physiotherapy, light but systematic exercise, and an anti-inflammatory diet are recommended as additional therapeutic tools.

Psychological support is also important, including support focused on better coping with stress, pain management, and learning relaxation techniques to relieve tension in the body.

Sometimes, only surgery, hormonal therapy and systematic use of all the above methods over a longer period of time can reduce the symptoms to a level at which active, satisfactory functioning is possible.

Hormone therapy, like any other long-term treatment, can be tolerated better or worse by patients and is associated with side effects. Some patients choose not to take hormones. In such situations, it is possible pain treatment, following an anti-inflammatory diet, avoiding stress, attending physiotherapy, and practicing light sports. Therapy CBD and other cannabinoids may be part of such an approach to treatment endometriosis.

CBD and other cannabinoids in endometriosis – scientific research

The most important properties of CBD that may be helpful in the treatment of endometriosis include: anti-inflammatory effects, analgesic effects, regulation of the immune system, mood regulation, and stress relief.

Let's take a look at two selected studies on the use of CBD in endometriosis:

An article published in 2022 described the results of an animal study that showed that daily administration of CBD significantly reduced the diameter, volume, and surface area of endometrial lesions and also modified the morphology of the lesions. CBD has shown to work antioxidant, alleviated inflammation in both the collected lesions and peritoneal fluids. CBD also demonstrated analgesic effects.

Patients who self-administer cannabis cannabinoids to alleviate endometriosis symptoms were recruited for a questionnaire study.

The collected data showed that 56% participants experienced a decrease in pain levels of 7.6 points on a 10-point scale during the 6-month treatment period.

The same group reduced their painkiller dose by 50%. Cannabis improved the quality of patients' sleep (some women with endometriosis complain of sleep problems, often caused by pain) and alleviated digestive issues.

A new study by Polish researchers confirms earlier foreign reports. Despite the small study sample (10 patients), the researchers consider the findings significant.
The study lasted 3 months and the endpoints were the assessment of the intensity pain and overall comfort of life of patients before and after therapy. All patients achieved improvement in both assessed parameters with low side effects.

Scientists agree that the current research results encourage further analysis of the effectiveness CBD and other hemp cannabinoids in the treatment of endometriosis. Clinical trials involving patients are currently taking place in several research centers around the world.