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Can CBD help with the management of Endometriosis?




Endometriosis is a painful chronic condition that affects approximately 1 in 9 women in Australia. Most women agree that period pain is uncomfortable and sometimes painful. Many women with endometriosis suffer with pain chronically and it can take an average of 6.5 years to get a diagnosis (Endometriosis Australia, 2024). As a result, many women are seeking alternative options for pain management to enhance their quality of life and reduce the severity of their symptoms. There is emerging research on the use of cannabidiol (CBD) in the management of the symptoms associated with endometriosis.  


What is endometriosis and how is it traditionally treated

The exact causes of endometriosis remain unclear, with ongoing research exploring various factors. Epigenetic influences, hormonal imbalances, inflammation, and immune dysfunction are thought to contribute to the disease's development. Women with endometriosis may have compromised immune responses, leading to reduced tissue clearance and increased growth. Estrogen fuels endometriosis growth, often managed post-surgery with hormonal birth control. Elevated inflammatory markers like CRP and CA-125 are common in endometriosis, indicating an inflammatory cascade. This chronic inflammation can lead to progesterone resistance, allowing estrogen to promote further growth and heightened pain perception. Anti-inflammatory treatments can help manage symptoms, highlighting the role of inflammation in the condition


Conventional medical treatment centres around reducing the symptoms of endometriosis and enhancing fertility. This may be done with surgery through laparoscopic removal of tissue or in some cases if required a hysterectomy. Commonly, the birth control pill is often prescribed as a hormonal therapy to reduce pain around menstruation (Sarris & Wardle, 2015).


What is CBD and how does it work 


Cannabidiol (CBD) is one of over 140 different cannabinoids found in the cannabis plant. It is most often dispersed in oil (e.g., CBD oil) and this is currently the most common way it is administered medically. Different from THC, another compound found in the cannabis plant, CBD is non-psychoactive and therefore does not produce a ‘high’, commonly associated with recreational cannabis use. CBD functions by interacting with the body’s endocannabinoid system, which controls the regulation of various bodily functions, including sleep, mood, inflammation and pain. CBD binds to receptors in the endocannabinoid system, helping to modulate these functions. Cannabidiol has also exhibited some anticonvulsant, anti-inflammatory, anxiolytic and antidepressant activity in various scientific studies (Armour & Sinclair, 2022) 


So what does the research say on CBD and its use in endometriosis 


Research is beginning to emerge on the use of CBD for the management of the symptoms associated with endometriosis. A paper on the biochemical mechanisms of cannabidiol in the management of endometriosis was produced by the International Journal of Molecular Sciences in 2022. The research indicated that CBD administered at high doses reduced lesion diameter, volume and area, it also showed strong antioxidant activity. It was concluded that CBD showed promising analgesic activity as well as being effective in suppressing endometriosis (Caudullo et al., 2022). 


Another study on the use of cannabis for endometriosis symptoms was investigated using data from a Canadian technology company that tracked dose, mode of administration, and its effects on various self-reported outcomes, including pelvic pain. The study found that cannabis was effective in the management of pelvic pain, gastrointestinal issues and mood, with effectiveness varying based on method of ingestion. Oral forms appeared to be superior compared to inhaled forms specifically on self reported mood or gastrointestinal symptoms. The paper highlights the importance of quality-assured and standardised cannabis products to achieve reproducible clinical results (Abbott et al., 2021). 



What are the current regulations in Australia around CBD 


In February 2021, the Therapeutic Goods Administration (TGA), made cannabidiol a Schedule 3 Pharmacist only medicine. This means it is currently not available to purchase over the counter but only after consultation with a pharmacist. However, there are strict regulations around cannabidiol products indicating that CBD contains 98% or more of the total cannabinoid content, with THC comprising no more than 1%. It can only be dispensed to people over the age of 18 and comes in packs consisting of no more than a 30 day supply. The maximum recommended dose by pharmacists is 150mg of CBD, whereas most scientific evidence around CBD is at doses higher than 150mg (Endometriosis Australia, 2024). 


How we can manage endometriosis from a holistic perspective


Endometriosis can be a challenging condition to manage. Research into the use of CBD for endometriosis is beginning to emerge, although there is still a long way to go in terms of exploring its efficacy and safety. Endometriosis is a complex condition that involves many body systems, therefore, it is important treatment approaches focus on the various pathways this condition can affect. We’ve got a bit more information on managing endometriosis holistically in this blog post here



References 

 

Abbott, J., Armour, M., Collett, L., Pate, D., Sarris, J., & Sinclair, J. (20221). Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms. Plos One, 16(10). doi: 10.1371/journal.pone.0258940


Armour, M., & Sinclair, J. (2022). Medicinal Cannabis, Endometriosis Australia. https://endometriosisaustralia.org/cannabidiol-cbd-and-aussies-with-endo-what-we-know/


Caudullo, S., Cordaro, M., Crupi, R., Cuzzocrea, S., Genovese, T., Gugliandolo, E., Fusco, R., Impellizzeri, D., & Siracusa, R. (2022). Molecular and Biochemical Mechanism of Cannabidiol in the Management of the Inflammatory and Oxidative Processes Associated with Endometriosis. International Journal of Molecular Sciences, 23(10). doi: 10.3390/ijms23105427


Endometriosis Australia. (2024). Cannabidiol (CBD) and endo: What we know. https://endometriosisaustralia.org/cannabidiol-cbd-and-aussies-with-endo-what-we-know/


Sarris, J., & Wardle, J. (2015). Clinical Naturopathy. Elsevier.  


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