Endometriosis is a chronic inflammatory condition in which tissue similar to the lining of the uterus grows outside the uterus, often causing severe pelvic pain, fatigue, and reduced fertility. It is estimated that up to one in nine women of reproductive age are affected by the condition worldwide, yet current treatments frequently provide incomplete symptom relief and can come with significant side effects.
A new study led by researchers at the University of Otago in Wellington, New Zealand, has found that medicinal cannabis can meaningfully reduce pain and improve quality of life in endometriosis patients. The findings, published in the journal BMC Complementary Medicine and Therapies, represent the first prospective cohort study of medicinal cannabis for endometriosis-related pain conducted in New Zealand.
How the Study Worked
The research team, led by Dr. Claire Henry from the Department of Surgery and Critical Care, enrolled 28 participants aged 18 to 50 who had been surgically or clinically diagnosed with endometriosis. Each participant was prescribed cannabidiol (CBD) oil, either on its own or in combination with dried cannabis flower, for a period of three months. Medicinal cannabis is legal by prescription in New Zealand.
Participants recorded weekly pain scores on a numerical scale from 0 (no pain) to 10 (worst pain imaginable). They also completed an Endometriosis Health Profile questionnaire (EHP-30) at the start and end of the 12-week period to measure their overall health-related quality of life. Seventeen participants were interviewed at the end of the study to share their experiences in greater depth.
Significant Pain Reduction
The results were encouraging. Overall pelvic pain scores dropped from an average of 5.4 to 3.7, a reduction of more than 30%. The severity of the worst pain experienced by participants fell from 7.6 to 5.3. The mean total EHP-30 score, which measures the broader impact of endometriosis on daily life, decreased significantly from 68.8 to 37.4, indicating a substantial improvement in quality of life.
Participants also reported improved sleep and reduced anxiety, with the benefits in these areas having an almost equal effect on their quality of life as the reduction in pain itself. Few adverse events were reported during the study period, and participants generally perceived cannabis as a gentler alternative to traditional pain medications.
Life-Changing for Some Patients
While CBD did not work for everyone, for some participants the impact was profound. One participant spoke of preparing to re-enter the workforce after three years out due to the severity of their condition. Another said they were in such an improved state of health that they were starting to try to have a baby.
Several participants reported that they had previously relied on opioid-based painkillers such as tramadol, but found the relief inconsistent and the side effects, including nausea, dizziness, and fatigue, difficult to manage. The study found that CBD was perceived as offering more consistent relief with far fewer side effects.
Why This Matters
Current treatment options for endometriosis include pain management through analgesics, hormonal medications, and surgery. However, patient satisfaction with these approaches is often low, and many women continue to experience debilitating symptoms despite treatment. Previous cross-sectional surveys have shown that a significant number of endometriosis patients already use cannabis, often illicitly, to manage their symptoms.
This study adds to a growing body of evidence suggesting that medicinal cannabis could serve as a valuable adjunctive therapy for endometriosis-related pain. The researchers noted that cannabinoids like THC and CBD have demonstrated anti-inflammatory, analgesic, and anxiolytic properties in scientific literature, and that the endocannabinoid system may play a role in endometriosis, though more research is needed to fully understand this relationship.
What Comes Next
The researchers concluded that their findings support the need for larger, controlled studies to further evaluate the safety, efficacy, and long-term outcomes of medicinal cannabis as a treatment option for endometriosis. They also noted ongoing challenges related to access, dosage optimization, and the social stigma that still surrounds cannabis use in a medical context.
As more countries expand access to medicinal cannabis, studies like this one provide important early evidence that could shape how the condition is treated in the future. For the millions of women living with endometriosis around the world, the search for better treatment options continues.
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