Endometriosis is a chronic inflammatory condition affecting millions of women and people assigned female at birth worldwide. If you or someone you know suffers from endometriosis, you know it often comes with debilitating symptoms that make everyday life challenging and overwhelming.

Current treatments for endometriosis, while available, are often invasive and may not fully alleviate symptoms. Unfortunately, there is no cure for the condition at this time.

This is why interest in alternative potential treatments, like cannabidiol (CBD) is growing. Let’s look into the connection between CBD and endometriosis, explore recent findings, and see if CBD is good for endometriosis.

What Is Endometriosis?

Endometriosis is a condition where tissue like the one inside the uterus grows in other places, like the cervix, Fallopian tubes, and ovaries. These growths induce chronic inflammation and pain in the affected areas.

Endometriosis Causes

We don’t know yet the exact cause of endometriosis, but several theories attempt to explain its origin:

• Retrograde menstruation: Sometimes, menstrual blood can go in the wrong direction and end up in the pelvis, causing endometrial cells to grow in places they shouldn’t.
• Lymphatic spread: Endometrial cells spread through the blood or lymphatic systems.
• Metaplasia: Cells in the abdominal wall transform into endometrial-like tissue.
• Immune dysregulation: The body’s immune system isn’t strong enough to stop endometrial cells from growing in places they shouldn’t.
• Genetic factors: Endometriosis can be influenced by both genetic and environmental factors.

Endometriosis Symptoms

Endometriosis symptoms can look very different from person to person, which makes diagnosis and treatment more complex. Plus, given they can affect a wide range of organs, you may not instantly link them to just one condition. Common symptoms include:

• Chronic pelvic pain (CPP): Persistent pain in the lower abdomen or pelvis.
• Dysmenorrhea or painful periods: Severe menstrual cramps that interfere with daily activities and don’t improve with over-the-counter medication.
• Dyspareunia: Pain during sex.
• Stomach issues: Painful bowel movements or diarrhea.
• Painful urination: Also referred to as dysuria.
• Infertility: Endometriosis can alter the functioning of reproductive organs, making it difficult to conceive. That is why endometriosis is often discovered during infertility tests.
• Fatigue: Extreme tiredness, even after adequate rest.

Endometriosis Comorbidities

People with endometriosis are often diagnosed with:

Irritable bowel syndrome (IBS): People with this condition often experience both stomach pain and irregular bowel movements.

Rheumatoid arthritis: These autoimmune conditions are associated with the chronic inflammation that comes with endometriosis.

Depression: Endometriosis can take a toll on mental health, especially when dealing with chronic pain.

Chronic fatigue syndrome: Extreme tiredness that lasts for long periods of time.

The Toll of Endometriosis

Endometriosis can take a toll on daily life. Chronic pain can make it difficult to keep up with your social activities, go to work or school, or even simply enjoy your hobbies. It can also take a toll on your mental health, leading to feelings of anxiety, depression, or frustration. 

The financial burden of medical costs can be stressful. Additionally, pain during intimacy can affect your relationships and self-esteem.

Endometriosis Diagnosis

Diagnosing endometriosis can be complex since symptoms can vary from patient to patient. However, there are some exams that healthcare professionals can use to diagnose endometriosis, including:

Pelvic Exam: When you describe your symptoms, your doctor may perform a pelvic exam to identify cysts or specific painful areas. This consists of a physical examination of the pelvic area, including the vagina, cervix, uterus, and ovaries. The doctor may use a speculum to examine the vagina and cervix and feel for any abnormalities in the uterus and ovaries.

Ultrasound and Magnetic Resonance Imaging (MRI): These exams help your doctor have a detailed view of your organs and identify any suspicious tissue. The ultrasound is performed by inserting a small probe into the vagina or placing it on the abdomen to create images of internal organs and tissues. On the other hand, an MRI is a painless test that uses strong magnets and radio waves to create detailed images of your body. You’ll lie inside a large, tube-shaped machine. The machine will make some noise, but you’ll be given earplugs to minimize the sound. The test may take 30-60 minutes.

Laparoscopy: This exam is generally performed under anesthesia, and it consists of using a device with a small camera to examine your pelvis from the inside. If they find any abnormal tissue, they will take a small sample so they can analyze it in the lab.

Limits of Current Treatments for Endometriosis

Treatment options include hormonal therapy, surgery, and analgesics. However, these approaches have limitations:

Hormonal treatments, like birth control pills, can help reduce symptoms, but they might cause side effects like mood swings or weight gain. Surgery can remove the endometrial tissue, but it’s a major operation with potential risks and often needs to be repeated.

Pain relievers can help ease discomfort, but they may not work for everyone, especially for the specific pain of endometriosis. Strong pain medications, like opioids, can be risky and addictive, so doctors usually try to avoid them.

In very serious cases, a hysterectomy (removal of the uterus and sometimes the ovaries) might be suggested. However, this is usually a last resort, as it can lead to early menopause and other side effects.

Is Endometriosis Underresearched?

Patients often feel endometriosis is underresearched; this has been suggested to be due to a mix of medical bias, diagnostic challenges, and stigma. For years, women’s health issues—especially those related to menstruation—have been dismissed or overlooked. 

The symptoms vary a lot, making it hard to diagnose and often mistaken for other conditions. Since the only way to confirm it is through an expensive and invasive procedure, many women go undiagnosed for years, leaving researchers with little data.

This lack of research has limited our understanding of the disease, delaying advancements in effective treatments. But recently, people have been looking into cannabis and CBD as possible ways to help those with endometriosis.

Is CBD Good for Endometriosis? This Is What Research Says

A 2023 narrative review explored how the endocannabinoid system (ECS) and gut microbiota interact in endometriosis. The ECS, which regulates pain and inflammation, and the gut microbiota, which influences immune responses and hormonal balance, both play roles in the disease’s progression. The review found:

• Gut Bacteria and Endometriosis: Certain types of gut bacteria, like Prevotella and E. coli, can be higher in people with endometriosis and may contribute to bloating and inflammation.
• The ECS and Pain: Problems with the ECS, like changes in CB1 receptors (protein molecules found on the surface of cells, especially in the brain and nervous system), can lead to chronic pain.
• The Protective Role of Endocannabinoids: Endocannabinoids are natural substances in our bodies that can interact with CB1 receptors. Increased levels of 2-AG can help reduce gut inflammation and improve gut health.

Additionally, a 2023 study tested the effects of CBD on endometriosis by inducing endometrial lesions in 36 rats. Researchers divided them into groups receiving different treatments, including CBD and leuprolide acetate (a common medicine used to treat endometriosis). Key findings include:

• Rats treated with 5 mg/kg CBD had smaller endometrial lesions and reduced levels of inflammatory markers such as IL-6 and TNF-α (substances in the body that can cause inflammation).
• CBD significantly increased antioxidant levels, suggesting it reduces oxidative stress.
• Results suggested anti-inflammatory effects and reduced blood vessel growth, which could make CBD a potential treatment for endometriosis.

Can You Use CBD for Endometriosis Symptoms?

Anecdotical evidence and early research have shown some promise in the potential therapeutic properties of CBD for endometriosis, including:

• Reduced Inflammation: CBD can potentially help reduce inflammation in the body.
• Improved Gut Health: CBD could influence the gut microbiota, reducing the levels of harmful bacteria and promoting a healthier gut environment.
• Pain Relief: CBD can interact with the endocannabinoid system, which can possibly help alleviate chronic pain.
• Antioxidant Properties: CBD could have antioxidant properties, which could help protect cells from damage.
• Reduced Blood Vessel Growth: CBD may potentially inhibit the growth of new blood vessels, responsible for contributing to the growth of endometrial tissue.
• Potential Mood Boost: CBD has been linked to some therapeutic effects for mental health. This suggests it may potentially help alleviate symptoms of depression and anxiety, which can often accompany chronic pain conditions.

Endometriosis and Cannabis

A 2019 survey of 377 endometriosis patients investigated their experiences with cannabis and CBD. Key results:

• Marijuana was reported as very or moderately effective by 68-76% of users.
• CBD was moderately effective for 32-37% of participants, especially for managing mild pain and improving mood.
• Inhalation was the most common method, with higher efficacy reported for pain relief compared to oral ingestion.

A 2021 study looked at how 252 participants with endometriosis used cannabis to manage their symptoms. Findings included:

• Most Common Consumption Method: Inhalation (smoking or vaping) was the primary method of cannabis consumption among people with endometriosis.
• Primary Symptom Treated: Pain, particularly gastrointestinal pain, was the most common symptom targeted with cannabis use.
• Method-Specific Efficacy: Inhalation was found to be more effective for pain relief, while oral consumption (eating or drinking cannabis products) was more effective for mood and digestive issues.

Best CBD for Endometriosis Pain: Full-Spectrum CBD or Isolate CBD?

When choosing CBD for endometriosis pain, you can opt for full-spectrum CBD or CBD isolate. 

A study from 2017 emphasized how important it is to modulate the cannabinoid system, which is how our body’s natural cannabinoids interact with receptors to affect pain and inflammation. 

It noted that compounds like PEA (palmitoylethanolamide, a substance that impacts inflammation response) can boost the effects of cannabinoids.

Full-spectrum CBD includes PEA and many other cannabinoids and terpenes, which can enhance its effects through the “entourage effect.” This means it may offer a wider range of therapeutic properties. 

In contrast, CBD isolate contains only pure CBD, making it a good choice for those who want to avoid THC altogether. 

Ultimately, your choice should depend on what you prefer and how your body responds.

CBD Dose for Endometriosis

The best CBD dosage for endometriosis varies from person to person. It’s generally recommended to start with a low dose (around 10-25mg per day) and gradually increase it as needed. Many people report finding relief with doses between 10mg and 50mg daily.

What Is the Best Way to Take CBD for Endometriosis?

CBD Oil: You have several options for taking CBD, and many women find using CBD oil is the easiest and most suited way to take CBD for endometriosis. This method involves placing several drops below the tongue for quick absorption.

Topical Creams & Salves: Ideal for localized pain relief, topical products can be applied directly to areas experiencing discomfort. They absorb slowly and target specific areas without significant systemic effects.

Final Thoughts

While research is still in its early stages, studies suggest that CBD holds promise as an alternative treatment for endometriosis. 

With its potential ability to reduce inflammation, oxidative stress, and pain, CBD may offer a new way to manage symptoms that traditional treatments struggle to address. However, more clinical research is needed to fully understand its efficacy in humans. 

If you want to explore CBD for endometriosis, take a look at our CBD products, and don’t forget to talk to your healthcare professional.

References

AE Reinert, M Hibner. Self-Reported Efficacy of Cannabis for Endometriosis Pain. Journal of Minimally Invasive Gynecology. Volume 26, Issue 7, Supplement, November–December 2019, Page S72. https://www.sciencedirect.com/science/article/abs/pii/S1553465019310921 

Bouaziz J, Bar On A, Seidman DS, Soriano D. The Clinical Significance of Endocannabinoids in Endometriosis Pain Management. Cannabis Cannabinoid Res. 2017 Apr 1;2(1):72-80. doi: 10.1089/can.2016.0035. PMID: 28861506; PMCID: PMC5436335. 

Farooqi T, Bhuyan DJ, Low M, Sinclair J, Leonardi M, Armour M. Cannabis and Endometriosis: The Roles of the Gut Microbiota and the Endocannabinoid System. J Clin Med. 2023 Nov 13;12(22):7071. doi: 10.3390/jcm12227071. PMID: 38002684; PMCID: PMC10671947.

Okten SB, Cetin C, Tok OE, Guler EM, Taha SH, Ozcan P, Ficicioglu C. Cannabidiol as a potential novel treatment for endometriosis by its anti-inflammatory, antioxidative and antiangiogenic effects in an experimental rat model. Reprod Biomed Online. 2023 May;46(5):865-875. doi: 10.1016/j.rbmo.2023.01.018. Epub 2023 Feb 2. PMID: 36997400.

Sinclair J, Collett L, Abbott J, Pate DW, Sarris J, Armour M. Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms. PLoS One. 2021 Oct 26;16(10):e0258940. doi: 10.1371/journal.pone.0258940. PMID: 34699540; PMCID: PMC8547625. 

Solinas M, Massi P, Cantelmo AR, Cattaneo MG, Cammarota R, Bartolini D, Cinquina V, Valenti M, Vicentini LM, Noonan DM, Albini A, Parolaro D. Cannabidiol inhibits angiogenesis by multiple mechanisms. Br J Pharmacol. 2012 Nov;167(6):1218-31. doi: 10.1111/j.1476-5381.2012.02050.x. PMID: 22624859; PMCID: PMC3504989.