Cannabis usage among Australian women with endometriosis

Cannabis may provide significant relief of pain and associated symptoms in endometriosis patients.

Key Points

Highlights:

• Some women with severe endometriosis symptoms use cannabis.

Importance:

• Self-reported illicit use of cannabis is relatively common in Australian women with endometriosis.
• Australian law currently requires legal medicinal cannabis use to follow specific, regulated pathways that limit prescription by this method.

What’s done here?

• A cross-sectional online survey to determine the prevalence, tolerability and self-reported effectiveness of cannabis in women with endometriosis was conducted.

Key Points:

• A total of 484 responses were included for analysis (Of all women, 76% reported using a self-management strategy in the past 6 months, and 13% of these women self-reported using cannabis for endometriosis symptom management)
• Self-reported effectiveness in pain reduction was high (7.6 of 10), with 56% also able to reduce pharmaceutical medications by at least half.
• Participants reported the greatest improvements in sleep, nausea, and vomiting.
• Adverse effects of cannabis, most commonly drowsiness, increased anxiety, or tachycardia, were reported to be around 10%.

Limitations:

• The strengths of this survey include participant anonymity, which likely improved participants’ willingness to disclose cannabis use.
• Participants were recruited through online advocacy groups, where women often have more severe symptoms than those recruited by other methods.
• The absolute number of women using cannabis in this study was small.
• The survey did not explore the drivers for cannabis use, so the authors could not determine why these women chose to use cannabis in particular or why some women chose not to use cannabis.

Lay Summary

Sinclair J. et al., a group of researchers from Australia, conducted a cross-sectional online survey to determine the prevalence, tolerability, and self-reported effectiveness of cannabis in women with endometriosis.

This study included 484 women with complete responses. Of all women, 76% reported using a self-management strategy in the past 6 months, and 13% of these women self-reported using cannabis for endometriosis symptom management.

Respondents had a median age of 30 years (25−36) and were mainly from urban areas (79% urban vs 19% rural).

Women using cannabis had higher "Pelvic Pain Impact Questionnaire" scores. Self-rated effectiveness on pelvic pain for cannabis was found to be high (7.6 of 10). Of the 48 women using cannabis, 27(56%) reported a significant reduction in pharmaceutical medication use related to endometriosis by at least half. In addition to pelvic pain, women reported significant improvements in sleep, anxiety, depression, and gastrointestinal symptoms, including nausea and vomiting.

Adverse events associated with cannabis use, most commonly drowsiness, increased anxiety, or tachycardia, were around 10%, less compared to non-steroidal anti-inflammatory drugs (11%−14%) and opioid-based medications (78%)

To conclude, this study showed that cannabis is currently used by a group of women with severe endometriosis symptoms. It may provide substantial relief of pain and associated symptoms. In order to determine efficacy, compliance, and side effect profile and better inform practice and policy for endometriosis, we need clinical trials of cannabis use in this group.

This paper has recently been published in the Journal of Obstetrics and Gynaecology Canada.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/31722852