Endometriosis is a chronic pain disorder that affects an estimated 1 in 10 women around the world between the ages of 15 and 49. Yet, despite the disorder’s prevalence and often debilitating pain, women suffering from it tend to be either dismissed or offered a limited number of treatment options. 

But a new study from researchers in Spain may change that. The research team has demonstrated, using a mouse model, that a moderate dose of THC could not only reduce pain associated with endometriosis, but could even be effective at reducing internal cysts associated with the disorder.

Not a Modern Medical Mystery 

While discussions of endometriosis may have become more common in recent years, with women voicing their first-person accounts of the disorder, the disease itself is far from new. Descriptions of the disorder appeared in medical texts as far back as the late 1800s, and despite a better modern understanding of what causes endometriosis pain — the inflammation of endometrial tissue that has grown outside of the uterus on a woman’s ovaries, bowels, or pelvis — the cause of endometriosis itself is still unknown.

As for treating the disorder, women often face challenges from the start, not only because endometriosis symptoms present similarly to other disorders, like pelvic inflammatory disease, but also because endometriosis pain is often dismissed as merely menstrual pain. After diagnosis, treatment options for endometriosis range from over-the-counter pain relief, like ibuprofen, to hormone treatments to, in severe cases, hysterectomy.

Mice and Medical Marijuana 

In search of better options, a team of Spanish researchers turned to mice and the psychoactive component of marijuana — THC. 

“With a lack of effective treatments, women with endometriosis usually rely on self-management strategies,” the study’s senior author Rafael Maldonado, Professor at the University Pompeu Fabra of Barcelona, Spain, said in a statement. “Although cannabis comes with a large number of potential side effects, its medicinal properties could provide pain relief in endometriosis and other conditions.”

The researchers implanted endometrial tissue around the pelvis of an experimental group of female mice, in order to mimic endometriosis symptoms, and left a control group of mice untouched. As with endometriosis in women, the afflicted female mice began to demonstrate pain and anxiety symptoms, as well as cognitive impairment and the development of endometrial cysts. Once these symptoms were established, both groups of mice were given daily 2mg doses of THC over a 28-day period. 

More Than Pain

The team found that the mice with endometriosis experienced decreased pain in their abdomens as a result of their THC doses, as well as lessened cognitive impairment. While this study certainly isn’t unique in connecting cannabinoids with pain relief, the team did find another surprising effect of the THC dosage: cyst inhibition. The researchers found that endometriosis mice had smaller endometrial growths after completing the THC regimen. 

Swing and a Miss 

Despite the promising results of the study, the researchers were still unable to determine THC’s effectiveness in several key areas of endometriosis, including anxiety, fertility, painful intercourse and extreme menstrual cramps. However, following this study the researchers have partnered with the Gynecology Service of the Hospital Clinic of Barcelona, Spain, to begin conducting clinical trials of this approach in women with endometriosis. 

With any luck, positive results from this impending clinical trial could finally spell relief for the tens of thousands of women suffering from endometriosis.

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Endometriosis is a painful condition where the lining of the uterus grows on other parts of the organ such as the fallopian tubes. The new study, published in eLife, shows initial results from treating endometriosis in mice with cannabinoids – suggesting they can alleviate symptoms of the disease.

The researchers say this new finding will pave the way for further clinical research.

The findings have led to the start of a clinical trial in collaboration with the Gynecology Service of the Hospital Clinic of Barcelona, Spain. The trial will evaluate the possible benefits of the naturally occurring cannabinoid ∆9-tetrahydrocannabinol (THC; the main psychoactive constituent of the cannabis plant) in women with endometriosis.

Endometriosis cannabis treatment

Endometriosis is a common, chronic and painful disease caused when the lining of the womb – the endometrium – grows outside of the womb cavity. These growths affect reproductive organs and can cause pain, infertility, anxiety, depression and result in a considerable impact on quality of life. Treatment options include surgery or hormone therapy, but these are not always effective and often have significant side-effects.

Rafael Maldonado, Professor at the University Pompeu Fabra of Barcelona, Spain, said: “With a lack of effective treatments, women with endometriosis usually rely on self-management strategies like dietary changes or exercise. Although cannabis comes with a large number of potential side effects, its medicinal properties could provide pain relief in endometriosis and other conditions.

“Since medical THC is available in some countries, the findings of our study may be of interest for gynecologists and pain specialists who manage the treatment of women with endometrial pain.”

THC improves symptoms and growths

The team studied mice with endometrial implants in their pelvis to mimic endometriosis in humans. Those with the implants were more sensitive to pain in their pelvis that can also be associated with emotional and cognitive alterations – similar to symptoms seen in some women with endometriosis.

The team next found that mice with endometriosis had similar anxiety-like symptoms experienced by some women with the condition. This was measured by the amount of time the animals spent in open areas of a maze, as those with higher anxiety levels tend not to explore too far. However, their experiments could not reveal whether THC had any significant effects in treating this anxiety.

As endometriosis can be known to impair cognitive function in some women, the team also studied memory performance in the mice. They provided the animals with two identical objects and allowed them to become familiar with them. They then replaced one of the objects and timed how long the mice spent exploring the new versus familiar object, to give an indication of what the animals remembered.

The team found that memory was impaired in the mice with endometriosis compared with those that did not have the condition. However, mice treated with THC did not show this impairment, suggesting that THC may have a protective effect.

Finally, the team studied the effects of THC on the endometrium inside and outside of the womb, and found that mice with endometriosis treated with THC for 32 days had smaller endometrial growths.

First author Alejandra Escudero-Lara, a PhD student at the University Pompeu Fabra of Barcelona, said: “Together, our findings show that THC limits the development and symptoms of endometriosis in an experimental model, and highlight the interest of conducting further research to ensure the safety and beneficial effects of this treatment in women with endometriosis.”

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