In recent years, there has been growing interest in the potential of medicinal cannabis as an alternative or complementary approach to managing endometriosis-related symptoms. Cannabis, known for its potential therapeutic properties due to the presence of cannabinoids, has gained traction as a potential treatment option for various chronic conditions, including pain management. Senior Research Fellow, Doctor Mike Armour has been researching the role medicinal cannabis could play in managing endometriosis symptoms.
Here are some points he discussed with our EndoWArriors support group members.
The history of cannabis
Throughout history, the cannabis plant has held a significant place in human medicine and trade, with its seeds, leaves, stems, roots, and inflorescence serving as valuable commodities. Historical records trace back its medicinal use to Emperor Shen Nung around 2700 BCE. More recent evidence reveals cannabis’s role in addressing diseases, such as endometriosis. Physicians have also compiled supporting evidence demonstrating its efficacy in managing concurrent symptoms and disorders often associated with endometriosis, such as anxiety, insomnia, and mental depression. Additionally, the medical community note cannabis’s benefits over opiate-based pain management.
The endocannabinoid system
The endocannabinoid system is a complex cell-signalling system found in the bodies of mammals, including humans. It plays a crucial role in regulating various physiological processes and maintaining homeostasis, which is the body’s internal balance. Medical treatment has undergone a significant transformation due to the rediscovery of the endocannabinoid system. The endocannabinoid system is named after cannabinoids, which are compounds found in cannabis plants, and it’s responsible for responding to both endocannabinoids (naturally occurring compounds produced within the body) and phytocannabinoids (compounds from plants like cannabis).
Phytocannabinoids
The cannabis plant produces a wide variety of phytocannabinoids, each with its own potential effects and benefits. The two well-known phytocannabinoids are THC (tetrahydrocannabinol) and CBD (cannabidiol),
Despite their structural similarity, THC and CBD have distinct modes of action. THC binds to CB1 and CB2 receptors, acting as a partial agonist, while CBD doesn’t bind to these receptors significantly. Instead, CBD activates channels related to serotonin and pain modulation. THC exhibits pain relief, anti-emetic, anti-inflammatory, muscle relaxant, and neuroprotective effects, while CBD shares similar properties but also serves as an anti-anxiety agent. The ratio of THC to CBD in cannabis plays a pivotal role in determining its therapeutic effects, including mitigating anxiety and paranoia sometimes associated with cannabis use.
The endocannabinoid system and endometriosis
The endocannabinoid system’s extensive involvement within the reproductive system sparks interest due to its potential in alleviating endometriosis-associated pain. Research suggests that the endocannabinoid system may be dysregulated in individuals with endometriosis, with altered levels of endocannabinoids and receptors. This dysregulation might contribute to symptoms and the progression of the disease. Although the studies mainly involve mice, there are indications that cannabis could impede disease progression by affecting processes like angiogenesis, apoptosis, nerve innervation, and cell migration. Whilst these findings are preliminary in nature, they highlight a promising avenue for future exploration.
Chronic pain and medicinal cannabis
The role of medicinal cannabis in managing chronic pelvic pain, and possibly extending to other conditions beyond endometriosis, is a subject of ongoing discussion. Emerging evidence suggests that cannabis use might have a substitution effect in diverse chronic pain situations, offering an alternative to medications such as opioid analgesics and potentially reducing dependence on them. This possibility highlights the need for further research to better understand the potential benefits, risks, and appropriate usage of medicinal cannabis in addressing chronic pain.
In Australia, medicinal cannabis is prescribed for the following conditions:
- Epilepsy
- Pain conditions
- Multiple sclerosis
- Nausea and vomiting
- Palliative care
Things to consider when taking medicinal cannabis
In Australia, medicinal cannabis finds itself in a complex regulatory landscape. It is not included in the Australian Register of Therapeutic Goods and is absent from the Pharmaceutical Benefits Scheme (PBS), primarily due to insufficient scientific evidence supporting its therapeutic claims. Additionally, only select health insurers extend coverage for its use. Making cost an issue in terms of accessing medicinal cannabis. The situation also varies across states, with regions like Tasmania even requiring the submission of scientific evidence to support a prescription for medicinal cannabis. Driving laws will also vary across states however, it is important to note in Western Australia, if you are taking medicinal cannabis containing THC, you cannot legally operate a motor vehicle.
Watch the full online event with Senior Research Fellow, Doctor Mike Armour here.