Cannabis And Endometriosis | Manipulating The Endocannabinoid System

Cannabis And Endometriosis

Manipulation of the endocannabinoid system (ECS) can help with the pain caused by endometriosis. Such results were provided by a study conducted by Jerome Bouaziza from the Department of Obstetrics and Gynecology at the Medical Center Chaim Sheba in Israel. For a long time, the scientist has been investigating the kind of pain associated with endometriosis and the role endocannabinoid system plays in this disease.

What Is Endometriosis?

The term endometriosis is used to describe the condition in which the endometrium — the tissue lining the inner cavity of the uterus (or womb) begins to grow pathologically outside its scope, e.g. in the peritoneum, internal organs or blood vessels.

This disease can affect up to 10.8 million women worldwide. Although the percentage of women affected by this diseases haven’t yet been recorded. The occurrence of endometriosis is associated with the deterioration of the quality of life, problems with pregnancy and chronic pain.

According to Bouaziz, the pain associated with endometriosis is complex and includes three distinct categories:

  • Nociceptive Pain
  • Inflammatory Pain
  • Neuropathic Pain.

Nociceptive pain

This pain occurs when sensory receptors of the peripheral nervous system, called nociceptors, are activated.

Inflammatory pain

This pain goes hand in hand with the nociceptive pain. And it is triggered by a damaged tissue, which results in the release of many pro-inflammatory factors.

Neuropathic pain

This occurs after a damage to the neurons (nerve cells).

Research Studies

Perhaps the research carried out by Bouaziza will add to a better understanding of the causes of this disease. According to Bouaziza,  the endocannabinoid system plays a key role in the development of pain.

The endocannabinoid system, consisting of cannabinoid receptors, CB1 and CB2  — naturally occurring endocannabinoids, are responsible for the regulation of many physiological processes, including the sensation of pain, mood, memory, appetite, sleep and adequate immune response.

Bouaziz’s research shows that excessive sensitivity to pain in women suffering from endometriosis is due to the decreased expression of CB1 receptors and the significant increase in endocannabinoids in blood plasma compared to healthy women.

He also said that the existence of a negative feedback loop impairs the ability of endogenous cannabinoids to control pain.

How it works

The endocannabinoid system produces endocannabinoids, substances that bind to cannabinoid receptors (CB1 and Cb2). When these receptors are not enough, then endocannabinoids can not sufficiently connect to them and the resulting physiological effect is definitely weakened or practically absent.

On the other hand,  studies included in the review published in Cannabis and Cannabinoid Research describes endometriosis as a condition caused by a deficiency of endocannabinoids when the body does not produce enough of them. This condition was defined as a deficiency of endocannabinoids.

Manipulation of the endocannabinoid system

Despite the fact that the above-mentioned findings differ from each other, it seems that the studies conducted by Jerome Bouaziza are, however, more reliable. On this basis. It can be concluded that a manipulation of the endocannabinoid system can be an effective option in dealing with the pain associated with endometriosis.


In the future, it would be worth checking whether agonists, i.e. substances that bind to cannabinoid receptors, including phytocannabinoids (CBD and THC and others) and found in different types of cannabis, can be effective in regulating the inflammatory response, thereby reducing the growth of endometrial changes and controlling neuropathic pain.

Final thoughts

“Further research is needed to ascertain the potential side effects of the therapy, especially on fertility and pregnancy outcomes, concludes Jerome Bouaziz”.


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