Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Apr 1;2(1):72-80.
doi: 10.1089/can.2016.0035. eCollection 2017.

The Clinical Significance of Endocannabinoids in Endometriosis Pain Management

Jerome Bouaziz  1   2 , Alexandra Bar On  1   2 , Daniel S Seidman  1   2 , David Soriano  1   2
Affiliations
Review

The Clinical Significance of Endocannabinoids in Endometriosis Pain Management

Jerome Bouaziz et al. Cannabis Cannabinoid Res. .

Abstract

Introduction: Patients with endometriosis often suffer from diffuse and poorly localized severe pain. The current pain management strategies include medical and hormonal therapy, as well as surgery. Medical management of pain is often insufficient and is associated with high rate of recurrence. Better pain management is therefore of urgent need. Methods: Among the various candidates, the endocannabinoid system (ECS) has recently emerged as a relevant pharmacological target for the management of endometriosis-related pain. A computerized literature search was performed to identify relevant studies combining the keywords "endometriosis," "endocannabinoid," "cannabinoid receptor," "THC," and "pain mechanisms." Conclusions: This review describes the multiple and complex pain mechanisms associated with endometriosis. Current data and theories concerning the link between the ECS and pain management for endometriosis patients are presented. Finally, we will discuss which aspects of endometriosis-associated pain can be targeted by modulation of the ECS.

Keywords: cannabis; endocannabinoid; endometriosis; pelvic pain.

PubMed Disclaimer

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
The different implications of ECS in endometriosis and pain. High levels of CB1 receptors and endocannabinoid ligands have been observed in endometriosis patients. Although this occurs as a mechanism to reduce inflammation, low CB1 levels in the tissue act as a negative feedback loop and disrupt the pain mechanism. However, several natural and synthetic agonists modulate ECS and reduce endometriosis-associated pain. ECS, endocannabinoid system; PEA, N-palmitoylethanolamine.
<b>FIG. 2.</b>
FIG. 2.
ECS interactions with mechanisms of endometriosis pain.
See this image and copyright information in PMC

References

    1. Dunselman GAJ, Vermeulen N, Becker C, et al. . ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29:400–412 - PubMed
    1. Abbas S, Ihle P, Köster I, et al. . Prevalence and incidence of diagnosed endometriosis and risk of endometriosis in patients with endometriosis-related symptoms: Findings from a statutory health insurance-based cohort in Germany. Eur J Obstet Gynecol Reprod Biol. 2012;160:79–83 - PubMed
    1. Gibbons WE. Management of endometriosis in fertility patients. Fertil Steril. 2004;81:1204–1205 - PubMed
    1. Fauconnier A, Chapron C, Dubuisson JB, et al. . Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril. 2002;78:719–726 - PubMed
    1. Practice T, Medicine R. Treatment of pelvic pain associated with endometriosis. Fertil Steril. 2008;90(5 Suppl.):260–269 - PubMed