cbd and endometriosis

7 Ways Cannabinoids Combat Endometriosis

When Foria first released its cannabinoid infused suppositories, the team was pleasantly surprised by the response from people who suffer from endometriosis.

The Foria team wasn’t surprised that these products worked for endometriosis pain — just how well they worked.

Though many folks are already familiar with the pain-relieving effects of CBD and THC, scientists have uncovered numerous ways that cannabis and hemp extracts could actually target the root causes of various conditions — including endometriosis.

Research indicates that cannabinoids could treat endometriosis by:

  • Stopping cell proliferation
  • Preventing cell migration
  • Inhibiting lesion vascularization (blood vessels)
  • Inhibiting lesion innervation (nerves)
  • Blocking synthesis of inflammatory prostaglandins
  • Modulating the immune response
  • Desensitizing nerves that transmit pain

But which cannabinoids have which effects?

And should you be using THC only? CBD only? Or some combination?

Whether you’re already using cannabinoids for your endometriosis, or you’re considering an experiment with them, we highly recommend reading on to learn about the effects of THC & CBD on endometriosis.

If you’ve been diagnosed with endometriosis, then you’re probably already aware that there’s currently no cure. The treatments offered by doctors — including painkillers, hormone therapy, and risky surgical procedures — are aimed at merely holding the endometriosis in check. And they are often ineffective at that.

This is why many endometriosis sufferers are seeking holistic approaches to deal with their recurrent symptoms – through diet and other lifestyle changes – and incorporating cannabinoids (like CBD and THC) into their treatment routines.

What is Endometriosis?

Let’s start with a bit of background first. (If you’re already deeply familiar with endometriosis, feel free to skip ahead to the cannabinoid therapies section down the page.)

Endometriosis is a frequently painful condition where tissue similar to that which normally lines the uterus – the endometrium – mistakenly grows outside of the uterus. Endometrial tissue can develop on the ovaries, fallopian tubes and other abdominal locations.

Although there is nothing intrinsically life-threatening about this tissue, it unfortunately responds to the hormones circulating in your body the same way it does in your uterus: Every month the endometrium builds up, then breaks down and sheds.

Unlike typical menstruation, the blood and tissue shed from these misplaced cells are frequently trapped in your body. This cyclical pattern can become excruciating — triggering inflammation and scarring as your body struggles to reabsorb the dead material.

For people who suffer from endometriosis, life is significantly more challenging: As a group, their quality of life goes down while anxiety and depression rates increase . Many endure the pain of endometriosis for years before being properly diagnosed — and it can be devastating to continue to get worse even while following prescribed treatments.

People with endometriosis typically suffer from at least one of the following symptoms:

  • Severe menstrual cramps
  • Painful intercourse
  • Painful urination or bowel movements
  • Chronic lower back, abdominal or pelvic pain
  • Diarrhea, constipation or nausea
  • Infertility or difficulty getting pregnant

How is Endometriosis Treated?

There is no known cure for endometriosis. Treatment focuses on symptom management while trying to prevent the endometriosis from spreading. Doctors typically suggest one or more of the following three treatment options:

  • Painkillers — The most widely-prescribed resource for dealing with endometriosis is an effective painkiller. Anti-inflammatory drugs (NSAIDs) and analgesic painkillers help sufferers cope with the painful symptoms of endometriosis, but do nothing to prevent the disease from progressing. Sometimes more extreme painkillers are prescribed, with debilitating systemic effects ( as one Foria client with endometriosis discovered before switching to cannabis therapy).
  • Hormones — Another popular prescription is for hormone therapy, which is thought to alleviate symptoms by reducing the strength and/or quantity of menstrual cycles. However, some patients respond poorly to hormone therapy.
  • Surgery — Doctors can surgically remove the misplaced endometrial tissue, which often provides tremendous relief. for a while. Unfortunately, there is a high risk of complications, and approximately half of patients will have their symptoms return within one year , requiring further treatment. Another surgical option is an ovariectomy — both surgical and natural menopause will end the cyclical nature of endometrial torture. Unfortunately, pain from permanent endometriosis scar damage could persist beyond menopause, requiring lifelong pain management.

What Causes Endometriosis?

In order to develop more effective treatments, scientists are working to piece together exactly how endometrial tissue thrives where it doesn’t belong. The most popular theory is that menstrual blood flows the wrong direction, carrying endometrial tissue to the fallopian tubes, ovaries or abdomen. Others speculate that environmental factors or toxins might cause the body to spontaneously produce endometrial cells in the wrong place.

However the initial cells arrive , once they are there, they grow and spread (similar to cancer cells) by somehow multiplying and avoiding destruction by the body’s security force. They recruit blood veins to supply nutrients and remove waste products (also like cancer), and they grow new nerve endings that increase pain perception. Also similar to cancer cells, endometriosis can migrate to other tissues in order to claim more territory — even reclaiming lost territory after surgery. Although endometriosis is considered a benign disease, patients whose bodies are unable to prevent the spread of endometriosis (due to genetics or environmental factors) also have a much higher risk for ovarian cancer .

Due to the similarities, some speculate that treatments that stop cancer from developing and spreading might do the same for endometriosis.

Cannabis & Endometriosis

People across the world use cannabis and hemp extracts to treat endometriosis, menstrual cramps and other gynecological complications — and they’ve been using them for millennia . In the last few decades, THC and CBD have been shown to be effective therapies with relatively few side effects.

One reason scientists are enthusiastic about these compounds is the recent discovery that the body’s natural endocannabinoid system is integral to the healthy functioning of the reproductive tract .

In fact, imbalances in these neurotransmitters are often linked to reproductive complications and diseases — including endometriosis — and it seems that careful use of phytocannabinoid supplements, topicals, and suppositories could make a huge difference in the underlying imbalance. How?

Cannabinoids Stop Cell Multiplication

Normally, your body has tools to prevent the growth of aberrant cells and to destroy them ( apoptosis ) before they become a problem. Unfortunately, apoptosis seems to be impaired in people who suffer from endometriosis and similar disorders.

The endocannabinoid system is involved in apoptosis and stopping cell growth. Perhaps the most famous application of these effects is in cancer treatments. When certain cannabinoid receptors are activated (either by the body’s endocannabinoids or by plant-sourced THC), they can prevent cancer cells from multiplying .

Similar research has shown that activating these receptors inhibits endometriotic tissue from proliferating in mice.

CBD: Preventing Cell Migration

A frustrating problem for patients who have their endometriotic lesions surgically removed is that the endometriosis frequently comes back. However, scientists recently discovered that endocannabinoids are involved in regulating cell-migration.

It turns out that molecules like CBD can stop endometriotic cells from migrating (by blocking the activation of the GPR18 receptor). However, molecules like THC that activate this receptor could potentially increase cell migration. This suggests that women who self-medicate with THC should consider counterbalancing its effects with CBD .

Starving the Bloodsuckers

In order for anything to grow, it needs a supply of nutrients. Likewise, endometriotic lesions can only proliferate if they develop a network of blood vessels (vascularization) in order to receive the required nutrients.

Although research on the influence of cannabinoids on endometriotic vascularization is limited, multiple studies have shown that both THC and CBD can inhibit vascularization of cancerous lesions.

CBD vs Painful Nerves

Some patients suffer from deep-infiltrating endometriosis — a more painful form of endometriosis that embeds deeper into abdominal tissue. One reason these lesions might be more painful is that they contain a much higher density of nerves than other lesions.

Endocannabinoids regulate nerve growth, and their receptors (CB1) are expressed on the nerves that innervate endometriotic lesions. Molecules like CBD interfere with innervation by preventing activation of this receptor. However, this might suggest that using THC without the counterbalancing effects of CBD could result in a long-term increase in endometriosis innervation.

CBD: Like Advil Without the Side-Effects

NSAIDs like Advil are one of the most frequently-prescribed treatments for endometriosis. NSAIDs work by inhibiting certain enzymes (named COX-2 ) that contribute to inflammation. Unfortunately, NSAIDs thin your blood and can have gastrointestinal side effects because they also inhibit other enzymes (such as COX-1 ). It turns out that CBD’s anti-inflammatory effects come with fewer of these side-effects because it specifically inhibits COX-2 but not COX-1 .

Cannabinoids Calm An Overactive Immune System

A large number of your body’s endocannabinoid receptors (CB2) are located on your immune system’s killer cells ( macrophages ). When these receptors are activated, they prevent macrophages from releasing inflammatory proteins ( cytokines ).

People who suffer from endometriosis become hypersensitized to inflammatory toxins and signals. Fortunately, THC activates CB2 receptors , which is a large contributor to THC’s anti-inflammatory properties. This is useful for out of control inflammation caused by an overactive immune system — though depressing the immune system isn’t always desirable.

CBD & THC vs Pain Signals

Nerves that innervate endometriotic lesions can increase the pain of endometriosis. These nerves also contain endocannabinoid receptors (CB1) , and when THC activates this receptor it can help decrease pain.

CBD also helps relieve feelings of pain, but through other targets. Most notably, CBD is capable of desensitizing the pain receptor TRPV1 .

Lifestyle Changes for Endometriosis

Scientists are still uncovering the different ways that cannabinoids like CBD and THC impact endometriosis, and standardized medical advice could be years away. Until then, careful self-experimentation is the best way to determine the optimal combination of cannabinoids to complement your current endometriosis treatment.

Many people with endometriosis have already incorporated cannabinoids into their self-care routine, and we encourage you to check out their testimonials before making your decision. To read about the personal stories and lifestyle changes that have helped other Foria clients gain control over their endometriosis, start here and here .

Whether or not you incorporate cannabinoids into your self-care routine, there are many alternative treatments available if a purely pharmaceutical or medical treatment is falling short.

Dietary changes often have profound effects on endometriosis symptoms. An anti-inflammatory diet that’s rich in omega-3 fatty acids, fiber and antioxidants is a good place to start. You may also find that acupuncture and meditation are effective tools for pain management. Additionally, other herbal supplements could target endometriosis in ways similar to cannabinoids.

As always, before making any changes to your endometriosis treatment, make sure to consult with a trusted medical professional.

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If you’ve been diagnosed with endometriosis, then you’re probably already aware that there’s currently no cure. This is why many patients are seeking holistic approaches to deal with their recurrent symptoms – through diet and other lifestyle changes – and incorporating CBD and THC into their treatment routine. Learn More.

Unexpected Ways to Ease Endometriosis Pain

Take Pain Relievers in Advance

Some painkillers work best if you take them before your pain is severe. Ask your doctor if non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are an option for you. You can take them up to 24 hours before you expect menstrual pain to start. They block your body from making chemicals that cause inflammation. You can take NSAIDs regularly until your period or ovulation ends. Check the label so you don’t overdo it.

Do Physical Therapy

PT isn’t just for rehabbing sports injuries or after an accident. Endometriosis can affect the way your pelvis and abdomen work, which can cause more pain. A pelvic or women’s health physical therapist can come up with a plan to help get those areas working right again.

Get Up and Moving

It’s understandable if you feel like lying on the couch when you’re hurting. But regular exercise can help you feel better. It doesn’t have to be extreme. Walking, stretching, and doing breathing exercises can all help ease your endometriosis pain.

Go Gluten-Free?

Some women who switch to a gluten-free diet feel less endometriosis pain. But it doesn’t work for everyone. Try cutting wheat from your diet for a few months to see how you feel. Instead of regular pasta, eat rice noodles or corn pasta. Replace wheat-based foods with rice, buckwheat, and lentils. After a month or two, you can try wheat again. If pain and bloating get worse, go back to a gluten-free diet. Talk to your doctor before you do.

Do Pelvic Floor Exercises

Endometriosis affects your pelvic floor muscles, and when they don’t work right, you can have even more pain. Pelvic floor exercises can strengthen the muscles and help you feel better.

Keep It in Perspective

It can be tough to face an ongoing disease, and some ways of handling it are healthier than others. It’s better to focus on the problem and what you can do about it rather than your emotions and how those feelings make you want to act. For example, when you’re in pain, think about what you can do to feel better instead of how bad it makes you feel. This can reduce stress and depression and help your body feel better.

Could CBD Oil Help?

Cannabidiol (CBD) is one of two key molecules in marijuana. The other one, THC, gets you high, while CBD doesn’t. Research suggests CBD can help with pain and inflammation. While there isn’t much research on CBD and endometriosis specifically, some women say taking CBD oil helps ease their pain. If you want to try it, be sure to check with your doctor about getting CBD oil from a safe and legal source.


Transcutaneous electrical nerve stimulation (TENS) is a therapy that uses mild electric currents to treat pain. The currents hit your nerves and stop them from sending pain signals to your brain. Ask your doctor if TENS therapy would be a good addition to your treatment plan.

Relax With a Massage

A spa day might be just what the doctor ordered. A back or abdomen massage can help ease your menstrual pain, both right after the massage and even more in the weeks after. Massages can help you beat stress, too.

Tap Into Acupuncture

This traditional Chinese medicine practice uses very thin needles to stimulate nerves and muscles. It is thought to release natural painkillers in your body, and research shows that acupuncture can help curb endometriosis pain.

Sprinkle on Cinnamon

This spice could counter inflammation and may lower a hormone in your body that causes discomfort during your period. It’s not clear if it works for endometriosis pain, but in an Italian study, about a teaspoon helped some women with their menstrual pain. If you like the taste, it’s a safe and natural option to try on food or in a drink.

Botox Perk?

Botulinum toxin (Botox) isn’t just for smoothing wrinkles on your face. Because it relaxes the muscles that it’s injected into, doctors use it to treat things like cerebral palsy, migraine, bladder problems, and eye twitching. A small study also found that it lessened pelvic pain and spasms for women with endometriosis. Though this sounds promising, more research is needed before it can become an approved treatment.

Don’t Skip Your Morning Coffee

A few studies have looked at a possible link between drinking coffee or caffeine and endometriosis. There doesn’t seem to be a link between the two, so if your daily routine includes a cup of joe, there’s no need to change that. It might even play a role in lowering your chances of getting endometrial cancer.

Take a Nap

Many women with endometriosis feel tired a lot. Try to keep a consistent sleep schedule and listen to your body. If you need a nap, take one. One study found that a short mid-afternoon nap in the days right before your period can boost your mood and make you more alert.

Talk to a Counselor

The physical pain of endometriosis can also affect your emotions as you adjust to life with the condition. Make time to take care of your mental health. Meet with a wise friend, counselor, or psychologist to get support. It helps to talk through what it looks like to live with an ongoing disease.

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15) KatarzynaBialasiewicz / Thinkstock “Painkillers,” “Five things that pelvic health physical therapy can do to improve your endometriosis-related pain,” “Dietary modification to alleviate endometriosis symptoms.”

Journal of Physical Therapy Science: “Efficacy of exercise on pelvic pain and posture associated with endometriosis: within subject design.”

Minerva Chirurgica: “Gluten-free diet: a new strategy for management of painful endometriosis related symptoms?”

Einstein: “Patients with endometriosis using positive coping strategies have less depression, stress and pelvic pain

Patients with endometriosis using positive coping strategies have less depression, stress and pelvic painPatients with endometriosis using positive coping strategies have less depression, stress and pelvic pain.”

Journal of Behavioral Medicine: “The association of coping to physical and psychological health outcomes: a meta-analytic review.”

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Cleveland Clinic: “Transcutaneous Electrical Nerve Stimulation (TENS).”

European Journal of Obstetrics, Gynecology and Reproductive Biology: “Effectiveness of complementary pain treatment for women with deep endometriosis through Transcutaneous Electrical Nerve Stimulation (TENS): randomized controlled trial.”

Iranian Journal of Nursing and Midwifery Research: “The effects of massage therapy on dysmenorrhea caused by endometriosis.”

Autonomic Neuroscience: “Physiological responses to touch massage in healthy volunteers.”

Mayo Clinic: “Acupuncture,” “Botox injections.”

PLOS ONE: “Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis.”

Pharmaceutical Biology: “Anti-inflammatory activities of essential oils and their constituents from different provenances of indigenous cinnamon (Cinnamomum osmophloeum) leaves.”

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Patients with endometriosis using positive coping strategies have less depression, stress and pelvic pain Journal of Clinical and Diagnostic Research: “Comparative Effect of Cinnamon and Ibuprofen for Treatment of Primary Dysmenorrhea: A Randomized Double-Blind Clinical Trial.”

Neurology: “Botulinum Toxin Treatment of Chronic Pelvic Pain in Women with Endometriosis.”

European Journal of Nutrition: “Coffee and caffeine intake and risk of endometriosis: a meta-analysis.”

Nutrients: “Caffeinated Coffee, Decaffeinated Coffee and Endometrial Cancer Risk: A Prospective Cohort Study among US Postmenopausal Women.”

Human Reproduction: “Fatigue – a symptom in endometriosis.”

Sleep and Biological Rhythms: “Napping during the late‐luteal phase improves sleepiness, alertness, mood and cognitive performance in women with and without premenstrual symptoms.”

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Reviewed by Neha Pathak, MD on January 11, 2021

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

You may be surprised by these ways to ease your endometriosis pain.