Cannabis Use, a Self-Management Strategy Among Australian Women With Endometriosis: Results From a National Online Survey

Sinclair et al. ·Journal of Obstetrics and Gynaecology Canada Impact 0.9

Mixed GRADE Low 66 citations

Samplen = 484 Pat.

DurationOctober to December 2017

EndpointSelf-reported pain reduction

Blindingn.a.

DesignKohortenstudie

Key finding

Women reported high self-assessed pain reduction (7,6/10) and improvement in sleep as well as nausea/vomiting, with 56% reducing pharmaceuticals by at least half; side effects were rare (10%) and mild.

Summary

n=484 Australian women with endometriosis, 13% report cannabis self-medication for pain control; descriptive survey without controlled outcomes, efficacy not quantified.

PopulationAustralian women with surgically confirmed endometriosis, age 18–45 years, n=484 (of which 13% cannabis users, n≈63)

InterventionSelf-administered cannabis for symptom control (mode of application not specified, predominantly illicitly obtained)

OutcomeSelf-reported pain reduction 7,6/10; 56% reduced pharmaceutical medication by ≥50%; improvements in sleep and nausea; side effects rare (10%) and mild

Confidence in the evidence

Low

The second of four GRADE levels, the effect estimate is of limited reliability.

Quality profile

Sample size ★★★★★

Blinding —

Effect size Mixed

Citations / year ★★★★★

Authors

Sinclair J, Smith C A, Abbott J et al.

DOI 10.1016/j.jogc.2019.08.033↗

Design: Kohortenstudie

Abstract

Objective: This study sought to determine the prevalence, tolerability, and self-reported effectiveness of cannabis in women with endometriosis. Methods: A cross-sectional online survey was conducted between October and December 2017. Recruitment targeted women with endometriosis through social media postings from endometriosis advocacy groups. Women aged 18 to 45, living in Australia, and with surgically confirmed endometriosis were eligible to participate. Survey questions investigated the types of self-management used, change in symptoms or medication use, costs, and adverse events. Results: A total of 484 responses were included for analysis, with 76% of the women reporting the use of general self-management strategies within the last 6 months. Of those using self-management, 13% reported using cannabis for symptom management. Self-reported effectiveness in pain reduction was high (7.6 of 10), with 56% also able to reduce pharmaceutical medications by at least half. Women reported the greatest improvements in sleep and in nausea and vomiting. Adverse effects were infrequent (10%) and minor. Conclusion: Australian law currently requires legal medicinal cannabis use to follow specific, regulated pathways that limit prescription by this method; however, self-reported illicit use of cannabis remains relatively common in Australian women with endometriosis. Women report good efficacy of cannabis in reducing pain and other symptoms, with few adverse effects reported. Further clinical research is warranted to determine the effectiveness of cannabis in managing endometriosis symptoms. In locations where medicinal cannabis is more accessible, there remains a paucity of evidence for its clinical efficacy with endometriosis-associated symptoms. Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

The impediment to action advances action. — Marcus Aurelius