Evaluating the impact of cannabinoid extracts on chronic pain and quality of life in endometriosis patients – a pilot study
- 1Department of Gynecology Charité with Centre of Oncological Surgery, Endometriosis Research Centre Charité, Berlin, Germany
Abstract
Endometriosis is a chronic gynecological disorder characterized by persistent pain and impaired quality of life, with limited effective treatment options. Emerging evidence indicates that cannabinoids may provide analgesic and symptom-relieving effects in chronic pain conditions. This prospective single-center cohort study investigated the effects of standardized oral cannabis extracts (cannabinoid-based medicinal products, CBMPs) on pain and quality of life in women with endometriosis. Thirty premenopausal women aged 18–45 years with confirmed endometriosis and chronic pelvic pain were enrolled; 27 completed the 3-month treatment period. Participants received oral CBMPs containing a balanced THC: CBD ratio. Pain intensity, frequency of pain episodes, analgesic use, fatigue, anxiety, central sensitization, disability, and quality of life were assessed using validated questionnaires (VAS, EHP-30, PDI, CFS, GAD-7, CSI). Significant improvements were observed after one month of treatment, with continued benefit over three months. Pain intensity decreased markedly (p = 0.0004), accompanied by reductions in the number of pain days and analgesic use, including both NSAIDs (e.g., ibuprofen, diclofenac) and opioid analgesics (e.g., tramadol, tilidin, oxycodone) (p < 0.001). Fatigue (p = 0.0013), anxiety (p < 0.0001), central sensitization (p < 0.0001), disability (p < 0.0001), and overall quality of life (EHP-30) improved significantly. Treatment was well tolerated; side effects were predominantly mild (severity score 1 on a 0–3 scale) and transient, occurring mainly during the titration phase and declining thereafter. Although limited by its single-center design, lack of placebo control, and short follow-up, this study provides preliminary evidence that oral CBMPs may represent a safe and effective adjunct therapy for managing pain and related symptoms in women with endometriosis. Larger randomized controlled trials are warranted to confirm these findings and establish optimal dosing strategies.
Related
- C-reactive Protein-to-Albumin Ratio for Evaluating Patients with Chronic Limb-Threatening Ischemia Following Endovascular Therapy
- Evaluating preoperative imaging in patients with chronic thromboembolic pulmonary hypertension: Is computed tomography pulmonary angiography a reliable alternative to pulmonary angiography?
- Evaluating the landscape and characteristics of endometriosis research published between 1990 and 2024.
- Whole-blood transcriptomic findings in emergency department patients with suspected cannabinoid hyperemesis syndrome: a pilot study.
- Second‐line MRI after expert transvaginal ultrasound in selected patients with suspected complex deep endometriosis: A prospective cohort study
BibTeX
@article{kratz2026evaluating,
title = {{Evaluating the impact of cannabinoid extracts on chronic pain and quality of life in endometriosis patients – a pilot study}},
author = {Janosch W. Kratz and Renata Voltolini Velho and Sandra Bock and Jalid Sehouli and Sylvia Mechsner},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0356768},
url = {https://doi.org/10.1371/journal.pone.0356768},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Evaluating the impact of cannabinoid extracts on chronic pain and quality of life in endometriosis patients – a pilot study
AU - Janosch W. Kratz
AU - Renata Voltolini Velho
AU - Sandra Bock
AU - Jalid Sehouli
AU - Sylvia Mechsner
PY - 2026
DA - 2026/09/22
JO - PLOS One
DO - 10.1371/journal.pone.0356768
UR - https://doi.org/10.1371/journal.pone.0356768
AB - Endometriosis is a chronic gynecological disorder characterized by persistent pain and impaired quality of life, with limited effective treatment options. Emerging evidence indicates that cannabinoids may provide analgesic and symptom-relieving effects in chronic pain conditions. This prospective single-center cohort study investigated the effects of standardized oral cannabis extracts (cannabinoid-based medicinal products, CBMPs) on pain and quality of life in women with endometriosis. Thirty premenopausal women aged 18–45 years with confirmed endometriosis and chronic pelvic pain were enrolled; 27 completed the 3-month treatment period. Participants received oral CBMPs containing a balanced THC: CBD ratio. Pain intensity, frequency of pain episodes, analgesic use, fatigue, anxiety, central sensitization, disability, and quality of life were assessed using validated questionnaires (VAS, EHP-30, PDI, CFS, GAD-7, CSI). Significant improvements were observed after one month of treatment, with continued benefit over three months. Pain intensity decreased markedly (p = 0.0004), accompanied by reductions in the number of pain days and analgesic use, including both NSAIDs (e.g., ibuprofen, diclofenac) and opioid analgesics (e.g., tramadol, tilidin, oxycodone) (p < 0.001). Fatigue (p = 0.0013), anxiety (p < 0.0001), central sensitization (p < 0.0001), disability (p < 0.0001), and overall quality of life (EHP-30) improved significantly. Treatment was well tolerated; side effects were predominantly mild (severity score 1 on a 0–3 scale) and transient, occurring mainly during the titration phase and declining thereafter. Although limited by its single-center design, lack of placebo control, and short follow-up, this study provides preliminary evidence that oral CBMPs may represent a safe and effective adjunct therapy for managing pain and related symptoms in women with endometriosis. Larger randomized controlled trials are warranted to confirm these findings and establish optimal dosing strategies.
SN - 1932-6203
ER -