CBD for Endometriosis

Ingesting CBD Better Than THC in Treating Endometriosis Symptoms

A study on self-rated effectiveness of cannabinoids in treating endometriosis-related symptoms found that both THC and CBD can be used to treat different symptoms.

Calvin Chan, Ph.D. November 29, 2021

The British and Australian retrospective research study used self-reported data collected from a mobile phone app developed by a Canadian-based data and analytics company, Strainprint Technologies Ltd. The app allowed users to self-track how different tetrahydrocannabinol (THC) and cannabidiol (CBD) products help with their disease conditions – one of which is endometriosis.

For those with a uterus, during a normal menstrual cycle, a type of tissue called the “endometrium” builds up inside and is then shed if the person doesn’t become pregnant.

But with endometriosis, “endometrium-like” tissue develops outside the uterus on other organs inside the abdomen where it’s not supposed to.

“Prevalence rates of the disease have been estimated at between 5% and 11% of reproductive-aged women,” the study authors explained. “Impacting an estimated 176 million women worldwide.”

This misplaced tissue still responds to hormonal changes and will build up and break down during the menstrual cycle causing bleeding inside the abdomen which leads to inflammation, severe pain, and excessive menstrual cramps.


Other common symptoms also include mood effects such as anxiety and depression along with gastrointestinal problems like irritable bowel syndrome.


Using the app, users can select the endometriosis symptoms they’re experiencing and self-rate severity on a 0­–10 scale. They can then select a cannabis product and dosage from a pre-populated list of 6500 commercially available products, and then rate the effectiveness of the product after use.


Effectiveness of Inhaling vs. Ingesting CBD and THC Varies with Symptom

A total of 252 users with endometriosis reported 16,187 separate self-treatment sessions. Over 57% of which were related to pain management, followed by treatment for gastrointestinal symptoms (29%) and mood (13.5%).

Most users seemed to prefer using inhaled forms of CBD and THC products, with over 67% of sessions using an inhaled product. Researchers suggest that this is likely because inhaling a cannabinoid product typically leads to the fastest symptom relief:

“Symptom reduction by cannabinoids administered via the inhaled route, usually [occur] within 5–10 minutes,” the study authors explained. “In contrast to the 45–180 minutes for oral dosage forms.”

But the study found that just because it was fast, doesn’t mean it was always the most effective.

Overall, CBD and THC appeared to be most effective in treating gastrointestinal symptoms according to user reports – particularly when the product was applied topically or orally ingested.

“There was also an increase in efficacy for those treating mood [symptoms] with orally ingested forms,” the study authors said. “Oral administration also provides patients with more stable plasma levels and, therefore, a more sustained therapeutic benefit.”

The researchers further explained that part of the reason could be because CBD is better absorbed when ingested rather than when inhaled. CBD is known to have anti-inflammatory, anti-nausea, and anti-depressant-like effects – all of which could play a key role in treating gastrointestinal and mood symptoms.

However, when it came to pain management, both inhaled forms and oral ingestion were similarly effective.

CBD More Effective Than THC When it Comes to Oral Ingestion

The research team also found that higher THC levels as compared to CBD generally led to improved symptom relief – except for when it was taken orally.

When ingested, every 10-fold increase in THC amount compared to CBD led to a 4.75 point decrease in treatment efficacy, suggesting CBD may be the superior cannabinoid for treating endometriosis-related symptoms when ingested.

The researchers also caution that while higher THC can appear to provide improved relief for certain symptoms, it can also trigger unwanted psychoactive side effects.

“Higher levels [of THC] may overly impair or increase known side-effects, potentially causing issues with participants being able to perform [daily activities],” the study authors said.

Even more surprisingly, the research team found that the best symptom-relief was seen in older users, although the cause of that is unknown.

Nonetheless, it’s clear from the study that when it comes to treating endometriosis with cannabinoids, the type of symptom being targeted and the speed at which relief is needed can all impact what products might work best.

The research teams said that further research will be needed to completely solve the puzzle of what works best.

“Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.”

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Calvin Chan, Ph.D.

Calvin Chan is a researcher and medical writer from Edmonton, Canada. As a big science nerd, he loves reading and writing about everything science - from cannabis to dark matter and even alien life. Calvin has a PhD from the University of Alberta.