Self-Reported Use and Effectiveness of Marijuana for Pelvic Pain Among Women with Endometriosis

Background/Objectives: Legal access to cannabinoids is increasing, and patients with chronic pelvic pain from endometriosis were hypothesized to explore and find benefit from the use of marijuana for symptom management. A survey of women with endometriosis was conducted with the objective of characterizing their experience with marijuana for management of pelvic pain: exploring symptom benefit, characteristics of use, and factors contributing to use and discontinuation. Methods: A descriptive cross-sectional survey was undertaken using an anonymous online questionnaire. Participants were recruited from an outpatient gynecology clinic using endometriosis ICD-10 diagnostic codes, and from the Endometriosis Association mailing list. Results: Marijuana use for symptom relief was reported by 78 (32.2%) Endometriosis Association participants, and 58 (46.8%) clinic participants. Within both populations, marijuana was considered very or moderately effective by most users (68.0 to 75.9%). Legality of recreational and medicinal marijuana in the state of residence was strongly associated with use (OR 7.13 [95% CI: 2.57–19.8]). Among users specifying current or past use, discontinuation was reported by 45% (54 of 121), and most frequently attributed to non-clinical factors of legal/employment risk and obstacles to marijuana access; 64.8% of former users attributed discontinuation to non-clinical factors only. Lack of symptom relief from other clinical management was the most cited motivation for initiation (55.1% clinic, 39.7% EA users). Conclusions: Marijuana use is common among women with endometriosis and chronic, refractory pelvic pain. Legality and access appear to impact use and discontinuation. While legal access to marijuana is associated with increased use, marijuana obtained outside of legal routes is also commonly being used for symptom relief.