Title : Alternative treatment options for endometriosis patients when traditional pain management is not working
Abstract:
Purpose Statement: The purpose of this literature review is to examine the current pain management options for endometriosis patients and explore cannabis and acupuncture as alternative options to optimize treatment. Background: Endometriosis is a gynecologic inflammatory disorder that effects 10% of women of reproductive age. The most central clinical feature is pain and only 72-93% of patients experience pain relief with treatment. There are three established mechanisms of pain: inflammation, central sensitization, and myofascial dysfunction. These mechanisms are useful targets for pain management therapy.
Methods: This literature review research study used PubMed as a primary database, after preliminary research using Google Scholar and The American College of Obstetricians and Gynecologists (ACOG). The following search terms were used to compile relevant literature: endometriosis, pain, cannabis, acupuncture, efficacy, pelvic pain, endocannabinoid.
Results: Patients who self-reported use of cannabis for pelvic pain related to endometriosis experienced improved quality of life which includes symptomatic relief, better sex lives, and less visits to the doctor. When reviewing how the endocannabinoid system plays a role in endometriosis pathology, studies showed that the endocannabinoid receptor, transient receptor potential vanilloid 1 (TRPV1), contributes to chronic inflammation. Additionally, CB1/2 receptors may also contribute to endometriosis pathology however more research is needed to support this mechanism. Studies also showed that patients who underwent acupuncture therapy for endometriosis experienced symptom relief.
Discussion: As previously stated, there is a need for more treatment options due to the lack of pain relief some patients experience. For this reason, it is important to explore cannabis and acupuncture as treatment options for pelvic pain in endometriosis. Studies have shown promising results indicating that both cannabis and acupuncture can alleviate endometriosis symptoms.
Conclusion: Studies are still working to establish the exact mechanism of action for both cannabis and acupuncture. These future studies are essential in addressing the efficacy of alternative treatment options. There is a demand for expanding pain management options in endometriosis patients due to the poor quality of life and mental health of patients suffering with uncontrolled pain. Limitations to the current literature review compiled include drug dependency, medical marijuana legislation, negative bias towards both cannabis and acupuncture, and patients being perceived as “desperate”. While other alternatives have been explored, such as diet and exercise, the evidence does not strongly prove that they will be as impactful as cannabis and acupuncture.
