Cannabis‐Based Medicinal Products for Endometriosis: A 2‐Year Prospective Analysis From the
UK
Medical Cannabis Registry
Tania Ahmed, Simon Erridge, Evonne Clarke, Katy McLachlan, Ross Coomber, Shelley Barnes, Alia Darweish Medniuk, Rahul Guru, Wendy Holden, Mohammed Sajad, Robert Searle, Azfer Usmani, James J. Rucker, Michael Platt, Mikael H. Sodergren ABSTRACT
Background
Endometriosis affects up to 10% of biological females of reproductive age. Current treatment options are limited and often unsuitable for prolonged use. Cannabis‐based medicinal products (CBMPs) have emerged as an alternative for pain management.
Aims
To analyse changes in patient‐reported outcome measures (PrOMs), prescribed opioid burden, and the prevalence of adverse events (AEs) in patients prescribed CBMPs for endometriosis‐associated pain.
Materials and Methods
This was an observational analysis of prospectively collected data from the UK Medical Cannabis Registry. Biological females (≥ 18 years) with a primary diagnosis of endometriosis, enrolled ≥ 2 years prior to data extraction on 06/01/2025, were included. PrOMs and prescribed oral morphine equivalents (OME) were assessed between baseline and 1, 3, 6, 12, 18, and 24 months. Changes from baseline were assessed by repeated‐measures ANOVA and Bonferroni‐adjusted post hoc pairwise t‐tests. p < 0.050 was considered statistically significant.
Results
One hundred and one patients were included. Improvements from baseline were observed in BPI Severity, BPI Interference, SF‐MPQ‐2 Total, Pain VAS, EQ‐5D‐5L Index, GAD‐7, and SQS at all follow‐ups ( p < 0.001). Mean prescribed OME decreased from 19.9 ± 17.2 mg/day at baseline to 14.8 ± 15.9 mg/day at 24 months. Eighteen participants (17.8%) reported 165 AEs, of which 84 (50.9%) were mild. The most frequent were fatigue ( n = 16; 15.8%), lethargy ( n = 15; 14.9%), and headache ( n = 13; 12.9%).
Conclusion
CBMP treatment was associated with sustained improvements in pain, health‐related quality of life, sleep, and anxiety at 24 months, with a favourable AE profile. Randomised controlled trials are required to establish efficacy and safety.