Evaluating the impact of cannabinoid extracts on chronic pain and quality of life in endometriosis patients - a pilot study.

Kratz J.; Velho R.; Bock S.; Sehouli J.; Mechsner S. · PloS one · 2026

**Background & Methods** This prospective single-center cohort study enrolled 30 premenopausal women (aged 18-45 years) with confirmed endometriosis and chronic pelvic pain; 27 completed the 3-month treatment period. Participants received standardized oral cannabinoid-based medicinal products (CBMPs) with balanced THC:CBD ratios, with outcomes measured using validated instruments including Visual Analog Scale (VAS), Endometriosis Health Profile (EHP-30), Pain Disability Index (PDI), and Central Sensitization Inventory (CSI). **Key Findings** • Pain intensity decreased significantly after one month with sustained improvement over three months (p = 0.0004), accompanied by reduced frequency of pain days and decreased analgesic medication use, including both NSAIDs and opioids (p < 0.001). • Secondary outcomes improved substantially: fatigue (p = 0.0013), anxiety (p < 0.0001), central sensitization (p < 0.0001), disability (p < 0.0001), and overall quality of life all showed statistically significant improvements. • Treatment demonstrated favorable tolerability with predominantly mild, transient adverse effects (severity score 1/0-3) occurring mainly during the titration phase and declining with continued use. **Dosage & Administration** Oral cannabinoid-based medicinal products with balanced THC:CBD ratio were administered; specific doses not reported. **Safety & Adverse Effects** Adverse effects were predominantly mild in severity and transient, occurring primarily during the titration phase before declining with continued treatment. Specific adverse events were not detailed in the abstract. **Evidence Quality** This pilot study provides preliminary evidence but has significant limitations: single-center design without placebo control, small sample size (n=27 completers), and short 3-month follow-up period. The lack of a comparator group limits causal inference, and findings cannot be generalized beyond the studied population. As acknowledged by the authors, larger randomized controlled trials with appropriate placebo controls and extended follow-up are necessary to confirm efficacy, determine optimal dosing regimens, and establish the role of CBMPs as adjunctive therapy for endometriosis-related pain. The study represents level 2-3 evidence.

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