Sinclair Justin, Eathorne Allie, Adler Hannah, Mardon Amelia, Holtzman Orit, Abbott Jason, Sarris Jerome, Armour Mike
Reprod Fertil. 2025 Jun 12;6(2). doi: 10.1530/RAF-24-0098. Print 2025 Apr 1.
People with endometriosis report consuming cannabis to manage their symptoms. Given the range of differing legalities and access pathways across the world, this study aimed to investigate the drivers and barriers to cannabis use worldwide. An online, anonymous, cross-sectional survey was distributed internationally by endometriosis organisations and was open to anyone consuming cannabis for endometriosis symptoms. Survey questions included motivations for both starting and ongoing cannabis consumption, concerns over cannabis use, reasons for stopping cannabis, and communication of cannabis consumption with healthcare providers. Eight hundred and eighty-nine responses were collected across >10 countries. Illicit cannabis (56.7%) was the most common access pathway. 99% of respondents stated they would continue to use cannabis to manage their endometriosis-based symptoms, with 90% reporting they would recommend its use to a friend or relative with the disease. The most common motivation(s) for cannabis consumption were inadequate pain control (68.6%) and bothersome side effects of medications (56.3%). Similar motivations were reported for ongoing cannabis consumption, with concerns over dependence/addiction on pharmaceutical medications (43.9%) being another common motivation. Those using illicit cannabis were significantly less likely (P < 0.0001) to disclose their cannabis consumption to medical professionals. Cannabis was viewed as superior to pharmaceuticals both in terms of effectiveness and side-effect profile. Despite this, concerns around cost, breaking the law, judgement due to stigma, and current drug-driving laws were reported. Illicit usage and lack of medical oversight raise concerns over potential drug interactions or withdrawal effects due to reduction in pharmaceutical medications because of cannabis.
Survey participants reported that it is most common internationally for people using cannabis to manage endometriosis pain and associated symptoms to access this illegally, despite medical access being available in many countries. Many respondents also reported that cannabis was more effective and had a more tolerable side-effect profile than pharmaceutical medications they had used previously. However, over half of respondents were concerned about the negative impact of stigma associated with cannabis and how this might affect their day-to-day lives. Other concerns were potentially breaking the law where they live, possibly losing their driving licence due to drug-driving laws, or losing their job due to workplace drug-testing policies. Such concerns may be why more than 30% of participants reported not disclosing their cannabis consumption to their doctor. This is concerning because medical supervision is important to monitor for side effects and potential drug interactions, which people using cannabis may not know exist.
患有子宫内膜异位症的人报告称使用大麻来缓解症状。鉴于世界各地不同的合法性和获取途径，本研究旨在调查全球范围内使用大麻的驱动因素和障碍。一项在线、匿名的横断面调查由子宫内膜异位症组织在国际范围内开展，任何因子宫内膜异位症症状而使用大麻的人都可参与。调查问题包括开始和持续使用大麻的动机、对使用大麻的担忧、停止使用大麻的原因以及与医疗服务提供者交流大麻使用情况。在10多个国家共收集到889份回复。非法获取大麻（56.7%）是最常见的途径。99%的受访者表示会继续使用大麻来缓解基于子宫内膜异位症的症状，90%的受访者称会向患有该病的朋友或亲属推荐使用大麻。使用大麻最常见的动机是疼痛控制不佳（68.6%）和药物令人烦恼的副作用（56.3%）。持续使用大麻的动机类似，对药物依赖/成瘾的担忧（43.9%）是另一个常见动机。使用非法大麻的人向医疗专业人员透露其大麻使用情况的可能性显著更低（P < 0.0001）。大麻在有效性和副作用方面被认为优于药物。尽管如此，仍有人报告了对成本、违法、因污名化而受到评判以及现行酒驾法律的担忧。非法使用和缺乏医疗监督引发了对因大麻导致药物减少而产生潜在药物相互作用或戒断效应的担忧。
调查参与者报告称，在国际上，使用大麻来缓解子宫内膜异位症疼痛及相关症状的人最常见的获取途径是非法的，尽管许多国家都有医疗渠道。许多受访者还表示，大麻比他们之前使用的药物更有效，副作用也更易耐受。然而，超过一半的受访者担心与大麻相关的污名化的负面影响以及这可能如何影响他们的日常生活。其他担忧包括在其居住地区可能违法、因酒驾法律可能失去驾照或因工作场所药物检测政策而失去工作。这些担忧可能是超过30%的参与者报告未向医生透露其大麻使用情况的原因。这令人担忧，因为医疗监督对于监测副作用和潜在药物相互作用很重要，而使用大麻的人可能不知道这些情况的存在。
