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Cannabidiol for the treatment of pelvic pain in endometriosis

Abstract

Chronic pelvic pain is a common clinical condition among women, especially during their reproductive years. Endometriosis is one of the gynecological diseases most frequently associated with chronic pain. The definitive diagnosis of endometriosis is only possible through the surgical procedure. However, the use of hormonal contraceptives is recommended as the first line of treatment when the diagnosis is presumed. Approximately 20% to 30% of women do not present any significant clinical improvement, and up to 60% of them maintain significant pain at the end of one year of treatment, with a high rate of recurrence or worsening of symptoms after treatment discontinuation. These failures make a significant proportion of these women eligible for surgical treatment. About 20% to 30% of women also experience no pain relief after surgery, and about 20% experience recurrence of symptoms after 2 years and 40-50% after 5 years. This culminates in a high rate of women with the disease who have already undergone surgical treatment, often aggressive, who persist with pain significantly interfering with their quality of life. Options for symptomatic relief are rudimentary, and no drug has been shown to be effective in this control.In recent decades, we have seen an increase in the range of uses of cannabinoids as useful medications in the treatment of a number of conditions, including chronic pain, without the undesirable psychological effects of cannabis. The accumulation of knowledge about this drug has allowed more robust clinical studies to be proposed to verify its efficacy. So much so that the International Society for the Study of Pain (IASP) has been organizing a task force since last year to guide and encourage the proposal of these interventions. Considering the lack of effective therapeutic options for these women with chronic pelvic pain associated with endometriosis who have already undergone surgery, considering the drug's potential as an anti-inflammatory, neuromodulatory, and analgesic drug, considering the safety of the drug (cannabidiol) and In the absence of unwanted effects associated with other cannabis derivatives, we believe that carrying out the study opens a real perspective for improving the symptoms and, as a result, the quality of life of this population. (AU)

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