best cbd oil products for endometriosis

CBD Oil for Endometriosis Pain – March 2022

Why Women Are Turning to CBD for Endometriosis Pain

Endometriosis (EM) is a condition caused by endometrial tissue growth outside of the uterus. This condition often causes severe menstrual pain and cramping .

Treatment options include hormone therapy, pain medication, or laparoscopic surgery. Hormone therapies, such as contraceptives ( birth control ), gonadotropin-releasing hormone (Gn-RH), and progestin therapy, may cause undesirable side effects .

For example, Gn-RH may cause artificial menopause (5 ) . Contraceptives and progestin therapies may cause headaches and bloating (6 ) .

Also, studies have debated the efficacy of non-steroidal anti-inflammatory drugs ( NSAIDs ), such as ibuprofen , on EM-associated pain (7 ) .

A review published by Deutsche Ärzteblatt International mentioned that 70% of young women with EM do not respond to NSAID treatments (8 ) .

These factors are why women with EM are turning to alternative options to improve quality of life.

The BMC Complementary and Alternative Medicine posted a cross-sectional online survey that measured the efficacy of self-management strategies. The strategies women used for EM pain were exercising, yoga, diet changes, hot compress, and CBD oil .

The study found that CBD oil produced the highest pain relief scores among women who participated in the survey (9 ) .

This anecdotal evidence from the survey may be explained by studies supporting CBD’s therapeutic benefits.

A study posted by Therapeutics and Clinical Risk Management mentioned that CBD has anti-inflammatory and analgesic properties. The author added that CBD was able to inhibit proinflammatory cytokines on animal subjects (10 ) .

Cytokines are cell-signaling proteins that trigger systemic inflammation in the body (11 ) .

This hypothesis was supported by an animal cross-study posted by Proc Natl Acad Sci USA. Study results showed that CBD’s immunosuppressive action decreased cytokine production, resulting in reduced inflammation in knockout mice (12 ) .

Although positive results have been observed from anecdotal and animal studies, more research is needed to determine CBD ’s clinical value as an endometriosis treatment.

How CBD Oil Works to Help With Endometriosis Pain

The endocannabinoid system (ECS) is a complex system composed of endogenous cannabinoids and G-coupled receptors. The human body is filled with these receptors (13 ) .

The endocannabinoid receptors, cannabinoid 1 (CB1) and cannabinoid 2 (CB2), are present in the central nervous system, immune system , and peripheral organs. The ECS’s function is to promote and maintain body homeostasis (14 ) .

Modulating the ECS has therapeutic benefits in several health problems, such as chronic pain (15 ) , anxiety, insomnia (16 ) , neurodegenerative diseases (17 ) , and epilepsy (18 ) .

CB1, the more abundant receptor, can be found in pain circuits. CB1 receptors also participate in producing analgesic and anti-inflammatory effects (19 ) . Meanwhile, CB2 receptors are mostly expressed in the intestines and the immune system.

A 2017 study explained how cannabinoid receptor agonists might stimulate CB1 receptors and CB2 receptors. This activity might be beneficial in treating EM pain and other chronic pain conditions (20 ) .

Phytocannabinoids, such as CBD , tetrahydrocannabinol ( THC ), and cannabigerol (CBG), have an affinity to CB1 receptors (21 ) .

Several studies suggested CBD ’s ECS modulation might inhibit proinflammatory cytokines (22 ) .

It has also been observed that CBD might act as an agonist for endocannabinoid receptors, therefore modulating the ECS (23 ) .

A study from Pain journal mentioned that CB1 could be found in rodent uterus. The authors added that CB1 receptors in the uterus are a potential target treatment to reduce endo-induced hyperalgesia (sensitivity to pain) (24 ) .

The authors mentioned that studies in EM rat models provided evidence that endocannabinoids and cannabinoids could be useful in reducing endometriosis symptoms (25 ) .

Although rats models have significant ECS differences with EM in human models, a study recognized that there might also be lateral aspects (26 ) .

The Pros and Cons of CBD Oil for Endometriosis Pain

The Pros
  • A study has acknowledged that CBD might influence receptors to suppress proinflammatory cytokine production (27 ) .
  • A study mentioned that CBD has anti-inflammatory and analgesic properties (28) .
  • A study found that CBD oil had the highest pain relief scores among women who self-managed their EM pain using alternative strategies (29 ) .
  • Studies acknowledged that CBD has an excellent safety profile and is well-tolerated (30 ) .
The Cons
  • There is a lack of clinical studies on how CBD may affect endometriosis pain in humans. Most existing studies are done on animal subjects.
  • The CBD industry lacks regulation. Customers must thoroughly research before buying any CBD product .
  • CBD may cause adverse effects, such as loss of appetite, dry mouth, diarrhea, and sleepiness (31 ) .
  • CBD may cause liver injury when used in extremely high doses (32 ) .

How CBD Oil Compares to Alternative Treatments for Endometriosis Pain

There is no cure for EM. The main goals of therapies are pain management and improving quality of life (33 ) .

There are several alternative medicines available for managing EM pain.

Xuefu Zhuyu decoction (XZD) is an herb used in treating EM pain in China. Clinical studies have shown that XZD has therapeutic benefits in relieving dysmenorrhea , promoting fertility, and shrinking ectopic lesions (34 ) .

Another herb, Qu Yi Kang (QYK), has been shown to alleviate dysmenorrhea symptoms and reduce endometrial lesions (35 ) .

Green Tea Epigallocatechin-3-Gallate (EGCG) is a compound extracted from green tea leaves. ECG might enhance apoptosis and inhibit lesion growth in rat models (36 ) .

Ginsenoside Rg3 is found in Panax plants. An animal study has shown that ginsenoside Rg3 reduced lesions in EM rat models (37 ) .

These herbs are some of the several alternative medicines for treating EM pain. Mostly, these herbs are geared toward pain management .

These herbal medications like XZD, QYK, EGCG, and ginsenoside Rg3 have been clinically studied due to their popularity as EM treatments in China.

Studies have shown that CBD might also reduce pain and inflammation (38 ) . Like ECGC, CBD might also enhance apoptosis and suppress cytokine production (39 ) .

However, CBD ’s efficacy on EM pain is not yet supported by clinical trials.

How to Choose the Best CBD Oil for Endometriosis Pain

Women with EM may opt for full-spectrum CBD or broad-spectrum CBD .

Full-spectrum CBD oil contains all the cannabinoids found in the hemp plants, such as CBD , 0.3% tetrahydrocannabinol ( THC ), cannabigerol (CBG), and cannabinol (CBN).

Broad-spectrum CBD contains all the same cannabinoids except for THC .

Both full-spectrum and broad-spectrum create the “entourage effect.” This term is named after the cannabis synergy, wherein an individual takes in the supposed health benefits of all the cannabinoids in one dose.

The entourage effect has been demonstrated by an animal study published by Frontiers in Plant Science . The author mentioned that cannabis extracts with predominant CBD concentrations might deliver better analgesic results than pure THC or CBD (40 ) .

Women who have an intolerance to other cannabinoids may opt for CBD isolate (90% pure CBD ).

CBD Dosage for Endometriosis Pain

There is a lack of clinical studies on the appropriate CBD dosage for EM pain.

However, a study from the British Journal of Pharmacology recommended that individuals start with less than 1 to 5 mg per kilogram a day. This dose can gradually increase once the system gets used to taking CBD (41 ) .

Another study also mentioned that pure CBD produced a dose-response curve. The author observed that a smaller dose was effective until the peak is reached. Afterwhich, additional dosings no longer induce any response (42 ) .

This dose-response curve was demonstrated by a cross-study posted in the Brazilian Journal of Psychiatry . The authors showed that 300mg pure CBD produced better results compared to 150mg and 600mg (43 ) .

When taking CBD for EM pain, women must remember to be cautious. An extremely high CBD dose has been shown to cause liver damage (44 ) .

How to Take CBD Oil for Endometriosis Pain

When taking CBD oil for EM pain, an individual may want quick pain relief . Therefore, the recommended administration is through inhalation of CBD vapors (45 ) .

A study mentioned that the lungs are very efficient in absorbing cannabinoids. Plasma concentrations can be delivered into the bloodstream in 10 minutes or less (46 ) .

However, vaping may also cause adverse effects, such as allergic reactions, shortness of breath, and chest pains (47 ) .

Oral CBD deliveries are available in the form of capsules, softgels, and gummies. This method is recommended to be taken with or without a meal.

CBD tinctures may be taken through sublingual delivery. This method can be done by using an applicator to drop CBD tinctures under the tongue.

Compared to vaping, oral and sublingual delivery may take longer to be absorbed into the body, but these methods allow for optimal absorption (48 ) .

Some CBD companies have designed CBD suppositories for painful periods . However, there are no studies on how CBD suppositories might help in relieving EM pain.

CBD isolate is often sold in powder form. Women may mix this in a carrier oil, like virgin coconut oil, olive oil, or hempseed oil. CBD crystalline isolate may be dissolved under the tongue.

Meanwhile, transdermal CBD is not recommended for EM pain.

What is Endometriosis?

The endometrium is a tissue lining inside the uterus. During each menstrual cycle , the endometrium thickens and bleeds.

In some women, endometrial cells can be found outside the uterus, particularly in the fallopian tubes , ovaries, and pelvic lining.

During the monthly cycle, the endometrial tissues thicken and bleed, irritating the surrounding tissues and organs. The blood clot buildup eventually becomes scar tissue and causes organs to stick to each other.

  • Severe menstrual cramps
  • Dysmenorrhea
  • Chronic pelvic pain
  • Pain during urination and bowel movements .
  • Lower back or abdominal pain
  • Pain with intercourse
  • Infertility

The exact cause of EM is unknown, but experts believe that EM can be caused by heredity, c-section and hysterectomy procedures, and immune system disorders.

Effective treatments are available, but the surgery produces the best result. Laparoscopic surgery can remove the lesions, adhesions, and scar tissue.

The laparoscopic procedure may also restore fertility. A study mentioned that the postoperative fertility rate was 43% (50 ) .

However, the study also mentioned that the recurrence of EM after laparoscopic surgery is 20% after five years (51 ) .

What is Deep Infiltrating Endometriosis?

Deep Infiltrating Endometriosis (DIE) is when scar tissues caused by endometrial lesions have infiltrated 5 millimeters into the tissues of pelvic organs (52 ) .

DIE is considered stages 3 and 4 of endometriosis . Stages 1 and 2 involve minimal lesions and superficial implants on surrounding organs, while stages 3 and 4 are when cysts are formed in the ovaries (53 ) .

The late stages also mean that surrounding organs have deep implants and dense adhesions (54 ) .

Treatments for DIE often involve surgery, NSAIDs , and hormonal therapies. DIE can lead to infertility and multiple cyst growths if left untreated (55 ) .

How is CBD Oil Different from Medical Marijuana?

CBD is a cannabinoid extracted from Cannabis sativa plants. Manufacturers use an extraction method to produce a concentrated version without the psychoactive effects one may get from cannabis products or medical marijuana .

Depending on the cannabis strains used by the dispensary, medical marijuana can contain up to 17-28% THC (56 ) . Federal law prohibits CBD oil from carrying more than 0.3% THC .

Hemp derivatives, such as CBD oil , hemp oil, and hemp seed oil, are legal in the United States.

Unlike medical cannabis or medical marijuana , CBD oil is legal in all 50 US states and territories. Medical and recreational cannabis use is only allowed in 11 US states.

Although CBD is legal, it remains highly unregulated. Some questionable CBD brands are not held accountable for falsely advertising their products as high-quality.

Customers can quickly identify legitimate CBD brands by checking the company’s transparency. High-quality CBD brands often post the certificate of analysis (COA) on their website.

The COA is a third-party lab result from ISO-certified laboratories. With the COA, consumers know exactly how much cannabinoids are contained in the product.

The COA also tests for heavy metals, fungicides, pesticides, and other contaminants. The COA ensures that the product is safe for use on humans or pets.


Animal studies have shown that CBD has anti-inflammatory and analgesic properties (57 ) . These findings suggest that CBD might be useful in alleviating difficult-to-treat pain.

Also, CBD oil has reduced EM pain among women who tried self-management strategies (58 ) .

Researchers also mentioned that studies in EM rat models provided evidence that modulating the ECS might reduce endometriosis symptoms (59) .

Best CBD Oil for Endometriosis Pain

Do you have endometriosis? You may want to try cannabidiol (CBD) to help alleviate the pain.

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Best CBD Oil for Endometriosis Pain 2022

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Compare the best CBD for Endometriosis Pain in 2021

Best CBD Oil for Endometriosis Pain

1. Spruce 750mg Lab Grade CBD Oil
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Each bottle of the 750mg CBD oil tincture contains 25mg of CBD per dropper full. The oil is peppermint flavor to mask any unpleasant tastes related to CBD.

2. NuLeaf Naturals 900mg Full Spectrum Hemp CBD Oil
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Natural remedy for various illnesses. NuLeaf Naturals’ CBD oil is a whole-plant extract containing a full spectrum of naturally occurring synergistic cannabinoids and terpenes.

3. Spruce 2400mg Lab Grade CBD Oil
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The largest bottle of CBD oil that Spruce offers contains 2,400mg of CBD. This is full-spectrum CBD oil, which is the maximum possible potency. Each high potency dropper full contains 80mg of CBD. There are no flavorings in it, which allows for the most CBD to fit in the 30ml bottle.

4. Avida Full Spectrum CBD Oil Tincture 500mg
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Avida Extracts Full Spectrum CBD oil is the latest iteration of the brand’s advanced Avida CORE Spectrum technology. They use a proprietary full spectrum blend, resulting in the highest naturally occurring Phyto-cannabinoids and Terpenes with THC (<0.3) to support your health.

5. cbdMD CBD Oil Tincture Natural 1500mg
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cbdMD’s CBD oil tinctures are made using only CBD sourced from medical hemp and MCT oil as a carrier oil. Tinctures are offered in orange, mint, natural, and berry flavors. Safe for daily use, the oil tinctures are packaged with a built-in rubber dropper to adjust CBD dosage easily. The packaging is made to be easy to transport and discreet to use.

6. CBDistillery THC Free CBD Oil Tinctures
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CBDistillery’s Isolate CBD Oil Tinctures harness the power of pure CBD. CBD Isolate Oil Tinctures include 0.0% THC. When you use CBDistillery CBD Isolate Oil Tinctures, you can be assured you’re using the highest quality CBD on the market.

7. NuLeaf Naturals 300mg Full Spectrum Hemp CBD Oil
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This is one of several concentrations from NuLeaf Naturals. As the lowest concentration, it is the company’s best option for those new to CBD oil. The product is lab-tested and fully organic. It is full-spectrum, so it contains THC in small quantities.

8. cbdMD CBD Oil Tincture Natural 750mg
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A 750mg bottle of cbdMD’s Broad Spectrum Oil Tincture does not contain THC. It also has a fairly wide flavor range which is perfect for those who prefer other taste. Vegan consumers are considered since cbdMD offers Vegan products. Aside from all of that, another reason why people love cbdMD is because it’s free from harmful chemicals.

9. Hemp Bombs 750mg CBD Oil
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Hemp Bombs offer CBD Oil Tinctures that come in a 30ml bottle containing 750mg of CBD. They provide a wide range of flavors perfect for those that have a knack for sweets. Consumers can safely intake this because it’s free of chemicals and pesticides. Hemp Bombs also offer a 20% off on products upon subscription.

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How CBD Helps With Endometriosis Pain

Endometriosis is an often painful ailment where the tissue that usually lines the insides of your uterus grows outside (1) .

The pain is sometimes difficult to alleviate without surgery, which often produces intolerable side effects (2) .

Based on a study from the Journal of Pain, the endocannabinoid system ( ECS ) may affect uterine function and dysfunction. Thus, the researchers hypothesized that the ECS may be involved in endometriosis and associated pain (3) .

The endocannabinoid system is present in almost all parts of the body and functions by maintaining homeostasis (4) .

Homeostasis is the process where living things maintain stability (5) .

Cannabidiol (CBD), which is an active element of cannabis (6) , works by interacting with the ECS (7) .

The ECS is composed of cannabinoid receptors , namely, CB1 and CB2 receptors found on cells throughout your body (8) .

CB1 receptors play a significant role in pain sensation (9) . They may be expressed on both the somata (body of an organism) and fibers of the sensory and sympathetic neurons that innervate ectopic growths (10) .

The findings suggested that the endocannabinoid system may contribute to mechanisms underlying the pain associated with endometriosis . The ECS may also affect the peripheral innervation of the abnormal growths ( 11) .

Note that the human body naturally produces endocannabinoids that interact with the cannabinoid receptors (12) .

However, if there is a shortage of endocannabinoids, plant-based cannabinoids like CBD and tetrahydrocannabinol ( THC ) may mimic their actions (13) .

THC is the primary psychotropic congener in the cannabis plant that produces a euphoric high. CBD, on the other hand, is non-psychoactive (14 ) .

When there is an endocannabinoid deficiency, administering CBD and THC may help the endocannabinoid system maintain its proper function (15) .

However, measuring the number of CB receptors stimulated and how each phytocannabinoid enters the bloodstream is complex (16 ) .

A national online survey conducted in 2019 focused on self-management strategies of Australian women with endometriosis (17) .

Among the many self-management strategies Australian women used to alleviate their symptoms, hemp or CBD oil displayed one of the highest pain relief scores (18) .

This result may be promising. Still , significant research must be done to understand the impact of the interaction between CB receptors and cannabinoids like CBD .

M ore studies are necessary to determine CBD’s therapeutic effects and its ability to alleviate endometriosis pain .

Benefits of Using CBD for Endometriosis Pain

Endometriosis may cause pain and discomfort due to the abnormal growth of the endometrial tissue (19) .

CBD may help with inflammation and pain (20) . Thus, CBD’s anti-inflammatory and pain-relieving properties may be promising for endometriosis .

A cross-sectional online survey from the BMC Complementary Medicine and Therapies reported that CBD oil was one of the most highly rated self-management strategies based on the female participants’ personal experience (21) .

Numerous clinical trials involving cannabidiol ’s purported benefits on chronic pain have been conducted since the early 2000s (22) .

A study published in the journal Antioxidant reviewed the main biological effects of cannabidiol and its synthetic derivatives, focusing on CBD’s antioxidative and anti-inflammatory properties (23) .

The researchers hypothesized that CBD may help with diseases associated with oxidative stress (24) .

For this reason, cannabidiol ’s antioxidative and anti-inflammatory properties may help women with endometriosis .

Note that endometriosis not only causes pain. The condition may also lead to infertility (25) .

Research from Oxidative Medicine and Cellular Longevity noted the role of oxidative stress, defined as a disproportion between antioxidants and reactive oxygen species (ROS) , on endometriosis (26) .

ROS plays a significant role in the modulation of cell survival and inflammation-related factors (27) .

Oxidative stress plays a pivotal role in infertility due to the decreased level of antioxidant mechanisms. Meanwhile, excessive ROS may reduce the likelihood of fertilization in IVF or in vitro fertilization because it causes an environment unsuitable for normal female physiological reactions (28) .

IVF is an assisted reproduction procedure where a woman’s egg and a man’s sperm are combined in a laboratory dish (29) .

Aside from CBD’s anti-inflammatory properties, this non-euphoriant compound also contains analgesics with a CB1 receptor antagonist and endocannabinoid modulating effect (30) .

Thus, CBD’s analgesic properties may help women with endometriosis in terms of pain management .

These studies are still inconclusive. Therefore, more research is needed to verify the efficacy of CBD on endometriosis .

How Long Does CBD Take to Help With Endometriosis Pain

Inhaling CBD using vape pens is the quickest way to benefit from the effects of cannabidiol (31) .

However, vaping should be done with caution as this ingestion method may damage your lungs (32) .

Meanwhile, taking substances under the tongue also ensures prompt delivery of CBD into your system ( 33 ) .

Most CBD tinctures or CBD oil products may include a calibrated dropper which you can use to dispense the content straight into your mouth. Usually, cannabidiol ’s onset is around 15 to 30 minutes via this method ( 34) .

For CBD topicals , the onset is also relatively quick (10 to 15 minutes), and the effects usually last from two to four hours (35) .

How Long Will CBD Help With Endometriosis Pain

Bioavailability is when a substance becomes entirely available to its intended biological destinations (36) .

A systematic review published in Frontiers Pharmacology determined that cannabidiol ’s bioavailability after smoking is 31% (37) .

The bioavailability is zero for the topical application since it does not allow the compound to enter the bloodstream (38) .

Meanwhile, CBD’s half-life is between 1.4 and 10.9 hours after an oromucosal spray, two to five days after chronic oral administration, and 24 hours after intravenous medications (administered through the veins) (39) .

A half-life means the estimated time it takes for a drug in your system to be reduced by 50% (40) .

Risk and Side Effects of Using CBD for Endometriosis Pain

  • Dry mouth
  • Diarrhea
  • Reduced appetite
  • Drowsiness
  • Fatigue

CBD Dosage

Most CBD brands may provide a recommended dosage for every CBD product they have.

Research from Current Drug Safety stated that humans may tolerate chronic use and high doses of CBD up to 1,500mg per day (42) .

Still, it is recommended that you speak with a physician before administering any CBD product to manage endometriosis pain .

Taking CBD Oil for Endometriosis Pain

CBD products are available in tinctures , vapes , edibles , and topicals , like balms and creams.

  1. Make sure to go for high-quality CBD products if you want to maximize the benefits of CBD . Always check the ingredients list and choose either full-spectrum CBD oil or CBD isolates. Remember that for a CBD product to be considered full-spectrum , its THC level must be less than 0.3%. Moreover, it must have all the extracts of cannabis plants. Meanwhile, CBD isolates are a pure form of cannabidiol (43) .
  2. Look for any disclaimers , certificates of analysis (CoAs), and lab test results.

Legality of CBD

The 2018 Farm Bill legalized the commercial use of industrial hemp on a federal level in the U.S (44 ) .

The bill noted that Cannabis sativa plants with not more than 0.3% THC are considered industrial hemp (45) .

Product Frequently
Asked Questions

When a woman has endometriosis, the normal tissue around the endometriosis implants becomes scarred and inflamed (46) .

CBD has anti-inflammatory properties and also contains analgesics ( 47) . Thus, CBD may help with endometriosis pain .

Research from the Antioxidant journal examined cannabidiol ’s antioxidative and anti-inflammatory properties ( 48) .

The researchers hypothesized that CBD may help with diseases associated with oxidative stress (49) .

Oxidative stress is associated with endometriosis ( 50) . Thus, CBD may be promising in the management of endometriosis pain.

There is no direct evidence linking CBD’s effect on making endometriosis pain worse.

Yes. There is a probability that CBD may interact with any medication you are taking for endometriosis. Remember that a lthough CBD is often well tolerated, it may also carry some risks. You may experience diarrhea and dry mouth (51) .

Thus, seeking medical advice is necessary, especially if you are considering CBD or medical marijuana for optimal wellness .

A physician may advise you regarding possible drug-to-drug interaction.

If you have endometriosis , several treatment options are available for pain relief .

You may take nonsteroidal anti-inflammatory drugs ( NSAIDs ) or ibuprofen to calm endometriosis and help alleviate painful menstrual cramps (52) .

However, CBD may interact with these painkillers . Thus, you must talk with a physician before using CBD with other endometriosis treatments or supplements for self-care .

No. Based on clinical trials , the oral administration of cannabidiol does not result in detectable THC blood concentrations (53) .

Therefore, the oral administration of CBD alone should not result in a positive drug test .

CBD as medication has not been approved by the U.S. Food and Drug Administration ( FDA ). Thus, there is no official dosage guideline for CBD.

However, the general rule is to start low and go slow and then adjust the dosage accordingly until you achieve the desired effects.

Endometriosis is caused by the growth of the endometrium outside your uterus (womb). This condition commonly involves your fallopian tubes and ovaries .

  • Pain with bowel movement
  • Infertility
  • Lower back pain
  • Pelvic pain

Risk factors include heavy periods and short menstrual cycles , which may be regulated by apoptosis (eliminating unwanted cells) (55) .

Aside from pain medication, your physician may also advise hormone therapy (56) . Furthermore, they may recommend a laparoscopy to detect any lesions (57) .

Endometriosis may sometimes be confused with ovarian cysts or any condition that can cause pelvic pain (58) .

However, defects in the immune system and genetics may play a vital role in determining whether a woman will develop this condition (59) .

If endometriosis invades organs near the uterus, it is called deep-infiltrating endometriosis (60) .

It is the positive effect that comes from terpenes and all of the cannabis plant components (61) . This phenomenon enhances cannabis’ purported benefits.