Increased Endocannabinoids and Related Mediators during Menstrual Cycle
Cannabis, also known as marijuana, contains over 500 natural compounds. They imitate the compounds that are produced naturally by our body, known as endocannabinoids, which activate to maintain internal stability and health. Cannabinoids and the modulators of endocannabinoid system affect specific mechanisms that are critical to the establishment and development of endometriosis.
A study was conducted to measure the systemic levels of endocannabinoids and related mediators in women with and without endometriosis and to investigate the levels that are correlated with endometriosis-associated pain.
In the study, plasma and endometrial biopsies were obtained from women with a laparoscopic diagnosis of endometriosis. Plasma levels of endocannabinoids and related mediators, messenger RNA expression of some of their receptors and enzymes involved in the synthesis and degradation of AEA, OEA and PEA were evaluated in endometrial stromal cells. The systemic levels were elevated in endometriosis in the secretory phase as compared to controls.
After the evaluation, it was observed that the expression of CB1 was higher in secretory phase endometrial stromal cells of controls versus endometriosis. However, similar expression levels of CB2, TRPV1 and NAPE-PLD and FAAH were detected in controls and endometriosis. Patients with moderate-to-severe dysmenorrhea and dyspareunia showed higher AEA and PEA levels than with low-to-moderate pain symptoms.
The association of increased circulating AEA and 2-AG with decreased local CB1 expression in endometriosis suggested a negative feedback loop regulation which may impair the capability of these mediators to control pain. These preliminary data suggested that the pharmacological manipulation of the action or levels of these mediators offered an alternative option for the management of endometriosis-associated pain.