Cannabidiol Use and Perceptions of Effectiveness in Women With Chronic Pelvic Pain

To investigate cannabidiol (CBD) use in women with chronic pelvic pain and nociplastic pain, as represented by a diagnosis of fibromyalgia, including impact on pain and associated symptoms, substitutions for other medications, and side effects.

This was a cross-sectional study using data derived from an online survey distributed through the National Fibromyalgia Association between April and May of 2020. This secondary analysis was limited to participants with concurrent chronic pelvic pain diagnoses. Participants were asked about their history of CBD use and sub-grouped by use patterns.

Of 1382 included participants, 501 (36.3%) were in the "Never Use" group, 404 (29.2%) were in the "Past Use" but not "Current Use" group and 477 (34.5%) were in the "Current Use" group. Of 477 participants in the "Current Use" group, 80.9% (n = 386) reported pain improvement. The most common indications for current CBD use were pain, insomnia, and anxiety. Participants who reported pain improvement were more likely to report improved sleep (P < 0.001), anxiety (P < 0.001), depression (P = 0.001), fatigue (P < 0.001), overall health (P < 0.001), and substitution of CBD for at least 1 other medication (P = 0.003) than those who reported no pain improvement. About half of the participants reported side effects, most of which were minor with the most common being drowsiness (n = 138, 29%).

Two-thirds of participants with concurrent chronic pelvic pain and fibromyalgia have used CBD. Improved pain with CBD use correlated with improvement in other symptom domains, such as sleep, mood, fatigue, and overall health. A large proportion of those using CBD reported substituting it for higher-risk medications.