Study Explores the Relationship between the Endocannabinoid System, Gut Microbiota, and Endometriosis

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Researchers explored this complex relationship, highlighting the impacts and benefits.

Researchers from Australia, New Zealand, and Canada explored how endometriosis, a chronic and painful condition, defined by “the presence of endometrial-like tissue outside of the uterus,” is influenced by the endocannabinoid system (ECS) and gut microbiota (1). Current treatments and pain management options for endometriosis are less than ideal for several reasons, the authors also noted, resulting in a need for this type of research (1). The study, titled “Cannabis and Endometriosis: The Roles of the Gut Microbiota and the Endocannabinoid System” was published in November 2023 in the Journal of Clinical Medicine (1).

In the study, the authors provided a review of current research and found that both the ECS and gut—which is part of the ECS—influence endometriosis, in particular, on immune response and hormone balance (1). “There is evidence that a dysregulation of the endocannabinoid system and the gut microbiota influence endometriosis symptoms and progression via changes in CB1 receptor expression and increased circulating levels of endocannabinoids,” the authors stated in the Abstract (1). “Protective effects of the ECS on the gut were observed by increases in endocannabinoids, including 2-AG, resulting in decreased inflammation and improved gut permeability.” Also summarized were findings from trials involving medical cannabis as a treatment for endometriosis (1).


The authors also stated the benefits of further understanding the interactions between the ECS, gut, and endometriosis (1). “While studies have not completely deciphered the molecular basis of these relationships, the current literature demonstrates the vital roles that the ECS and the gut microbiota play in potential implications in preventing the development of endometriosis as well as effective therapeutic strategies,” stated the Conclusions and Future Directions section (1).

At the end of the study, researchers called for more exploration of the influence of cannabinoids on gut microbiota in endometriosis (1).

See our blog for more information on the connections between the ECS and gut.


  1. Farooqi, T.; Bhuyan, D. J.; Low, M.; Sinclair, J.; Leonardi, M.; Armour, M. Cannabis and endometriosis: The roles of the gut microbiota and the endocannabinoid system. Journal of Clinical Medicine 2023, 12 (22), 7071 DOI: 10.3390/jcm12227071.