Survey Study: Cannabis Use for Chronic Pelvic Pain Syndrome in Males
What is Chronic Prostatitis?
Chronic prostatitis is caused by inflammation of the prostate (a gland in a male’s body that releases fluids which aid in achieving sexual reproduction), which leads to long-lasting, lost-term pain in the pelvic region (e.g. around the penis, anus, lower abdomen, and lower back). There are two types, including:
- chronic prostatitis/chronic pelvic pain syndrome (also known as chronic nonbacterial prostatitis): non-infective; more common (9/10 males with chronic prostatitis)
- chronic bacterial prostatitis: infective; less common (1/10 males with chronic prostatitis)
What is Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)?
Since infective/chronic bacterial prostatitis is caused by bacteria, the inflammation can be treated with medications like antibiotics, which kill bacteria (reduction of inflammation would also lead to decreased pain). However, the cause of inflammation in noninfective chronic prostatitis/chronic pelvic pain syndrome is often unknown (although theories exist), so the syndrome can be difficult to treat. Additionally, because the cause of chronic nonbacterial prostatitis is unknown, it may not technically be “prostatitis” (inflammation of the prostate). It is therefore sometimes referred to only as “chronic pelvic pain syndrome”.
Other symptoms of chronic prostatitis/chronic pelvic pain syndrome may include:
- difficulties with urination (too difficult or too easy to urinate, experience of pain when urinating),
- sexual dysfunction (difficult to maintain an erection, experience of pain when ejaculating), and
- generalized pains and fatigue.
While there are many options available for management (e.g. prescribed medications like opioids, heat therapy and alternative treatments, certain food restrictions, sexual activity recommendations, surgery options), they are sometimes ineffective in fully managing patient discomfort, or inaccessible to those without reasonable health insurance. Chronic prostatitis/chronic pelvic pain syndrome can be experienced by males at any age, but is most common in those 30 to 50 years old. While females can also experience chronic pelvic pain, the cause is different, as they do not have prostates.
Results of Study
A survey study published on December 2014 in the Canadian Urological Association Journal recently found that over half of the participants with chronic prostatitis/chronic pelvic pain syndrome reported cannabis use, and approximately 61% of those users reported improvement in symptoms as a result of use.
The researchers surveyed participants either in the clinic (49 Canadian residents) or online (89 residents, mostly from the United States residents), and found:
- 50% of participants reported use of whole-plant cannabis
- Of cannabis users, 36.8% of clinic participants reported that cannabis use improved their symptoms, while 75% of online participants noted improvement.
- Of cannabis users who found that use improved their symptoms, 57% of clinic participants and 63% of online participants reported that it was “somewhat/very effective”.
- Overall, symptoms reported to be improved: “mood, pain, muscle spasms, … sleep”
- Overall, symptoms reported to not be improved: “weakness, fatigue, numbness, ambulation [walking], … urination”
- Side effects were similar between users, with approximately 70% of participants noting that they were either nonexistent or mild.
- Most users reported that use of cannabis was rare.
This information adds to a large collection of evidence showing that cannabis use may be effective for the management of pain, mood, muscle spasms, and sleep. Additionally, evidence shows the potential utility of cannabis and cannabinoids as anti-inflammatory agents.
“Evidence shows the potential utility of cannabis and cannabinoids as anti-inflammatory agents.”
While self-reports have significant weaknesses that limit the ability to use them as accurate, reliable information according to scientific standards, they should not be discounted by healthcare professionals, especially given that patient stories/self-reports are often used as the “real world” gauge of treatment effectiveness in the clinic for symptoms like pain.
Given that (1) opioid prescription is a pain management option for patients with chronic prostatitis/chronic pelvic pain syndrome, (3) use of opioids can lead to severe negative side effects, abuse, dependence, and death, and (3) cannabis use may be able to partially (as an add-on therapy) or fully replace opioid use in some instances, patients may benefit from access to alternative, safe pain management options like whole-plant cannabis.
Increased research will help to assess whether or not whole-plant cannabis use is an effective treatment option for chronic prostatitis/chronic pelvic pain syndrome.
For information on reasonable expectations and safety in considering whole-plant medical cannabis use, as well as how you can advocate to move cannabis out of the Schedule I controlled substance classification in order to increase research on phytocannabinoids in the United States, click here.