Can you get medical cannabis for endometriosis in the UK?

Endometriosis causes pain that is frequently dismissed and frequently undertreated, with an average diagnostic delay in the UK measured in years. That history matters here: people arrive at private consultations having already been let down, and they deserve accuracy rather than enthusiasm.

Is endometriosis treated with medical cannabis in the UK?

Endometriosis-related pain is assessed by private specialists, usually where pain persists despite hormonal treatment, surgery, or both. It is not an NHS treatment for endometriosis and nothing is licensed for it.

The distinction to keep hold of is between the disease and the pain. Endometriosis is managed by gynaecology through hormonal treatment, excision or ablation surgery, and fertility care where relevant — as set out in NICE guideline NG73. A cannabis-based medicine addresses none of that. It is considered only for pain, and only alongside continuing gynaecological care.

Endometriosis pain also frequently becomes centralised over time, behaving more like chronic pain than like pain from a single lesion. Where that has happened, the assessment looks much like the one for chronic pain.

What the evidence actually shows

There is no randomised controlled trial of cannabis-based medicines in endometriosis. The UK evidence is observational, recent, and reported by the researchers themselves as preliminary.

A longitudinal case series from the UK Medical Cannabis Registry, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, followed 63 endometriosis patients prescribed cannabis-based medicinal products and reported improvements in pain-specific measures, quality of life, anxiety and sleep quality from baseline to 18 months, with over a quarter reducing prescription opioid use. Adverse events were reported by around a quarter of participants and were described as mild or moderate. The authors state plainly that causation cannot be inferred and that the findings are intended to support the design of randomised trials.

Eighteen months of follow-up in 63 self-selected patients is worth something. It is not evidence that the medicine caused the improvement. A case series has no comparison group, so it cannot separate a real effect from the natural fluctuation of endometriosis pain, from other changes to a person's care, or from the improvement people often report simply from starting a treatment they have chosen. That is precisely why the authors frame their work as a step towards randomised trials rather than a substitute for them, and why an honest specialist will present this as promising but unproven.

What a specialist will want to see

There is no UK list of qualifying conditions, so nothing here entitles you to a prescription. A specialist works through your history and decides whether a monitored trial is justified for you. For endometriosis-related pain they will typically look at:

• Whether endometriosis has been confirmed, and how — imaging, laparoscopy, or clinical diagnosis
• What hormonal treatments you have tried, and what happened with each
• Whether you have had excision or ablation surgery, and whether further surgery is planned
• Whether your pain is cyclical, constant, or has become widespread and centralised
• Your fertility plans, and your contraception — treatment is not considered suitable in pregnancy
• Bladder, bowel and fatigue symptoms, which often travel with endometriosis and change the picture

The general requirements — age, a documented diagnosis, the convention that two standard treatments have been tried, and access to your medical records — are covered in What are the requirements?

Risks and reasons a specialist may say no

The most important caution is about pregnancy. Cannabis-based medicines are not considered suitable in pregnancy or breastfeeding, and a specialist will discuss reliable contraception with anyone who could become pregnant before prescribing.

Otherwise the profile is the familiar one: drowsiness, dizziness, dry mouth, impaired concentration, and driving impairment from THC-containing products. A personal or family history of psychosis, unstable mental illness or significant cardiovascular disease will normally count against treatment. And because pain relief can mask a change in the disease, continuing gynaecological review matters — new or worsening symptoms still need investigating.

How medical cannabis is thought to help

The mechanism in endometriosis pain is not fully understood, and it is best described in general terms. The body has an endocannabinoid system — receptors and signalling molecules found throughout the nervous system — that is involved in how pain is processed, and the cannabinoids in cannabis interact with it. The target here is the pain, not the endometriosis.

THC and CBD act on that system in different ways, which is why products are described by the balance between them rather than as a single medicine. Because endometriosis pain often becomes centralised over time — the nervous system itself becoming more sensitive to pain signals — the rationale for trying a cannabis-based medicine tends to follow the reasoning used in chronic pain rather than anything specific to the lesions. None of this changes the disease, and it does not replace hormonal or surgical management. For the underlying biology, see the endocannabinoid system explained and THC and CBD explained.

What treatment involves in practice

Where a specialist judges a supervised trial reasonable, the approach is a cautious one: start at a low dose, increase slowly, and review against a clear goal for your pain and how you are functioning day to day.

The usual formats are oils or capsules by mouth and dried flower for vaporising. Oils are steady and easy to measure; vaporised flower acts faster but its effect is shorter, which can suit breakthrough pain. Your specialist decides the format and cannabinoid balance with you, and there is no dose that fits everyone — how a dose is set and adjusted is covered in how a dose is decided and adjusted, and the formats in how cannabis-based medicines are taken.

Follow-up is where the decisions are made. Reviews check whether the pain has genuinely eased and whether side effects are tolerable, while your gynaecology team keeps managing the disease and your contraception. Treatment that is not helping enough is stopped rather than continued out of habit. How quickly any effect appears varies — see how long cannabis medicines take to work — and the common unwanted effects are set out in side effects of cannabis-based medicines.

Living with treatment day to day

A prescription brings some practical responsibilities that are easier to manage once you understand them, particularly around driving, work and travel.

• Driving. THC-containing products can impair driving, and you must never drive while impaired; a medical defence applies when a prescribed medicine is taken as directed. See driving with a medical cannabis prescription.
• Work and testing. A workplace test can detect THC, so it helps to know your position in advance: medical cannabis, drug testing and work.
• Travel. Taking a prescribed cannabis-based medicine abroad depends on the destination country's law: travelling abroad with a prescription.
• Your GP. Telling your GP keeps your record complete and your care joined up: telling your GP.

If you want to take this further

The useful next step is a proper assessment, not a better list. Gather your diagnosis, the treatments you have already tried and what happened with each, and your current medicines — that is what a specialist needs in order to give you a straight answer.

The consultation itself, and what happens after it, is set out in What is the process to get a medical cannabis prescription? If endometriosis-related pain is not the only thing you are being treated for, say so early: other conditions and other medicines change the assessment.

Patient guide · Written by the Flora House editorial team · Last reviewed: 7 October 2026