Palabras clave
Cannabidiol
H4CBD
Dolor pélvico
Terapias alternativas
Cómo citar
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Resumen
Objetivo: Analizar, mediante una revisión narrativa de la literatura, el potencial terapéutico de los cannabinoides cannabidiol (CBD) y tetrahidrocannabidiol hidrogenado (H4CBD) en el contexto de la endometriosis, con énfasis en los principales mecanismos biológicos implicados. Revisión bibliográfica: La endometriosis es una condición ginecológica crónica e inflamatoria que afecta a millones de mujeres en edad reproductiva, caracterizada por dolor pélvico persistente, infertilidad e impactos significativos en la calidad de vida. Las terapias convencionales, como las hormonales y quirúrgicas, presentan eficacia limitada, alta tasa de recurrencia y efectos adversos relevantes, lo que refuerza la necesidad de alternativas complementarias. La evidencia científica demuestra que el CBD ejerce acciones analgésicas, antiinflamatorias, antioxidantes y antiangiogénicas, atribuidas a la modulación de los receptores CB1, CB2, TRPV1 y GPR55, además de la regulación de citocinas proinflamatorias y la reducción del estrés oxidativo. Aunque no existen estudios clínicos específicos sobre el H4CBD en la endometriosis, sus propiedades farmacodinámicas sugieren un potencial similar o incluso superior al CBD, especialmente por su mayor estabilidad química. Consideraciones finales: Se puede considerar que los cannabinoides, en particular el CBD, representan alternativas emergentes para el manejo de la endometriosis, mientras que el H4CBD se perfila como un candidato innovador que requiere investigación experimental y clínica.
Referencias
AGUIAR ASN, et al. A comprehensive molecular analysis of cannabidiol: From solid state to antioxidant potential. Computational and Theoretical Chemistry, 2024; 1241: 114890.
ALIABAD RA, et al. Cannabidiol as a possible treatment for endometriosis through suppression of inflammation and angiogenesis. Immunity, Inflammation and Disease, 2024; 12: 1-8.
ALONSO A, et al. Medical management of endometriosis. Current Opinion in Obstetrics and Gynecology, 2024; 36(5): 353–361.
ARMOUR M, et al. Endometriosis and cannabis consumption during the COVID-19 pandemic: an international cross-sectional survey. Cannabis and Cannabinoid Research, 2022; 7(4): 473-481.
BELELLIS P, GIACOMETTI CF. Utilização da cannabis medicinal no tratamento da endometriose. BrJP, 2023; 6(2): S95-S96.
BEZERRA EF, et al. A eficácia do uso do canabidiol no tratamento de mulheres com endometriose: uma revisão sistemática. Brazilian Journal of Implantology and Health Sciences, 2024; 6(9): 516-525.
CANO-HERRERA G, et al. Endometriosis: a comprehensive analysis of the pathophysiology, treatment, and nutritional aspects, and its repercussions on the quality of life of patients. Biomedicines, 2024; 12: 1-20.
DESAI J, et al. Holistic approaches to living well with endometriosis. F1000Research, 2024; 13: 1-19.
DUARTE AN, RIGHI M. Associação entre endometriose e infertilidade feminina: uma revisão de literatura. Acta Elit Salutis, 2021; 4(1): 37-48.
ELLIS K, et al. The experiences of endometriosis patients with diagnosis and treatment in New Zealand. Frontiers in Global Women’s Health, 2022; 3: 1-20.
GARCIA MH, et al. Pseudocannabinoid H4CBD reduces cardiac damage indicator 4HNE in OLETF rats. Physiology, 2024; 39(S1): 1-8.
GENOVESE T, et al. Molecular and biochemical mechanism of cannabidiol in the management of the inflammatory and oxidative processes associated with endometriosis. International Journal of Molecular Sciences, 2022; 23(10): 1-16.
GRIMLING B, et al. Optimization and evaluation of cannabis-based magistral formulations: a path to personalized therapy. Pharmaceuticals, 2025; 18(1): 1-18.
HARSHAVARDHAN L, et al. Endocannabinoids and their receptors modulate endometriosis pathogenesis and immune response. eLife, 2024; 13: 1-15.
JASINSKI V, et al. Cannabis use in endometriosis: the patients have their say – an online survey for German-speaking countries. Archives of Gynecology and Obstetrics, 2024; 310: 2673–2680.
JOACHIM GE, et al. Cannabis smoking, tobacco cigarette smoking, and adenomyosis risk. Fertility and Sterility, 2023; 119(5): 838–846.
LI L, et al. Complementary therapy for endometriosis related pelvic pain. Journal of Endometriosis and Pelvic Pain Disorders, 2023; 15(1): 34-43.
MARTÍNEZ NAYA N, et al. An overview of cannabidiol as a multifunctional drug: pharmacokinetics and cellular effects. Molecules, 2024; 29(2): 473.
MASCAL M, et al. Synthetic, non-intoxicating 8,9-dihydrocannabidiol for the mitigation of seizures. Scientific Reports, 2019; 9: 1-6.
MISTRY M, et al. Cannabidiol for the management of endometriosis and chronic pelvic pain. Journal of Minimally Invasive Gynecology, 2021; 29(2): 169-176.
SAUNDERS PTK, HORNE AW. Endometriosis: Etiology, pathobiology, and therapeutic prospects. Cell, 2021; 184(11): 2807-2824.
ȘERBAN M, et al. O sistema endocanabinóide em doenças humanas: sinalização molecular, farmacologia de receptores e inovação terapêutica. International Journal of Molecular Sciences, 2025; 26(22): 11132.
SILVA R, et al. In silico study of the pharmacokinetics and human and environmental toxicological analysis of cannabidiol. Brazilian Journal of Biology, 2025; 85.
SOUZA MAP. O uso de canabinoides no tratamento da endometriose: uma revisão de literatura. 2023
STAROWICZ K, et al. The endocannabinoid system in pain and inflammation: its relevance to rheumatic disease pathophysiology and therapy. Pharmacological Reviews, 2020; 72(4): 990–1019.
TAHERMANESH K, et al. Treatment of ovarian hyperstimulation syndrome in a mouse model by cannabidiol, an angiogenesis pathway inhibitor. BioMed Research International, 2022; 1-10.
TIJANI EO, et al. Current and emerging therapies for endometriosis- associated pain: a review. Middle East Fertility Society Journal, 2025; 30(9): 1-14.
WILSON JN, et al. Pseudocannabinoid H4CBD improves glucose response during advanced metabolic syndrome in OLETF rats independent of increase in insulin signaling proteins. American Journal of Physiology – Regulatory, Integrative and Comparative Physiology, 2024; 326: R100-R109.
WITHANARACHCHIE V, et al. Motherhood and medicinal cannabis. Drug and Alcohol Review, 2025; 1-12.
WILSON JN, et al. Synthetic cannabidiol reduced body mass and visceral adiposity but not blood pressure in rats with advanced metabolic syndrome. FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology, 2022; 36 Suppl 1: S1.