Medical Marijuana: A Possible Treatment for Menstrual Cramps?
Andrea Chisolm, MD, is a board-certified OB/GYN who has taught at both Tufts University School of Medicine and Harvard Medical School.
Jessica Shepherd, MD, is a board-certified women’s health expert and nationally-recognized speaker addressing physical, sexual, and emotional health.
Medical marijuana has proven to have some significant medical benefits, most especially pain control. Although it isn’t strong enough to treat severe pain (such as bone fractures or post-surgical pain), it can be effective in relieving different types of chronic pain in many people.
Practitioners of alternative medicine will frequently include menstrual cramps as one of the conditions that medical marijuana can help treat. Insofar as it has been reported to help relieve symptoms of endometriosis and interstitial cystitis, it would seem reasonable to assume that marijuana can help treat the cyclical cramps and pelvic pain that can occur with menstruation.
Mechanism of Action
Marijuana (Cannabis sativa) contains more than 100 different compounds called cannabinoids, some of which have psychoactive properties. These compounds are easily absorbed when inhaled or eaten and can cross the blood-brain barrier to act directly on the brain.
The body is populated with a vast quantity of cannabinoid receptors, called CB1 and CB2, found mainly in the central nervous system but also in the lungs, liver, kidneys, and joints. These are the same receptors that naturally-occurring compounds, called endocannabinoids, attach to.
Endocannabinoids, part of the body’s endocannabinoid system, are believed to play an important role in regulating pain and inflammation. The ability of cannabinoids to attach to these receptors suggests that they may exert similar activity.
The two most recognized cannabinoids in marijuana are:
- Delta-9 tetrahydrocannabinol (THC), which is primarily responsible for marijuana’s psychoactive “high”
- Cannabidiol (CBD), which does not cause a “high”
While THC and CBD are thought to have anti-inflammatory and analgesic (pain-relieving) properties, how they do so differs from other anti-inflammatory or analgesic agents.
What the Evidence Says
Not surprisingly, there is a lack of quality research regarding the benefits of medical marijuana in treating menstrual pain. Even so, cannabis has a long history of use in gynecology. Back in the late-19th century, Sir John Russell Reynolds, Queen Victoria’s personal physician, was said to prescribe hemp tincture to relieve the monarch’s painful menstrual cramps.
How marijuana is meant to achieve the relief remains unclear. At its heart, menstrual cramps are triggered by the release of inflammatory compounds, called prostaglandins, during menstruation. Women who produce are excessive amounts of prostaglandins are more likely to experience severe cramps.
Nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to treat menstrual cramps—like Advil (ibuprofen) and Celebrex (celecoxib)—block the production of prostaglandins by binding to COX receptors in the brain and other tissues.
By contrast, cannabinoids like THC and CBD exert no activity on COX receptors. and, therefore, have no influence on the production of prostaglandins. Rather, they stimulate the release of the “feel-good” hormone dopamine in the brain (where CB1 resides in high density) while reducing inflammation in the nerves and joints (where CB2 resides in high density).
This suggests that THC and CBD are most beneficial in treating chronic neuropathic pain and inflammatory joint disorders like rheumatoid arthritis. Even so, a 2018 review from the University of Alberta suggests that the benefits may be small.
Because THC and CBD have no effect on prostaglandin production—the compound responsible for menstrual cramps—it is unclear how they are meant to relieve menstrual pain and inflammation.
With that said, it is possible that THC induces euphoria than can reduce the perception of pain. By contrast, CBD’s effect on menstrual cramps remains unknown and largely unsubstantiated.
Safety of Medical Marijuana
At this point, we don’t really know how safe medical marijuana use. Although many people presume it to be safe, the National Institute of Drug Abuse (NIDA) warns that the long-term consequences of marijuana use are still unknown.
Moreover, CBD oils, extracts, and tinctures popularly sold as alternative therapies sometimes contain unknown ingredients, and it is often difficult to know if the doses list on the product label are accurate.
Based on current advisement from the NIDA, medical marijuana in its inhaled form should not be used in people who:
- Are under 25 years of age
- Have a personal or strong family history of psychosis
- Have a current or past cannabis use disorder
- Have a current substance abuse disorder
- Have heart or lung disease
- Are pregnant or planning a pregnancy
Because there is little evidence about the safety of marijuana in pregnancy, it is best to avoid the drug if you are of reproductive age or use a proven form of birth control.
Though marijuana has not been shown to be cause birth defects, the presence of cannabinoid receptors in the fetal brain suggests that marijuana may impact a child’s cognitive and behavioral development in later years.
There is also evidence that marijuana use during pregnancy may increase the risk of pregnancy loss due to the overstimulation of cannabinoid receptors in the lining of the uterus.
A Word From Verywell
At present, there is no compelling evidence to support the use of medical marijuana in treating menstrual cramps. However robust the testimonials or anecdotal evidence may be, they lack any clear explanation of how the drug is meant to work. Do not be swayed by manufacturer claims that may or may not be true.
If you have severe, recurrent menstrual cramps that do not respond to conservative treatment, talks to your gynecologist about hormonal therapies or surgical options (like endometrial ablation or hysterectomy) that may help.
Heard the buzz about medical marijuana and menstrual cramps? Learn more about what we know and what we don't know about this controversial therapy.
Can weed relieve menstrual pain?
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Top things to know:
Cannabis is believed to have therapeutic uses for illnesses and pains, including menstrual discomfort
Researches are still scarce, but some studies already show effectiveness of cannabis on the relief of menstrual pain
Worldwide, there has been a noticeable trend in favor of legalising cannabis for medical and recreational use
If youвЂ™ve ever visited a healthcare provider for painful periods or cramps, you may have been recommended anti-inflammatory pain medicines or hormonal birth control (D). However, people with menstrual pain often look for other alternatives to painkillers and birth control (B).В
Medicinal plants have been used by many cultures for thousands of years for the treatment and prevention of diseases and their symptoms (A). Cannabis is one such plant that may relieve or lessen menstrual pain (12). Menstrual pain is commonвЂ”about half of people who menstruate have some pain for one to two days each cycle (C).
The use of cannabis (also called weed and marijuana, among other names) for the treatment of pain has been identified in various places around the world pre-Christianity. ItвЂ™s believed that medicinal cannabis was introduced to European medicine when physicians first observed the use of the substance in India. The introduction of cannabis in the Americas may have occurred when African slaves who were taken to Brazil brought the plant with them (2).В
What does research say about weed and the menstrual cycle?
Cannabis is believed to have therapeutic uses for a variety of illnesses, including but not limited to chronic pain, headache, epilepsy, symptoms of multiple sclerosis and gastrointestinal disorders (E).В
The science around cannabis and its ability to relieve menstrual pain is scarce, and more research is needed. In 2015, researchers from the University of British Columbia, asked a sample of 192 women if they had used cannabis to relieve menstrual pain. Marijuana is available for purchase from dispensaries in Vancouver.В
Of all the women surveyed, 85 percent said they had used cannabis for menstrual pain and almost 90 percent of these women said it was effective at relieving the pain (12).В
These participants said that the most common ways they consumed cannabis were smoking and eating. Other research indicates that using it might have side effects on the hormones that regulate the menstrual cycle.В
A study of 47 women between 17 and 29 years old who habitually consumed cannabis for at least one year found alterations in progesterone, prolactin and testosterone.В
Compared to women who didnвЂ™t use cannabis, these women had more frequent menstrual variations, including shorter cycle length and heavy periods (16). This study didnвЂ™t look specifically at period pain, but the results might have indications for period pain since frequency and intensity of bleeding can impact pain.
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A global panorama of cannabis use
Worldwide, there has been a noticeable trend in favor of legalising cannabis for medical use. But before digging into the details of current legislation in some Western countries, it’s important to clarify the uses of this substance and understand the arguments that usually accompany its prohibition.В
Uses of cannabis
There are several possible types of cannabis usage:
Medical purposes: usage eases symptoms of diseases or assists in treating an existing diagnosis.
Scientific purposes: usage as a tool to investigate the substanceвЂ™s roles in people’s health or diseases (3).
Recreational purposes: usage for pleasure.В
The status of cannabis around the world
For governments around the world, the more well-known reasons for prohibiting the use of cannabis are:
The psychotropic aspect of cannabis, meaning the alteration of the central nervous system.
The addictive aspect , or the difficulty in controlling its consumption.
The prohibition, in addition to criminalising the consumption of cannabis, imposes several inhibitors to conducting scientific research (3).В В
Countries like Canada, United States and the Netherlands are remarkable for having opener politics around cannabis. When it comes to Canada, since the 17th of October, 2018, it has allowed the recreational and medicinal use (5). In the United States, more than 20 states allow its medicinal use, and in the Netherlands since 2001 the medicinal and research uses have been allowed, and under strict control the purchase and consumption of soft drugs have been allowed (3).
As cannabis becomes more popular and mainstream, novel ways of using it for sexual and reproductive health are emerging. Vaginal suppositories and bath salts with THC are being marketed to people with periods as a solution for cramps (15). ThereвЂ™s even arousal lube with THC marketed to intensify sexual pleasure (15).
This diversity of approaches for the consumption and use of cannabis might help increase its popularity. Ideally, as more people use cannabis for period pain, researchers will produce more science about the risks and benefits, in hopes that we learn all the effects of cannabis for women and people with cycles.
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Ideally, as more people use marijuana for period pain, researchers will produce more science about the risks and benefits.