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 board-certified in obstetrics-gynecology. She practices at the University of Illinois at Chicago and appears regularly as an expert on Good Morning America, The Today Show, and more.
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 CBD Help With Period Pain?
by MARIA DEL RUSSO
Disclaimer: This information isn’t a substitute for professional medical advice, diagnosis, or treatment. You shouldn’t rely on this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
It seems like these days, you can’t do a Google search on pain without coming across an article that talks about cannabidiol (CBD) for pain management. CBD, which is a chemical found in both hemp and cannabis, has plenty of anecdotal evidence of pain relief — for example when it comes to period cramps. CBD, is especially attractive for folks because, when consumed, it is not known to intoxicate or cause the user to be “high” as with the other cannabis component, THC. But you don’t just have to vape or eat CBD to feel its effects. There are brands that sell suppositories, rubs, gels, oils, bath salts, and other products laced with CBD that are meant to help mitigate the pain.
But is it true? Is CBD a miracle-worker when it comes to period cramp pain management?
The answer is maybe. Unfortunately, because cannabis isn’t legal in all 50 states, studying the effects it has on humans is incredibly difficult. And while we do have studies on how CBD can help with pain management (more on that below), there hasn’t been a peer-reviewed clinical study on whether or not it can help relieve the pain from period cramps or other period-related ailments. Instead, we have the anecdotes of folks who have tried CBD-based products for period relief, and not much else.
So, could CBD be useful in your quest for pain-free periods? Let’s dive a little deeper into what we know.
What does the science say?
As mentioned above, there aren’t any specific studies on CBD for period pain. But there are studies on CBD for pain in general, which means it might work for the hurt you feel around your time of the month. One study suggested that medical cannabis, of which CBD is a compound, can help with the treatment of chronic pain (1), but noted that the study wasn’t controlled. It has also been shown to help reduce inflammation and pain-related behaviors in rats. (2)
That second study is especially compelling because a lot of the pain that you feel during your period is the result of inflammation. Prostaglandin, which is released after ovulation and right before your period starts, is an inflammatory chemical that contracts the muscles in your uterus, causing cramps. In fact, women with higher prostaglandin levels have been known to also have stronger, more painful contractions. (3) So if CBD reduces inflammation, and inflammation causes cramps, the logic follows that CBD could reduce your cramps. It is, however, important to note that rats and humans don’t necessarily respond to chemicals the same way, so there are many steps between a study like this and efficacy of CBD for period cramps.
Scientists have also discovered that CBD can actually inhibit the enzyme that produces prostaglandin, which can stop this whole mess before it even starts. (4) But since there hasn’t been extensive research on the subject, it’s hard to say that there is a connection between CBD and pain reduction.
Is there a delivery method that works best?
It’s all about trial and error when it comes to which delivery method works best for you — or if it works at all. (Which, again, is still scientifically unproven.) If you’re consuming CBD, whether it’s with a gummy, a vape pen, or a tincture that you place under your tongue, it has to go through your digestive tract, which means the effects are delayed. But if you apply the CBD topically, with a rub, a suppository, or an oil, your body absorbs it almost immediately. That’s why people love CBD rubs for muscle pain.
There also isn’t a lot of information regarding dosing for CBD and pain, since there haven’t been many studies. Since everyone’s metabolism is different, too, different doses can affect different people, well, differently.
CBD can be easy to get your hands on in many states that have made it legal. And with so many companies providing different means of consumption, you can try it out as an option that may work best for you.
- The Clinical Journal of Pain. The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain. Accessed September 6, 2019. View resource.
- The European Journal of Pain. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. Accessed September 6, 2019. View resource.
- The Global Library of Women’s Medicine. Prostaglandins and the Reproductive Cycle. Accessed September 6, 2019. View resource.
- Organization for Frontier Research in Preventive Pharmaceutical Sciences. Cannabidiolic acid as selective cycloocygenase-2 inhibitory component in cannabis. Accessed September 6, 2019. View resource.
Could CBD be useful in your quest for pain-free periods? The answer is maybe. Let’s dive a little deeper into what we know.