Does Weed Actually Work for Period Cramps?
Soma, a marijuana dispensary in Crested Butte, Colorado, only stocks a few dozen of a product called Foria Relief at a time, and they don’t sell them as quickly as some of their other items. But people who come in looking for them know exactly what they’re looking for, and typically say they heard by word of mouth how well they work, according to the store.
Foria Relief is for periods. They’re cannabis-filled suppositories, meant to be inserted directly into the vagina, and sold as holistic treatment for menstrual cramps. It’s one of a handful of pot products claiming to ease period pain—Whoopi Goldberg, for one, has a line of topical ointments, tinctures and bath salts marketed for period pain.
Is there evidence that weed ca help treat period pain?
There’s a solid body of evidence on the pain-relieving properties of marijuana, so using pot for this particular type of pain seems to make sense. In some states, lawmakers are pushing to add menstrual pain, or dysmenorrhea, to the list of conditions that qualify for medical marijuana.
However, there are a few factors to consider before turning to weed each month, and when selecting your weed delivery system. Even though anecdotal evidence, easily found online, points to pot as a period cure-all, there hasn’t actually been any scientific research on it. There’s one scientific case study done on cannabis and period pain—but it was published in 1847.
Just because there hasn’t been any research done on the subject doesn’t mean that it doesn’t work. It does mean, though, that doctors aren’t likely to list it as a medically approved option. “I can’t fully recommend it, because we don’t know everything about its efficacy and safety,” says Leena Nathan, an obstetrician-gynecologist at UCLA Health.
It’s not ideal that there isn’t much research on the subject, says Jordan Tischler, an emergency physician who oversees InhaleMD, a cannabis clinic in Massachusetts. “Is cannabis effective for menstrual pain? The answer is, anecdotally, yes. The flip side is, ‘has anyone studied this in a rigorous, scientific manner?’ And the answer is no.” But that doesn’t discount it entirely, Tischler says. “For the right condition, and severity of discomfort, I think cannabis is a good bet.”
Doctors and scientists also don’t know how, exactly, weed might interact with the causes of period pain. Cramps are largely caused by hormones called prostaglandins, which are released from the lining of the uterus and signal it to contract. The hormones also cause inflammation, which contributes to pain. Birth control pills, which can help with painful periods, reduce the amount of prostaglandin produced during the menstrual cycle. Non-steroidal anti-inflammatories, like aspirin and ibuprofen, do as well.
More from VICE:
Weed has anti-inflammatory properties, which is one potential way it could help period pain, Nathan says. Feeling relaxed, in general, and dampening pain, might have some effect. And cannabinoids might be able to interact with prostaglandins, though there’s not enough evidence to say for sure. “It’s hard to say, just based on how cramps during menstrual cycles work,” she says.
Are cannabis suppositories safe?
If cannabis is still your drug of choice during that time of the month, it’s worth considering how you’re taking it. Foria’s cannabis suppositories are probably the most out-of-the-box pain relieving products, and Nathan says they raise some red flags. “I’m not sure how safe that would be,” she says. We don’t know how, or how much, of the active ingredients might be absorbed into the vagina, or how that entry point might be different from the lungs. (Experts such as gynecologist Jen Gunter have expressed similar concerns.)
Creams, rubs, butters, and bath salts—topical treatments that you don’t ingest—are also advertised as cramp-relievers. In mice, studies show they relieve pain caused by inflammation, but there’s very limited research on how effective they might be overall.
“Part of what we’re talking about is trying to sort out marketing hype from good doctoring,” Tischler says. He sees patients struggling with menstrual pain, and if they’re interested in using cannabis, he recommends they stick with basic, tried-and-true smoking. “A fairly simple approach, just a low dose of vaporized flower,” he says. “It’s effective, and without a lot of risk.”
If the standard treatments for menstrual cramps like over-the-counter painkillers don’t work, Nathan says people should talk to their doctors before trying something new. “There are other medications that can help,” she says. “There are lots of methods we can use that are evidence proven. People who don’t necessarily talk to doctors might be hearing things anecdotally, and going with that information.” It’s hard to know what’s reliable, she says, and what’s just someone’s opinion.
Nathan guesses that some patients might be scared, or embarrassed, to tell their doctor if they’re using something like marijuana to treat a medical problem themselves. “But I would encourage everyone to be open with their physician, even if it’s something out of the ordinary.”
Sign up for our newsletter to get the best of Tonic delivered to your inbox weekly.
Get a personalized roundup of VICE’s best stories in your inbox.
By signing up to the VICE newsletter you agree to receive electronic communications from VICE that may sometimes include advertisements or sponsored content.
Menstrual pain could soon be a condition that qualifies for medical marijuana.
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.