The use of weed to treat menstrual cramping is nothing new, dating back to the 1800s when Queen Victoria’s clinician allegedly prescribed her Mary Jane to alleviate period pain and symptoms of PMS. Fast forward a couple centuries and we’re drowning in Reddit (and other) testimonials for period pain relief products containing cannabidiol (CBD) and tetrahydrocannabinol (THC)—the active ingredients in cannabis.
Dysmenorrhea—the technical term for intense period pain—affects nearly 85 percent of women. For around 20 percent of women, particularly for those with endometriosis, the cramping is severe enough to interfere with daily activities. Cannabis may likely play a role in the future of period pain treatment, but currently the data is lacking, says Leah Millheiser, clinical assistant professor and obstetrician/gynecologist at Stanford Health Care. “When we have the research to say that marijuana is safe and effective for women who don’t respond to first-line therapies for dysmenorrhea, then it may be reasonable for gynecologists to [recommend]. But we’re not there yet.”
The first-line treatment for menstrual pain is ibuprofen, followed by hormonal treatments such as combined birth control pills or the progesterone IUD. While there is plenty of anecdotal evidence that CBD and THC products are effective in the relief of menstrual pain and endometriosis, there is limited to no scientific research in peer reviewed journals, Millheiser says. “We need more of an understanding of how [cannabis] is working to treat the pain, and the most appropriate way to use it: Is it CBD or THC that’s working? Do we really need to use THC to get relief, and if we’re using THC, how is it working? Is it because we’re finding relaxation or euphoria versus actually blocking pain receptors?”
Despite Millheiser’s point about the lack of data, women who aren’t comfortable putting drugs and hormones in their body don’t need peer-reviewed studies to trust something that works for them. For Ali Francis, co-founder of The Baking Supply Company, 10-20 mg of CBD each morning has drastically reduced her symptoms of endometriosis. “After about a month and a half, I had next to no PMS, and went from taking eight midol per day for a week, to literally nothing but a couple Advil here and there. [It] has completely changed my life.”
Francis had suffered from endometriosis for the better part of seven years, experiencing incredibly painful periods, abdominal cramping, and having to undergo minor surgery. “For my whole life, doctors had shrugged and handed me prescriptions for the pill. That, and surgery, seem to be modern medicine’s answers to a condition many women suffer from.”
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Her business, best described as the “Blue Apron for marijuana edibles,” sells gluten- and refined sugar-free baking kits optimized for cannabis infusion. Francis and her brother founded the company on the belief that recreational and medicinal cannabis use are at odds with each other in the current market. “We both agreed that it was completely oxymoronic that an herb we believe to be extremely medicinal is being ingested in such an unhealthy way: Smoking is, well, smoking, and most edibles are full of sugar, preservatives, and chemicals.”
While there’s growing awareness around the medicinal benefits of CBD, there’s still a stigma around its use, Francis says. “It’s a real bummer. There are starting to be a limited number of exciting studies around CBD use for psychosis, autoimmunity, sleep, anxiety, and chronic pain—it’s been shown to significantly reduce inflammation in mice—but they’re all really preliminary and there’s not a lot around how it reacts with the hormonal system.”
What we do know though, is that humans have an endocannabinoid system—a group of cannabinoid receptors designed to receive cannabis that regulate the way we move, feel and react—in place in their brains already. “CBD is one of many cannabinoids which interacts with these receptors to regulate important bodily functions. It’s that knowledge, plus personal and anecdotal results that keep me fighting the good fight,” Francis says. But it’s not a reactionary solve, she says. In her own experience, “similar to many herbal remedies, a little everyday is the way to go.”
In the same way that medical marijuana has been adopted into treatments plans for cancer patients undergoing chemotherapy, there’s room for these types of therapies in the treatment of severe or retractable menstrual pain, Millheiser says, “as long as we understand how it’s working.”
“It took a long time for doctors to feel comfortable recommending [cannabis] as a therapy, but once we start to see the research and see it compared to other types of treatments for dysmenorrhea and understand how it’s working, then it could certainly become an option for women who are not responding to first or second-line therapy,” she adds.
The stigma that still exists around periods is just one aspect of a general apathetic approach to women’s health issues, says Kiana Reeves, operations manager at FORIA, a California-based company making CBD and THC products for women’s pleasure as well as period pain relief. “Menstruating has sort of been put in a corner and you’re not supposed to talk about it, but menstrual pain is a huge issue and a lot of people don’t realize how common it is and how many women it affects.”
For the medical community and the general public to start changing its perception of cannabis use, there needs to be a move away from the ‘stoner’ mentality, Reeves says. Alongside cannabis products for pleasure, FORIA also produces high-dose THC vaginal suppositories for localized relief of menstrual cramps—they’re essentially weed tampons.
A quick look at the company’s testimonials page confirms its popularity an alternative to pain meds. “[Period] pain has typically just been masked by the pill, or by taking a crazy amount of painkillers, but our systems are complex and individual and unique to each women. It would be a huge undertaking for Western medicine to say ‘We’re going to treat you as an individual’, rather than going for the cure-all option,” Reeves says.
While this may be the case for many women using THC products for menstrual pain, we still don’t know what the long-term effects of regular use, Millheiser reminds us. “We don’t know the long-term risks on cognitive function, for example, and we need to know that before we can even think about recommending these products.”
She acknowledges that treatments for dysmenorrhea or endometriosis don’t work equally well for all women, and for those with intractable pain who are not responding to ibuprofen or hormonal manipulation, or who have had surgery and still don’t have relief, there is room for another treatment option. “If there is a role for cannabis in treating period pain, let’s show that role: Let’s do the science, let’s prove it, let’s get it out there. Only then we’re going to see clinicians recommending it.”