Every month, women all over the world look for new products to relieve the same old painful period symptoms, including abdominal cramps, breast tenderness, irritability, and stabbing lower back pain. Considering how popular cannabis has become as an all-around pain reliever, it’s no surprise women are using it to self-treat their menstruation symptoms as they hope for that miracle cure.
Products on the market range from CBD oil you can rub on your abdomen for painful cramping to tampons, called suppositories, that are intended for local muscle relaxation and “inflammation relief,” according to one company that sells them, with each suppository containing 100 mg of CBD.
While there’s plenty of anecdotal evidence that cannabis products relieve many of the symptoms of painful periods — the products have legions of fans — there are no published scientific studies as of yet that deal specifically with cannabis as a treatment for period pain. There is, however, significant scientific evidence that cannabis relieves chronic pain, so you may consider adding cannabis as an alternative treatment to the typical ibuprofen and heat regimen.
What Causes Painful Periods?
Thankfully, menstrual cramps that aren’t caused by another condition, such as endometriosis, tend to lessen with age and may improve after giving birth, according to the Mayo Clinic. The cramps are caused by the uterus contracting in a spasmodic response to expel its lining. Substances that act like hormones, called prostaglandins, that are involved in pain and inflammation trigger the contractions.
The higher the level of prostaglandins, the more severe the cramps. Although cramps are often the most debilitating menstrual symptom, periods come with a host of other pains, including back pain, and breast tenderness. Many women also experience premenstrual syndrome, or PMS, where symptoms begin about a week before the period and continue for the first couple days of the period. Bloating, fatigue and changes in sleep and eating habits are all common.
Staci Gruber, a professor of psychiatry at Harvard Medical School and the director of the Cognitive and Clinical Neuroimaging Core and the Marijuana Investigations for Neuroscientific Discovery program, is conducting an observational survey of 400 women who will administer vaginal suppositories over the course of a few months.
The cannabis-infused suppositories by a company called Foria contain 60mg of THC, the main psychoactive component of marijuana, and 10mg of CBD, a non-psychoactive cannabinoid known for its pain-killing properties with minimal psychoactive effects. An inch long, bullet-shaped, and made out of cocoa butter and cannabinoids, once inserted it takes 15 to 20 minutes as it melts and the CBD’s anti-inflammatory and pain-relieving properties are supposed to work.
How Cannabis Works for Pain and Inflammation:
According to a study published in the Journal of Headache Pain, the cannabinoids in marijuana, THC and CBD, are well-known for relieving pain and reducing inflammation. However, it’s still unclear whether certain types of pain may respond better to particular cannabis strains with different combinations of cannabinoids.
There has been a multitude of studies showing benefit in many forms of chronic pain, but there have been no studies attempting to differentiate which types and strains of cannabis along with the associated composition of cannabinoids…may be more effective for certain subsets of pain,” the study reported. The way these cannabinoids work is by interacting with specific cannabinoid receptors in the body — two have been found so far, called CB1 and CB2.
The effects the cannabinoids have on a user reflect the areas of the brain they interact with, but interactions generally occur in the areas that affect memory and cognition, feelings of reward and are “widely distributed in areas of pain perception,” according to a University of Washington fact sheet. Additionally, there are cannabinoid receptors in the female reproductive tract.
A 2015 review published in JAMA looked at 79 trials of cannabinoids for different conditions, including nausea, chronic pain, sleep disorders and anxiety, and found promising results for pain sufferers: compared with a placebo, cannabinoids were associated with a greater number of patients showing a reduction in pain, though there was also an increased risk of adverse events, including dry mouth, dizziness, vomiting, and confusion.
Overall, the study noted there’s “moderate-quality evidence” to support the use of cannabinoids for chronic pain. So if cannabinoids affect the body’s general perception of pain, as noted above, it makes sense that women with painful periods say cannabis products help them with cramps and other symptoms.
More pointedly, menstrual pain is a hormonally driven inflammatory response and with its highly touted anti-inflammatory properties, it is not surprising that the relief is real.
Cannabis for Endometriosis
Though cannabis hasn’t been studied specifically for menstrual cramps, it has been studied in a female reproductive condition known as endometriosis, where tissue that normally lines the inside of the uterus grows outside the uterus.
The tissue breaks down and bleeds during a menstrual cycle, but has no way of leaving the body and becomes trapped. The pain associated with the condition is often severe, particularly during a woman’s period, the Mayo Clinic reports. One 2019 Australian survey found that self-care and various lifestyle choices were common pain-relief strategies among women who suffered from the condition.
Specifically, women using cannabis reported the highest self-rated effectiveness. Cannabis, heat, hemp/CBD oil, and dietary changes were the most highly rated for reducing pain, while physical exercise, stretching, and yoga or pilates were considered less effective.
With cannabis becoming such a popular strategy to manage pain, it’s not surprising one New York lawmaker tried to introduce a bill in 2017 that would have added dysmenorrhea to the list of conditions for which doctors could authorize medical marijuana use. Though evidence specifically for period pain is lacking, there’s plenty of evidence that cannabis reduces pain and inflammation - at least it’s helping more than yoga, anyway.
A Historical Perspective
Menstrual cramps come with a lot of pain — both physical and emotional — so it also makes sense that women have been turning to cannabis since ancient times to treat symptoms that can become severe enough every month to interfere with daily activities. In fact, 9th century, medical texts from ancient Iran state that cannabis and its preparations are known to “calm uterine pains.”
A manuscript of medicine dated circa 1596 based on ancient Chinese therapies remedies recommends cannabis for menstrual disorders and it is thought than C.indica made its way into the heart of the British Empire because of its pain-alleviating qualities - championed by Queen Victoria herself with her monthly intake of Cannabis indica as the only remedy for her severe and intractable menstrual cramps.
As quoted by her private physician, Dr R. Reynolds in the prestigious medical journal The Lancet, he stated [cannabis is] “of great service in cases of simple spasmodic dysmenorrhea,” aka menstrual cramps.