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.
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.
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.”
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.
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.”
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.
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.
Menstrual pain could soon be a condition that qualifies for medical marijuana.
The most recognized of the cannabinoids in marijuana are:
Researchers are still trying to figure out exactly how cannabinoids work to reduce pain. Medical marijuana is administered in three ways:
Since I aspire to be a well-informed and open-minded allopathic physician, I felt compelled to learn more about (and share with you) the use of medical marijuana to treat this very common women’s health condition.
One thought is that the euphoria achieved with inhalation or ingestion creates an emotional response causing an altered perception of pain. Another is that pain centers in your brain are blocked by exogenous cannabinoids binding to specific receptors.
There is no strong evidence at this time to support the benefits or the risks of medical marijuana use for the treatment of menstrual cramps. There are testimonials from women reporting relief from menstrual pain with the use of medical marijuana, but that doesn’t replace scientific evidence.
Of particular concern is that the majority of women seeking treatment for severe menstrual cramps are of reproductive age, and there is a lack of strong evidence for the safety of marijuana use in pregnancy. The small amount of current evidence suggests that:
This guidance, although based on limited evidence, states that inhaled medical marijuana should not be used in patients who:
Not surprisingly, there is a lack of good quality scientific evidence regarding medical marijuana use in general. This is not surprising since the legalization of medical marijuana is relatively recent and limited. We have, however, begun to see some research looking at how marijuana and its components might be helpful in treating certain medical conditions, including chronic pain.
Topically administered cannabinoids—especially CBD—seem to not be psychoactive and do not produce a euphoria or “high.” It is thought that they bind to the cannabinoid receptors in the peripheral nervous system and interrupt pain signals to your brain.
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.