Over the years, I’ve increasingly been asked my opinion on using cannabis medicinally. It’s a complicated topic as cannabis is both a very complex and potent plant, there’s a lot of misunderstanding in the mainstream, and its legal status varies considerably from state to state and country to country. This article reflects my current perspective in the domain of women’s health. As this is a fast-developing area, I am sure I’ll be updating it as my thinking and understanding do too.
Please also know that I am a naturopath and herbalist in Victoria, Australia, where cannabis use is currently illegal. I have little direct clinical experience with it, aside from observing its effects and hearing experiences from clients who live in areas where it is legally available for therapeutic use. With that said, let’s take a look at the herbal history of cannabis in women’s health, exploration of how it interacts with the body to relieve pain and a summary of the science that’s available.
Cannabis has a long coevolutionary history with humans
Cannabis is among the first plants to be domesticated by humans. It has been used for medicine, consciousness-altering, textiles (it’s strong fibre) and nutrition (hemp seeds are rich in fatty acids). Cannabis’s is an excellent example of a plant that’s evolved in such a way that it’s remained highly desirable to humans in our modern times.
We have entire industries dedicated to it, its power has sparked drug wars, incited heated political debate and enfolded many a soul in its velvet chains of dependence. It’s also offered extraordinary medicine to many who fell through the cracks of what is pharmacologically effective and could find relief and reprieve from their symptoms. For the latter, these have been most notable in epilepsy, chronic pain, nausea, and insomnia. In women’s health, it’s gained a reputation for relieving period and chronic pelvic pain conditions, as well as easing labour pains in childbirth.
How herbalists think of Cannabis
Cannabis for us herbalists is another valuable plant in the treasure trove of nature’s pharmacy. We’re less likely to give it celebrity status and accolades, simply because there are thousands of medicinal plants that can help, heal and relieve.
Its essence is powerful and overall relaxing. Cannabis plant chemistry is complex, with an estimated 400 to 700 plant constituents, only of which 60 to 70 are understood. The actives most well-known and understood are THC, which attributes to its consciousness-altering effects, loved by many for its social uses and CBD, the pain-relieving compounds that interact with the body’s endocannabinoid system (pain receptor system).
It can be made into various medicinal preparations, including oil, ghee, salve, tincture and smoking blends. The Eclectic Physicians of the 19th-century primarily used it as a tincture, with a low dosing strategy of 1–5 drops two to four hours for pain relief.
Its medicinal actions include:
- Narcotic and anodyne – pain-relieving
- Antispasmodic – relieves spasms of the muscles
- Sedative – powerful relaxant that can ease anxiety and the psychological experience of pain
- Aphrodisiac – libido-enhancing
As with all medicinal plants, it’s not for everyone, nor is it a panacea despite the frothy marketing talk from medicinal cannabis companies. Everyone has unique biochemistry primarily determined by our genes. Not everyone’s pain receptors enzyme systems or detoxification pathways work in the same way. Therefore cannabis will interact differently for everyone.
Getting the right strain is crucial. In my opinion, there’s no point approaching this plant therapeutically if you can’t access high-quality, strain-specific medicine grade cannabis. In Australia, because only the Australian Capital Territory and South Australia, allow medicinal cannabis use there are a small variety of strains available or isolated constituents.
What evidence do we have for cannabis and menstrual pain or chronic pelvic pain?
The short answer is: minimal. There is a rich amount of anecdotal evidence based on survey studies and traditional accounts of therapeutic use. No randomized control trials exist for period pain, chronic pelvic pain, endometriosis or childbirth (Klimkiewicz and Jasinska, 2018). Given that the endocannabinoid system is involved in all of these occurrences, there’s a compelling rationale for its use in these cycle-related health conditions (Bouaziz et al., 2017). John Scudder, a 19th-century Eclectic Physician and herbalist whose writings I greatly admire remarks that cannabis can be “used as a sedative in painful spasmodic affections of the reproductive system”.
An Australian study of 435 women with confirmed endometriosis found that 1 in 10 used illicit cannabis to manage symptoms. This group reported improvements in pain, sleep, nausea, digestive upset, anxiety, and depression. It also found that of those using cannabis to manage endometriosis symptoms, 56% could reduce their other pain medications by 50% (Sinclair et al., 2020). These findings correlate with a 2015 Canadian study that found 89.4% of women with period pain, using cannabis reported relief in symptoms (Wiebe et al., 2015).
Like all medicinals, there are side effects. There appears to be a correlation of cannabis use and heavier period bleeds, and more instances of cycle irregularities, suggesting it impacts the ovulation, which is essential for women’s hormonal health and fertility. I would be remiss not to mention that chronic and heavy users of cannabis are at a higher risk of psychosis. However, this is linked to recreational, not medicinal use. At this stage, there is not enough evidence of safety in pregnancy.
If you’d like to learn more about how you can self-manage period pain and endometriosis, I’ve written longer posts you’ll find useful: Endometriosis: A Holistic Perspective and Healing Paths and The Essentials Of Easing Period Pain Naturally.
Sense and Sensibility
I hope this has helped round out your understanding of this remarkable plant and adding some stepping stones to navigate the hype, trendiness and conservatism that abounds. Remember, cannabis is not for everyone, nor is it a cure-all. It’s essential if you’re considering using this plant in your health care to ensure you get a strain that is specific to your health needs and ensure it’s high quality and medicinal grade. And finally, it’s with hope that further resources are directed to understanding this plant in women’s health, and its potential to improve the quality of life for many people with chronic conditions. Plants have always been and should remain medicine for the people.
References and Resources
Armour, M., Sinclair, J., Chalmers, K. J., & Smith, C. A. (2019). Self-management strategies amongst Australian women with endometriosis: A national online survey. BMC Complementary and Alternative Medicine, 19(1), 17. https://doi.org/10.1186/s12906–019–2431-x
Bouaziz, J., Bar On, A., Seidman, D. S., & Soriano, D. (2017). The Clinical Significance of Endocannabinoids in Endometriosis Pain Management. Cannabis and Cannabinoid Research, 2(1), 72–80. https://doi.org/10.1089/can.2016.0035
Carrubba, A. R., Ebbert, J. O., Spaulding, A. C., DeStephano, D., & DeStephano, C. C. (2020). Use of Cannabis for Self-Management of Chronic Pelvic Pain. Journal of Women’s Health, jwh.2020.8737. https://doi.org/10.1089/jwh.2020.8737
Klimkiewicz, A.,Jasinska, A (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. National Academies Press. https://www.nap.edu/login.php?record_id=24625
Russo, E., Dreher, M. C., & Mathre, M. L. (Eds.). (2002). Women and cannabis: Medicine, science, and sociology. Haworth Herbal Press.
Sinclair, J., Smith, C. A., Abbott, J., Chalmers, K. J., Pate, D. W., & Armour, M. (2020). Cannabis Use, a Self-Management Strategy Among Australian Women With Endometriosis: Results From a National Online Survey. Journal of Obstetrics and Gynaecology Canada, 42(3), 256–261. https://doi.org/10.1016/j.jogc.2019.08.033
Wiebe, E., Jaffar, S., Zelmer, J., & Byczko, B. (2015). Using marijuana to cope with the pain and other symptoms of medical abortions and menstrual periods. Contraception, 92(4), 402. https://doi.org/10.1016/j.contraception.2015.06.188