Menstruation cycle is a normal, physiological process of the female reproductive system that occurs approximately every 28 days. Although for many women menstrual cramps may go unnoticed, it is quite common to experience mild to moderate menstrual cramps and abdominal pain. Menstrual cramps and pain are caused by powerful, frequent smooth muscle contractions of the uterus. Dysmenorrhea, or menstrual cramps, is characterized by painful periods that can interfere with daily activities.
For most women, response to this pain can get severe enough that it leads to vomiting, fatigue, dizziness, and fainting. These symptoms are usually treated with over-the-counter pain medications and hormonal pills. In certain individuals, these symptoms do not go away – even after prescription drug use. Even more unfortunate, these prescription medications can cause moderate to serious adverse events.
While there is so much news trending on social media around the health benefits of cannabis and its potential to treat psychiatric problems, PTSD, cancer, etc, scant amounts of information are available to understand how marijuana can treat female problems, such as dysmenorrhea and premenstrual symptoms.
I’m not sure if it is a gender bias, but no appreciable research has been done within the cannabis industry to treat female-specific problems like dysmenorrhea. These problems recur every month, and I believe women are the most underserved population just because these problems are being largely overlooked. Even many of the women suffering from these issues are unaware of the cannabis health benefits that can potentially treat gynecological problems.
New Jersey’s Initiative to Soothe Women’s Monthly Discomfort
Recently, the lawmakers in New Jersey proposed a medical marijuana bill that allows the state’s women to use cannabis-based products to relieve menstrual pain and cramps. Currently, New Jersey medical cannabis law permits pot use for a few ailments including terminal cancer, certain chronic diseases, multiple sclerosis, muscular dystrophy, treatment-resistant glaucoma, and seizures.
Even after limited legalization, the state’s medical marijuana program is tightly restricted with registration of the patient, healthcare providers, caregivers, and a $200 fee towards issuance of an identification card.
Nearly 20 other states already legalized cannabis for medicinal use, while four states have legalized marijuana for any and all uses.
Looking Back
Treating menstrual cramps with marijuana is not something new. It dates back to the early 19th century. Back then, Sir J. Reynolds, one of the notable royal physicians prescribed cannabis to treat Queen Victoria’s menstrual cramps.
In those days, cannabis-contained formulation called Dysmenine was widely employed to treat dysmenorrhea. Dysmenine contained cannabis constituents and capsicum to promote rapid pain relief by synergistic action on pain receptors, including vanilloid and cannabinoid receptors.
In the late 1800s, most of the medicines that were indicated to treat over 350 medical conditions were comprised of cannabis in some form or another. The same treatment trend continued until cannabis was banned in the 1940s.
If we look at this evidence and the past wisdom of medicine, we are able to understand the importance of medical cannabis. Really, we’re in the nascent stages of cannabinoid research, and there is so much to learn about the medicinal benefits of cannabinoids.
CBD Can Ease Dysmenorrhea, and Here is the Scientific Proof…
To aid uterine contraction and menstrual flow, the body releases prostaglandins and other chemical mediators, which are also associated with pain and inflammation. These powerful chemicals cause uterine contractions, blood flow restriction, and diminished oxygen supply to the uterus with localized or radiating pain and cramps. Conventional pain relieving drugs act by inhibiting prostaglandin release by blocking an enzyme called cyclooxygenase. These drugs can cause gastrointestinal ulcers, bleeding, and irreversible renal problems. It is desirable to treat primary dysmenorrhea by optimal relaxation of the contracted smooth muscles (uterine muscles) without causing significant adverse events.
The smooth muscle relaxing effects of cannabinoids are widely studied, and a variety of underlying mechanisms, including alteration of sympathetic nervous tone, direct interaction with localized cannabinoid receptors on smooth muscle cells (uterine muscles) and on pre-junctional neurons and modulation of vanilloid receptors present in sensory nerves that is associated with anandamide-induced vasodilation are implicated.
Fortunately, endocannabinoids structurally mimic arachidonic acid (the precursor of prostaglandins) and hence, endocannabinoids can significantly interfere with the prostaglandin-induced inflammatory process causing menstrual pain.
In vitro studies have shown that phytocannabinoids, including THC and CBD, can inhibit COX-1 and COX-2, but with a weaker action. Studies have shown that cannabinoids suppress the prostaglandin (PGE) synthesis, and the rate of inhibition is dose dependent. Δ9-THC has been shown to be a very weak inhibitor of COX-1 in experimental studies. After discovery of COX-2 and its recognition as a potential therapeutic target, researchers are trying to discover non-selective COX inhibitors to avoid side effects. Although CBD and THC possess anti-inflammatory properties, the anti-inflammatory effects are not attributed to COX enzyme inhibition. Considering this scientific evidence, it is clear that CBD is an inhibitor of COX2 via selective non-enzymatic inhibition and down-regulation processes. By these properties, cannabinoids can modulate pain symptoms and ease cramps without causing systemic side effects.
Additionally, CBD treatment increases the relaxation of arteries by augmented synthesis of vasodilator COX-1/2 derivatives that acts on EP4 receptors. Relaxation of arteries can improve the blood flow and oxygen supply in the smooth muscles, including uterine smooth muscles, thereby reducing cramps and the accompanying pain symptoms of dysmenorrhea.
In addition to pain relieving benefits, cannabis ingestion reduces depression and the mood swings associated with hormonal influx, and it also improves the overall sense of well-being by its central action.
Specific Strains That are Helpful in Treating Dysmenorrhea
While opting for pain relief, it is important to choose indica-dominant strains over sativas. Indicas are comparatively more effective for pain relief than sativa-dominant strains. Here are some strain suggestions that provide effective pain relief:
Obama Kush:
This hybrid strain contains beneficial properties of both sativa and indica that alleviate menstrual pain and improve mood perceptions during periods. Obama Kush is a perfect and preferable choice for women, particularly those who suffer with moderate to severe dysmenorrhea.
Black Cherry Cheesecake:
This strain is a hybrid of three different strains with dominant properties of indica to relieve pain. By antagonizing prostaglandins, this strain numbs the pain while giving a ‘relaxing high’ that may last for as long as to 2-3 hours. This strain is useful if you’re in need of rapid pain relief.
Blue Dream:
Although this is an indica-dominant hydrid, this particular strain provides equal parts pain relief and central effects.
Harlequin:
Harlequin is a clone-only hybrid with 75% sativa and 25% indica phenotype. This sativa dominant strain has 10% THC and 9% CBD. The action of CBD can counter the psychotropic effects of THC. Hence, Harlequin can provide significant pain relief without causing much ‘high’.
Purple Urkle:
This is an indica strain, recommended for cramp relief and to promote normal sleep. However, it is not suitable to achieve heavy pain relief.
Some other strains that are also useful to alleviate the symptoms of dysmenorrhea are white widow, pineapple kush, $100OG, Dutch treat, orange kush, purple diesel, sensi star, thin mint girl scout cookies, white rhino, lemon kush, mango kush, romulan, flo, casey jones, SAGE, space queen, shikshaberry, black domina, strawberry diesel, afgooey, the white, A-10, dairy queen, champagne kush, violator kush, and grape stomper.
What is in Stores Now?
Recently, the actress-turned ‘Cannapreuner’ Whoopi Goldberg joined hands with Maya Elisabeth, an award-winning edibles maker, to commercialize cannabis-infused edibles and salves to relieve painful menstrual cramps. Named ‘Whoopi & Maya’, the medical cannabis company is exclusively focused on the female-specific niche.
Some of the top four products of Whoopi & Maya are a THC-infused tincture, a topical rub, an edible, a sipping chocolate infused with either THC or CBD which can be eaten or mixed with warm liquids, and finally, a THC-infused bath soak to improve pain and mood problems.
Why Not Weed Tampons?
If you’re unwilling to ingest or smoke cannabis, you don’t have to!
Recently, a California-based cannabis company, Foria, has started commercializing weed tampons as FORIA Relief. These are cannabis-filled vaginal suppositories to relieve PMS symptoms without causing much ‘high’. The tampon has been designed with a novel drug delivery system that aids the purified cannabis constituent to relieve menstrual pain and maximize muscle relaxation in the female reproductive organs. Unlike traditional tampons, FORIA Relief is not meant for absorbency, but to relieve period woes.
FORIA Relief contains THC and CBD in a balanced concentration to effectively relieve pain and to relax smooth muscles by activating certain cannabinoid receptors in the pelvic region tissues.
Thanks to the benefits of medical marijuana, women need not worry about those painful period days every month.
Good article. However, we don’t know for sure if Sir J. Reynolds prescribed cannabis to Queen Victoria, only that he was one of her physicians and that he wrote glowing about the use of cannabis for menstrual cramps, etc.