Cannabis and Women’s
Health
Cannabis has been used since ancient times for a variety of
women’s health issues. Even into the 20th century as cannabis was
being outlawed around the world, physicians and medical textbooks were
continuing to recommend cannabis to women as a treatment for dysmenorrhea,
heavy menstrual bleeding, menopausal symptoms, and migraine headaches
associated with menstruation.
Cannabis has proven a reliable herbal treatment for medical
conditions unique among women across a range of cultures. From mild symptoms or
premenstrual syndrome (PMS) to conditions such as endometriosis, cannabis
medicines and their interaction with the Endocannabinoid System can play a
significant role in supporting women’s health. Because endocannabinoids mediate
many aspects of reproductive health in women, the informed use of medical
cannabis is crucial to avoid potential side effects.
There is a longstanding bias against the study of sex
differences, and of females in general, in scientific research. (Beery 2011) An
understanding of the sex differences in endocannabinoid system expression and
function is important. (Craft 2013) (Wagner 2016)
Within the brain, cannabinoid CB1 receptors are differently
expressed between males and females. Researchers have found evidence for
sex-dependent differences in the cannabinoid CB1 receptor density in the
brain’s prefrontal cortex and amygdala, where the hormone estradiol appears to
decrease the number of CB1 receptors expressed. In female rats, estradiol
interacts with the endocannabinoid system and modulates emotional behavior. A
neural connection exists between the amygdala and the prefrontal cortex that
responds to emotional events, and the amygdala modulates fear and anxiety
responses. These brain regions are also involved in attention and in social
behaviors.
There are also sex- and/or hormone- dependent differences
related to brain structures responsible for motivation, reward behavior, and
motor activity, where cannabinoid CB1 receptors play crucial roles.
As of 2017, preclinical research has been conducted, and
recent findings underscore the role played by the endocannabinoid system in
women’s health. Receptors and endocannabinoids have been found at high
concentrations within a range of tissues throughout the uterus and female
reproductive system. (Taylor 2010)
It is currently believed that the endocannabinoids,
especially anandamide, play a significant role in regulating fertility and
early pregnancy. (El-Talatini 2010)
In self-reported surveys of women, there is a large amount
of data supporting the contention that cannabis has a positive influence on
female sexual function and receptivity, with lower doses increasing desire and
perceived pleasure, and higher doses suppressing them.
Recent preclinical research has found that females’
blood-serum endocannabinoid levels can vary in conditions such as depression.
Women with major depression were found to have significantly lass 2-AG in their
blood serum. However, the number of circulating endocannabinoids did not vary
by the severity of the level of depression experienced by the patient.
It is also important to note that women are much more likely
than men to experience side effects from prescribed medications. Since cannabis
has a more tolerable side-effects profile, it presents an attractive
alternative medicine.
Women appear to be much more sensitive than men to many
aspects of phytocannabinoids action.
There is preclinical research underway to examine the
potential role of CBD and THC in possible future treatments for specific
breast-cancer lines. (McAllister 2011)
Women are using cannabis to relieve some symptoms of
menopause, including hot flashes, with success. (Gammon 2005)
Polycystic ovary disease may benefit from fish-oil
supplements that the body uses to build precursors to fatty amide hydrolase
(FAAH), the endocannabinoid enzyme linked to the condition.
The endocannabinoid
system regulates many aspects of reproductive function in females
Levels of the endocannabinoid anandamide (AEA) fluctuate
somewhat during the menstrual cycle, peaking near ovulation and plummeting
before menstruation. (Scotchie 2015)
At its peak concentration, the uterus contains more
anandamide than any other organ in the body. This fluctuation may provide
support for the preference of many women to treat premenstrual syndrome (PMS) by supplementing a cyclical AEA
deficiency with phytocannabinoids such as THC.
Recently, researchers looked for potential genetic
variations in CB1 cannabinoid receptors in women suffering from extreme PMS
symptoms, a condition called premenstrual
dysphoric disorder (PMDD). The researchers noted that an endocannabinoid
link to PMDD is likely, just not subject to CB receptor variation.
Among the most common conditions for which women have used
cannabis, dysmenorrhea may be an
inflammatory disorder, and partially mediated by endocannabinoids. (McPartland 2001)
CB1 receptor agonists, such as THC, may decrease endometriosis-associated pain, but
caution is advised, since THC may increase cell migration in the disease. (Dmitrieva 2010) (McHugh 2012)
The cannabinoid receptor, GPR-18 appears responsible for the migration of
endometrial tissue in endometriosis and, in cell studies, is activated by THC.
It appears to be inhibited by CBD. Women with endometriosis are therefore
advised to avoid high-THC cannabis products, in favor of hybrids with both CBD
and THC with at least 3:1 (CBD:THC) ratio, until more research is available.
According to preliminary preclinical data, the
endocannabinoid system may be dysregulated in endometrial uterine cancer.
Fatty acid amide hydrolase (FAAH), which breaks down
anandamide, is deficient in women with polycystic
ovary disease. This could support the use of omega-3 supplements, which the
body uses in the process of synthesizing the FAAH enzyme. (Cui 2017)
Low-lymphocyte FAAH expression and high-plasma AEA levels
have been associated with lower odds of successful pregnancy after in-vitro fertilization and increased risk of
miscarriage.
Studies of women with eating
disorders found abnormal levels of anandamide (AEA) in women with anorexia nervosa and binge-eating disorder, but not in women with bulimia. The
scientists posited that AEA production may be mediating the rewarding and
reinforcement aspects of behavior associated with these syndromes.
Endocannabinoids appear to play a role in the processes that are regulated by
leptin, the peripheral fat hormone involved in body weight and energy balance.
In preclinical research, it has been shown that female
animals are more resistant to experimental attempts to interfere with CB1
function, which the researchers believed may be evidence that females are less
vulnerable to certain stress disorders, but that this compensation may increase
female susceptibility to depressive
disorders.
Research has also shown there is sex-specific modulation of
how the female hormone estradiol regulates the hippocampus, a key brain
structure that is associated with maintaining proper endocannabinoid tone in
women related to neurological or
psychiatric disorders that differ between the sexes.
It has been known that female mammals are more sensitive
than males to cannabinoid-induced behavioral effects. This difference is likely
due to ovarian function, as female rats deprived of both ovaries are less
responsive to rewarding properties of cannabinoids. This confirms the role of
estrogens in THC reward response, but also may increase the risk of women for cannabis dependency.
Dosing with Cannabis
for Women’s Health
Effective dose will vary widely, depending on the symptom
being treated. High amounts of THC have been shown in a variety of studies to
impact hormonal release. Endocannabinoid signaling plays an important role in
female reproductive events, including embryo development. Interfering with
endocannabinoid signaling through high-dose cannabis may significantly impair
these processes.
Doses of THC and CBD
between 2.5 and 5 mg are popular for patients looking to relieve discomfort
associated with PMS, dysmenorrhea, and menopause.
Women with susceptibility to endometriosis should avoid
high-THC cannabis products and select cannabis that contains at least half of
its cannabinoid content in CBD. CBD at doses between 5 and 20 mg may help
reduce pain associated with endometriosis, though THC on its own should be
avoided with this condition.
There is some observational data that the frequency of
migraine associated with menstruation may be reduced, and even controlled,
through a very small (1 – 2 mg) prophylactic dose of high-THC cannabis a few
times a week, taken immediately before and during the woman’s menstrual period.
Low doses of oral
cannabis medicines are very popular with female patients for their
convenience and the length of their effects. Cannabis teas and tinctures have a
long history in effectively treating female medical conditions.
Vaporizing and
smoking are the preferred method among female patients; vaporization is
recommended since it reduces exposure to combustion toxins, and can be
discrete.
Topical cannabis
preparations, such as skin creams, are of increasing interest to many
women. CBD creams are potent anti-inflammatory agents and can be useful for
maintaining skin health and have significant promise in reducing signs of skin
aging.
Cannabis topical formulations designed for vaginal
application, developed by women-owned companies, are an emerging trend. Many
women have reported these products to be effective and enjoyable for enhancing
and improving sexual response, especially after menopause.
Women report that Blueberry and Blue Dream, both high in
terpenes Pinene and Myrcene, are effective for the pain associated with menstrual
cramping.
Cannabis strains high in Myrcene, Limonene, and
Caryophyllene, such as the Kush varieties, are reported by patients to be
particularly effective for evening use with dysmenorrhea and PMS.
For daytime use, caryophyllene varieties, such as Cookies,
should be effective at low doses.
One of the most legendary of all cannabis strains is Haze,
which was developed in Santa Cruz, CA, in the 1970s by a woman.
Women LOVE cannabis. And we are huge advocates for its legitimacy!!
Information about Cannabis and Women’s Health was taken from
the amazing book: Cannabis Pharmacy, The Practical Guide to Medical Marijuana
by Michael Backes, Andrew Weil, M.D., and Jack McCue, M.D.
If you look for it, on search engines, or social media groups, like Facebook, you may be able to find a local society of cannabis women. If you live in Colorado, I recommend the
Denver Women of Cannabis. It is important to gather with other like-minded individuals who understand and support your interest in cannabis wellness. It's also a great place to network and make new friends. A friend with weed is a friend indeed!
More Resources for Women and Cannabis
* Denver Women of Cannabis -
https://www.facebook.com/groups/Denver.Women.Of.Cannaibs
* Women Grow -
https://womengrow.com/
* Top Women in the Cannabis Industry -
https://www.finder.com/women-in-cannabis
* Exploring Cannabis and Women's Health -
Leafly.com - also a great place to find cannabis educational information, local dispensaries, and strain specific information -
Leafly.com