The Use of Medical Cannabis for Gynecologic Pain

Within our bodies, the endocannabinoid system plays a vital role in pain perception and inflammation. Cannabis contains both CBD and THC which bind to the system’s receptors. Tetrahydrocannabinol, or THC is rapidly absorbed into the bloodstream and can spread rapidly throughout the body binding to receptors of the endogenous cannabinoid signaling system. This interaction has a variety of effects on the central and peripheral nervous system. Although these receptors are primarily expressed in the brain, they have also been found in various tissues of the female reproductive system. Studies have shown that the female reproductive system is incredibly sensitive to the effects of cannabinoids, particularly sex hormones and ovulation timing. Cannabis users showed a longer follicular phase during menstruation indicating an ovulatory delay.

Cannabis has been used as a pain reliever in patients with premenstrual syndrome and premenstrual dysphoric disorder. Data suggests that severity of PMS/PMDD has been alleviated by cannabis use. However, there are limited studies on the impact of cannabis on reproductive fertility. Within the studies that have been performed, there has been no associations reported between time to pregnancy or probability of conception. However, fetal cannabis exposure during pregnancy has been associated with adverse effects such as stillbirth, preterm birth, increased NICU admission rates and low birth weight.

Cannabis use has been frequently cited as a way to alleviate symptoms during the peri and postmenopausal period. Symptoms experienced during menopause include hot flashes, depressed mood, poor sleep, joint/muscle pain and vaginal dryness. Typically, the postmenopausal period lasts between 2-6 years depending on the individual. Cannabis was seen to be largely beneficial in treating joint/muscle pain, sleeping problems, hot flashes and anxiety. However, cannabis use had no effect on symptoms such as exhaustion, and vaginal dryness. Medical marijuana has also been used to alleviate neuropathic pain, a type of chronic pain caused by damaged nerves. However marijuana use has adverse effects on functions of the brain including memory, learning, attention, decision making and reaction time. Long term use has been linked to some cases of psychosis. Therefore, the role of cannabis in positively impacting health must be explored further.

References

Centers for Disease Control and Prevention. (2021, June 8). Data and statistics. Centers for Disease Control and Prevention. Retrieved June 30, 2022, from https://www.cdc.gov/marijuana/data-statistics.htm

Corsi DJ, Murphy MSQ, Cook J. The Effects of Cannabis on Female Reproductive Health Across the Life Course. Cannabis Cannabinoid Res. 2021 Aug;6(4):275-287. doi: 10.1089/can.2020.0065. Epub 2020 Dec 28. PMID: 33998877; PMCID: PMC8380785.