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I Really Need CBD Brands to Stop Lying to Me About Period Cramps

CBD tincture for PMS period cramps and endometriosis.

Getty Images/ razerbird

I was scrolling through my emails recently, exorcising spam, when one subject line caught my eye: “CBD for PMS? 🙌🏼Hallelujah! 🙌🏼.” The hemp company’s newsletter could not have been more on point—I was smack dab in the middle of one of my most painful periods to date. I opened the email, and my heating pad slipped as I shifted to the edge of my seat.

Could this really be the magical answer to the burning ball of fiery knives inside my uterus? I thought.

The newsletter was riddled with seemingly relatable Friends GIFs, clever alliterations, and marketing buzzwords to get the reader to buy, buy, buy! “PMS Pain Be Gone!” it read. But what it didn’t have was products that have been proven to—in any way, shape, or form—actually minimize excruciating period cramps.

I was floored. Not just as someone with intense period pain due to endometriosis, but also as a C-suite-level marketing professional. I couldn’t tell what was worse, the cramps in my uterus or the knife in my back.

One of the products was a patch with only 15 mg of CBD, also called cannabidiol, a compound found in cannabis that does not produce a high. Using that to try to manage my pain would be like putting a Band-Aid on a gushing head wound. How do I know this? For starters, I typically consume between 30 mg and 50 mg of CBD in a single dose when I’m taking it to manage my pain. And as much as I feel CBD assists me in my pain management, it’s not my cure-all. I could replace my blood with CBD oil and I would still have intense cramps. If something has only 15 mg of CBD, I don’t have to try it to know it’s not going to cure my PMS. Not to mention, there’s just no science or regulation behind these claims.

I quickly grabbed my phone and did what all opinionated millennial women do: rant on social media. Messages immediately poured in. I was not alone. Other women had similar experiences with the new wave of CBD products. Screenshots of high-end packaging and their ingredient labels flooded my DMs. Once again, I was taken aback by the prices, claims, ingredients, and minimal CBD contents.

If a product hasn’t been approved by the Food and Drug Administration (FDA), the brand behind that product cannot legally claim it will cure any ailment. From the FDA itself: ”Unlike drug products approved by the FDA, unapproved CBD drug products have not been subject to FDA review as part of the drug approval process, and there has been no FDA evaluation regarding whether they are safe and effective to treat a particular disease, what the proper dosage is, how they could interact with other drugs or foods, or whether they have dangerous side effects or other safety concerns.”

This is an incredibly personal issue for me because my periods are definitely not normal. I received my official endometriosis diagnosis after a laparoscopy in the summer of 2015. I have been working ever since to manage the painful, frustrating symptoms, which I’ve dealt with unofficially for over a decade. Traditional painkillers barely scratch the surface of my pain, and I had trouble getting doctors to take my level of pain seriously.

Up until my surgery, I was subjected to bouts of extreme discomfort and frequent UTIs. Sex was painful, and sometimes I would bleed during or after. I developed depression and anxiety while going through these unsuccessful battles with an ever-growing list of symptoms that went undiagnosed for years. I was opposed to opioid use and searched for an alternative. Not only do I understand the allure of using cannabis for period paid—I do it myself, and I find that some products really do help.

CBD and hemp brands are marketing their products for managing pain and period cramps, but as someone with endometriosis, I know they won’t help me.

Medical Marijuana: A Possible Treatment for Menstrual Cramps?

Andrea Chisolm, MD, is a board-certified OB/GYN who has taught at both Tufts University School of Medicine and Harvard Medical School.

Jessica Shepherd, MD, is board-certified in obstetrics-gynecology. She practices at the University of Illinois at Chicago and appears regularly as an expert on Good Morning America, The Today Show, and more.

Medical marijuana has proven to have some significant medical benefits, most especially pain control. Although it isn’t strong enough to treat severe pain (such as bone fractures or post-surgical pain), it can be effective in relieving different types of chronic pain in many people.

Practitioners of alternative medicine will frequently include menstrual cramps as one of the conditions that medical marijuana can help treat. Insofar as it has been reported to help relieve symptoms of endometriosis and interstitial cystitis, it would seem reasonable to assume that marijuana can help treat the cyclical cramps and pelvic pain that can occur with menstruation.  

Woman laying on a couch holding her stomach

Mechanism of Action

Marijuana (Cannabis sativa) contains more than 100 different compounds called cannabinoids, some of which have psychoactive properties. These compounds are easily absorbed when inhaled or eaten and can cross the blood-brain barrier to act directly on the brain.

The body is populated with a vast quantity of cannabinoid receptors, called CB1 and CB2, found mainly in the central nervous system but also in the lungs, liver, kidneys, and joints.   These are the same receptors that naturally-occurring compounds, called endocannabinoids, attach to.

Endocannabinoids, part of the body’s endocannabinoid system, are believed to play an important role in regulating pain and inflammation.   The ability of cannabinoids to attach to these receptors suggests that they may exert similar activity.

The two most recognized cannabinoids in marijuana are:

  • Delta-9 tetrahydrocannabinol (THC), which is primarily responsible for marijuana’s psychoactive “high”
  • Cannabidiol (CBD), which does not cause a “high”

While THC and CBD are thought to have anti-inflammatory and analgesic (pain-relieving) properties, how they do so differs from other anti-inflammatory or analgesic agents.

What the Evidence Says

Not surprisingly, there is a lack of quality research regarding the benefits of medical marijuana in treating menstrual pain. Even so, cannabis has a long history of use in gynecology. Back in the late-19th century, Sir John Russell Reynolds, Queen Victoria’s personal physician, was said to prescribe hemp tincture to relieve the monarch’s painful menstrual cramps.  

How marijuana is meant to achieve the relief remains unclear. At its heart, menstrual cramps are triggered by the release of inflammatory compounds, called prostaglandins, during menstruation. Women who produce are excessive amounts of prostaglandins are more likely to experience severe cramps.

Nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to treat menstrual cramps—like Advil (ibuprofen) and Celebrex (celecoxib)—block the production of prostaglandins by binding to COX receptors in the brain and other tissues.  

By contrast, cannabinoids like THC and CBD exert no activity on COX receptors. and, therefore, have no influence on the production of prostaglandins. Rather, they stimulate the release of the “feel-good” hormone dopamine in the brain (where CB1 resides in high density) while reducing inflammation in the nerves and joints (where CB2 resides in high density).  

This suggests that THC and CBD are most beneficial in treating chronic neuropathic pain and inflammatory joint disorders like rheumatoid arthritis. Even so, a 2018 review from the University of Alberta suggests that the benefits may be small.  

Because THC and CBD have no effect on prostaglandin production—the compound responsible for menstrual cramps—it is unclear how they are meant to relieve menstrual pain and inflammation.

With that said, it is possible that THC induces euphoria than can reduce the perception of pain. By contrast, CBD’s effect on menstrual cramps remains unknown and largely unsubstantiated.

Safety of Medical Marijuana

At this point, we don’t really know how safe medical marijuana use. Although many people presume it to be safe, the National Institute of Drug Abuse (NIDA) warns that the long-term consequences of marijuana use are still unknown.

Moreover, CBD oils, extracts, and tinctures popularly sold as alternative therapies sometimes contain unknown ingredients, and it is often difficult to know if the doses list on the product label are accurate.  

Based on current advisement from the NIDA, medical marijuana in its inhaled form should not be used in people who:

  • Are under 25 years of age
  • Have a personal or strong family history of psychosis
  • Have a current or past cannabis use disorder
  • Have a current substance abuse disorder
  • Have heart or lung disease
  • Are pregnant or planning a pregnancy  

Because there is little evidence about the safety of marijuana in pregnancy, it is best to avoid the drug if you are of reproductive age or use a proven form of birth control.  

Though marijuana has not been shown to be cause birth defects, the presence of cannabinoid receptors in the fetal brain suggests that marijuana may impact a child’s cognitive and behavioral development in later years.  

There is also evidence that marijuana use during pregnancy may increase the risk of pregnancy loss due to the overstimulation of cannabinoid receptors in the lining of the uterus.  

A Word From Verywell

At present, there is no compelling evidence to support the use of medical marijuana in treating menstrual cramps. However robust the testimonials or anecdotal evidence may be, they lack any clear explanation of how the drug is meant to work. Do not be swayed by manufacturer claims that may or may not be true.

If you have severe, recurrent menstrual cramps that do not respond to conservative treatment, talks to your gynecologist about hormonal therapies or surgical options (like endometrial ablation or hysterectomy) that may help.

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.