Menstrual Cramps – Medical Marijuana Research Overview

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Menstrual cramps are painful sensations that women experience in their lower abdomen before and during the menstrual period. Research has shown cannabis to be highly effective for reducing pain, while a handful of studies indicate that cannabinoids are specifically beneficial for treating pain associated with endometriosis-related menstrual cramps.

Overview of Menstrual Cramps

Menstrual cramps, or dysmenorrhea, refer to the painful cramps that occur in women immediately before or during the menstrual period. The pain or throbbing from menstrual cramps, which can be mild to severe, is usually isolated to the lower abdomen or back.

There are two types of menstrual cramps. Primary dysmenorrhea is the most common type, and it typically develops one or two years after a woman starts getting her period. The pain can last one to three days. Secondary dysmenorrhea is not as common and is caused by a disorder in the woman’s reproductive organs, such as endometriosis – a disorder in which tissue that normally lines the inside of your uterus grows on the outside. In secondary dysmenorrhea, pain often develops earlier in the menstrual cycle and lasts longer than cramps associated with primary dysmenorrhea.

Menstrual cramps are caused by contractions in the uterus. Throughout a woman’s menstrual cycle, the uterus contracts to help expel its lining. If it contracts too strongly, it can press on nearby blood vessels and cut off oxygen to the uterus’ muscle tissue, causing pain. Some women will experience mild discomfort, while others can have cramps so severe that they interfere with everyday activities. The cramps can also cause nausea, loose stools, headache, and dizziness.

Menstrual cramps don’t cause any additional medical complications, and those that aren’t related to an underlying condition will often lesson with age and even subside altogether after a woman has given birth.

Pain relieving medications, including ibuprofen and naproxen sodium, are most typically used to treat menstrual cramps. Doctors may also prescribe non-steroidal anti-inflammatory drugs. Hormone birth control pills can also reduce their severity. In addition, exercise and heat in the form of a heating pad or hot bath have shown to help some women.

Findings: Effects of Cannabis on Menstrual Cramps

Through vast research, cannabis has established itself as highly effective for relieving pain. Two of cannabis’ major cannabinoids, cannabidiol (CBD) and tetrahydrocannabinol), have shown to manage pain associated with an array of conditions, suggesting that they would be effective for menstrual cramps1. The cannabinoids interact with the endocannabinoid system’s two cannabinoid receptors, CB1 and CB2, to help regulate the release of a neurotransmitter to manage pain levels10. Studies even show cannabis to lower pain levels that had otherwise proven refractory to traditional treatments2.

The first recorded use of cannabis to treat menstrual cramps dates back to ancient Mesopotamia, as Queen Victoria would reportedly consume monthly doses of cannabis tinctures to reduce menstrual discomfort3. Research specifically examining cannabis’ effects on menstrual cramps, however, is severely lacking. Findings in a small collection of studies do indicate cannabis’ efficacy for treating menstrual pain in those with endometriosis6,7. In addition, studies have determined that there are CB1 and CB2 receptors located in many cells throughout the uterus, suggesting that cannabinoids’ pain-relieving effects could help address menstrual discomfort8. Research also shows that the CB1 receptor is associated with the management of dysmenorrhea-related pain7.

States That Have Approved Medical Marijuana for Menstrual Cramps

While no states have approved medical marijuana specifically for the treatment of menstrual cramps, nearly all states with comprehensive medical marijuana legislation allow cannabis for the treatment of pain. Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island and Vermont have approved cannabis for the treatment of “chronic pain.” The states of Nevada, New Hampshire, North Dakota, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have approved cannabis for the treatment of “intractable pain.”

Two additional states will consider allowing medical marijuana to be used for the treatment of pain with recommendation by a physician. These states include: Connecticut (other medical conditions may be approved by the Department of Consumer Protection) and Massachusetts (other conditions as determined in writing by a qualifying patient’s physician).

In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.

Recent Studies on Cannabis’ Effect on Menstrual Cramps
  • Using cannabis has been shown to significantly improve pain that had otherwise shown to be refractory to traditional treatments.
    The effectiveness of cannabinoids in the management of chronic nonmalignant neuropathic pain: a systematic review.
    http://www.ncbi.nlm.nih.gov/pubmed/25635955
  • Preclinical data shows that the CB1 receptor is associated with dysmenorrhea-related pain and that cannabinoids offer an alternative option for discomfort caused by endometriosis.
    Reproductive Sciences.
    https://www.ncbi.nlm.nih.gov/pubmed/26887427

References:

  1. Baron, E.P. (2015, June). Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It’s Been… Headache, 55(6), 885-916.
  2. Boychuck, D.G., Goddard, G., Mauro, G., and Orellana, M.F. (2015 Winter). The effectiveness of cannabinoids in the management of chronic nonmalignant neuropathic pain: a systematic review. Journal of Oral & Facial Pain and Headache, 29(1), 7-14.
  3. History of Cannabis. (n.d). BBC News. Retrieved from http://news.bbc.co.uk/2/hi/programmes/panorama/1632726.stm.
  4. Jensen, B., Chen, J., Furnish, T., and Wallace, M. (2015, October). Medical Marijuana and Chronic Pain: a Review of Basic Science and Clinical Evidence. Current Pain and Headache Reports, 19(10), 524.
  5. Menstrual cramps. (2014, May 8). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/menstrual-cramps/basics/definition/con-20025447.
  6. Sanchez, A.M., Vigano, P., Mugione, A., Panina-Bordignon, P., and Candiani, M. (2012, December). The molecular connections between the cannabinoid system and endometriosis. Molecular Human Reproduction, 18(12), 563-71.
  7. Sanchez, A.M., Cioffi, R., Vigano, P., Candiani, M., Verde, R., Piscitelli, F., Di Marzo, V., Garavaglia, E., and Panina-Bordignon, P. (2016, August). Reproductive Sciences, 23(8), 1071-9.
  8. Taylor, A.H., Abbas, M.S., Habiba, M.A., and Konje, J.C. (2010, May). Histomorphometric evaluation of cannabinoid receptor and anandamide modulating enzyme expression in the human endometrium through the menstrual cycle. Histochemistry and Cell Biology, 133(5), 557-65.
  9. Ware, M.A., Wang, T., Shapiro, S., and Collet, J.P. (2015, September 15). Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS). The Journal of Pain. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26385201.
  10. Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role of the endocannabinoid system in pain. Handbook of Experimental Pharmacology, 227, 119-43.
  11. Your Guide to Menstrual Cramps. (n.d.). WebMD. Retrieved from http://www.webmd.com/women/menstrual-cramps#1.

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