Cannabis has been used for assisting women with premenstrual syndrome (PMS), endometriosis, and menstrual cramps (for which Queen Victoria notably used cannabis monthly for dysmenorrhea by prescription from her doctor, Sir John Russell Reynolds).
Although cannabis has had an extraordinary long history of use, as mentioned in part one of this article series, modern science has yet to focus much research on the use of cannabinoids for these common ailments that affect millions of women. Commonly used tinctures for menstrual cramps, patented by US pharmaceutical companies, included cannabis in their formulas.
Changes in hormones during the premenstrual phase can create a wide range of symptoms. The most common mood-related symptoms are depression, crying, irritability, oversensitivity, and emotional swings. The most common physical symptoms are bloating, breast tenderness (mastalgia), fatigue, acne flare-ups, and appetite changes with food cravings. Hormone levels of progesterone greatly increase during this phase, where other hormones, such as estrogen, decrease. PMS affects up to 75 percent of women in their childbearing years, although there is a sign that just 20 percent to 40 percent have difficulties as a result.
The endometrium, or interior lining of the uterus, is also governed by hormonal changes. When the cells that make up this lining proliferate outside the uterus, painful growths and adhesions occur in a condition known as endometriosis. Read more studies in our article on endometriosis.
Fascinatingly, estrogen levels are directly linked to endocannabinoid levels, and both peak at ovulation and drop off after menopause. As mentioned previously, FAAH, the enzyme that breaks down the endocannabinoid anandamide and controls its levels, is regulated by estrogen. Notably, activation of estrogen receptors and cannabinoid receptors on the same cells often works synergistically to elicit stronger effects, helping to alleviate PMS emotional swings. For more information, see our article on Hemp & Maca.
The endocannabinoid system (ECS) is a system of physiology inside the body that maintains order and balance across all other areas of the body, from the immune system to the endocrine and reproductive. The ECS is formed at 8-weeks gestation and the endocannabinoids it produces are found in breast milk; supporting healthy development. The ECS can become overwhelmed when under too much pressure and stress. When this happens, it becomes dysfunctional, leading to other pressure on other systems of the body.
An example of too much physical stress could be seen as a rower on a sail ship barely surviving off rations alone for days or weeks on end. The amount of energy, stress, and demand placed on the body is too much, notwithstanding the fact rations instead of a healthy diet rich in calories is on the menu. An example of too much emotional, mind-related stress could be seen as a baby or child growing up around emotionally abusive parents, arguing a lot, or in the case of an adult going through a major life change or passing of a friend, and not having any close-friends or family they can rely upon for support. The amount of emotional stress is too great, let alone the lack of natural healthy emotional support. Chronic pain conditions such as fibromyalgia and multiple sclerosis affect mostly women (70 percent), with women being three times more likely to develop multiple sclerosis than men. Painful reproductive conditions such as endometriosis seem to be on the rise, rarely seen a generation ago, currently affect roughly 10 to 20 percent of women.
The information contained in this article is for informational purposes only and does not constitute medical advice of any kind. Prior to making changes to your lifestyle or treatment plan, always consult with a licenced medical practitioner. It is recommended those wishing to utilize cannabinoids, do so under the guidance of a physician who has experience in prescribing CBD product and medical marijuana so that the dosage and delivery method may be customized to the patient. At the same time, well educated and aware persons may be their own highly informed health consultants. Availability of CBD and hemp products will vary based on country of origin and legal status.
Often, women are given the hormone progesterone by their Doctors as a supplement to assist them with PMS and premenstrual dysphoric disorder (PMDD), along with during menopause, women are given a cocktail of hormones as replacement therapy during menopause, however, studies reveal it’s vital to have one’s individual hormonal levels checked to accurately assess if supplementation is needed. Although it’s typically thought that abnormal premenstrual symptoms are linked to low progesterone levels during which they should be high, some forms appear to be linked to excessive progesterone levels and reduced estrogen levels. 
The current research has discovered that CBD cannabis use can lower progesterone during the luteal (post-ovulatory) phase  and potentially adjust levels of other important hormones such as cortisol and prolactin.  A study from 1986 showed that THC could affect the luteinizing hormone connected to ovulation. It’s impact on fertility is not fully understood, but it is possible that a woman’s cycle may be effected enough to alter the chances of ovulation and implantation, so it is advisable for women attempting to conceive to avoid THC if they are new to cannabis. In saying that, it has been found that the bodies of regular users adapt, and fertility returns to normal levels. The effects of THC on fertility is relatively short-lived, and hormones return to baseline within one or two cycles of abstinence.
Cannabidiol (CBD) hasn’t been studied enough for a full understanding or conclusion to be reached with regard to its effect on fertility, though some stories and research does suggest that, when accurately timed, it may have beneficial effects for women suffering from infertility, especially related to endometriosis.   High levels of anandamide are beneficial for encouraging ovulation (CBD allows this endocannabinoid to be more available in the system, see our article on Hemp & Maca), but for an embryo to implant, anandamide levels must be low.   One hypothesis is that cannabinoids like CBD could decrease the likelihood for pregnancy in women with naturally high anandamide levels, whereas it could alternatively, increase the likelihood in women whose anandamide levels are low.  
The benefits of CBD products with a ratio of 20:1 or higher, given as capsules, edibles or drops, can be extremely effective in alleviating pain from menstrual cramps, and may help to stabilize mood. Most recommend finding the ideal dosage is vital to managing the symptoms of PMS with cannabidiol. Other cannabinoids with low psychoactivity are also powerful in relieving pain, such as CBG, CBC, THCA, and THCV. Strains that are higher in the terpenes beta-caryophyllene, linalool, and myrcene can provide even more pain and symptom relief along with actually increasing the effectiveness of other cannabinoids for analgesia (for more on this, see our article covering the Entourage Effect).
Studies reveal that the cannabinoid CBD can actually improve anxiety and depression, and has shown efficacy in relation to assisting with both the physical and mental symptoms associated with them. See more in our articles on depression and anxiety. It has also been shown to help with sleep disorders such as insomnia.
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This article is part of our Women's Wellness series:
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