Women and medical cannabis: addressing gender-specific health issues

Understanding women’s health

“Women’s health” is a broad term that can encompass a huge number of health issues. From puberty to later life, women and people who menstruate face several gender-specific health problems, including endometriosis, perimenopause and menopause. Unfortunately, accurate diagnosis and effective management of these conditions is often lacking. 

In honour of World Menopause Day 2024, we’re looking closer at these three women’s health issues and current evidence of the potential benefits of medical cannabis.

Endometriosis

Endometriosis is a chronic condition in which cells similar to those in the lining of the womb begin to grow in other parts of the body. The condition most commonly affects the ovaries and the fallopian tubes; however, tissue can also grow in other organs, including the bladder and bowel. 

Symptoms of endometriosis can include:

• Severe period pain
• Heavy periods
• Pain when going to the toilet
• Pain in the lower back and tummy
• Pain during or after sex
• Fatigue

The cause of endometriosis is unknown, and it’s symptoms can be similar to other conditions. This can result in a long diagnosis process. On average in the UK, it takes 7.5 years from the onset of symptoms to get a diagnosis for endometriosis. This, in addition to the symptoms of endometriosis, can have a significant impact on patients' lives, with many requiring additional physical and emotional support.

Conventional treatments for endometriosis

There is no cure for endometriosis and treatments focus on achieving satisfactory symptom relief. First-line treatments for endometriosis typically include medications such as painkillers and hormone pills that can help to reduce pain associated with the condition, and some patients may also be prescribed antidepressants. 

While these treatments are often effective at managing the symptoms of endometriosis, they can be associated with undesirable side effects that make them intolerable to some patients. 

Furthermore, if these treatments are ineffective, patients may be offered surgery to remove areas of endometriosis, and ovarian cysts caused by the condition, the womb, or the ovaries. 

Medical cannabis for endometriosis

Interest in the potential of medical cannabis for endometriosis has been on the rise in recent years. Since the legalisation of cannabis in the UK in 2018, patients have been able to access cannabis-based medicines for the management of endometriosis symptoms from private medical cannabis clinics like Releaf. 

But, what does the evidence say?

Several studies have assessed cannabis-based medicines for endometriosis. One study, published in 2021, assessed the self-reported efficacy of cannabis among 252 participants with endometriosis. According to the collected data, pelvic pain was the most common symptom being treated with the condition, followed by gastrointestinal distress, cramps, nausea, and depression. Participants of the study reported the benefits of medical cannabis for pain and gastrointestinal symptoms.

Another study, published in 2023, found that dysregulation of the endocannabinoid system (ECS), a receptor system that plays a role in many vital bodily processes, and the gut microbiota may influence symptoms of endometriosis. This indicates that the ECS may be a valuable therapeutic target for the management of the condition.

A number of patients are already receiving medical cannabis on prescription for endometriosis. These patients include Chloe Durrington, a Releaf patient who is using medical cannabis to manage her symptoms better: “Since starting my treatment plan with Releaf, I’m genuinely shocked at how well it has worked.”

Perimenopause and menopause

Menopause is a natural biological process that occurs in women and all people who have periods. It occurs when a person’s menstrual cycles end and their uterus ceases to produce eggs. This leads to a reduction in some hormones, chiefly oestrogen and progesterone, which is often linked to a wide range of symptoms. 

Menopause refers to the stage when a person hasn’t had a period for 12 months or more. Perimenopause is the transition period before this point when the body’s hormone levels have begun to change and menopausal symptoms may begin to occur. 

Typically, menopause occurs between the ages of 40 and 60; however, it can begin earlier and be triggered by factors such as surgery and some cancer treatments.

Some common symptoms of menopause and perimenopause include:

• Hot flashes

• Sleep disturbance

• Brain fog

• Anxiety and depression

• Joint pain and stiffness

• Heavy periods

• Low interest in sex

Conventional treatments for menopause and perimenopause

For many people going through perimenopause and menopause, the associated symptoms can be a significant burden. As a result, many women will seek treatments to help alleviate their symptoms. This can include lifestyle changes, such as eating a healthy diet and getting regular exercise, as well as medical interventions. 

Hormone replacement therapy (HRT) is the main treatment for menopause symptoms. It works by replacing the hormones that are reduced as a result of the menopause. HRT can be extremely effective at helping to manage menopause symptoms; however, evidence shows that only 14% of menopausal women are reported to be taking HRT. Furthermore, product shortages can further exacerbate the already limited access to HRT. 

Medical cannabis for menopause and perimenopause

A growing number of menopausal and perimenopausal women are reportedly turning to alternative treatments to better manage their symptoms. This may be due to unreliable access to conventional therapies, difficulty achieving adequate relief with these therapies, or simply due to personal choice. Some evidence indicates a growing interest in medical cannabis for menopause symptoms. 

Cannabis contains a variety of active compounds, many of which have been found to possess impressive anti-inflammatory, anti-anxiety, and pain-relieving properties. For some patients, these properties could prove particularly useful in effectively managing some of the most common and debilitating symptoms of menopause, such as joint pain, anxiety, and sleep disturbance. 

In recent years, a number of studies have aimed to understand the potential of medical cannabis in managing menopause symptoms. In 2022, a study of perimenopausal and postmenopausal women in the US found that most participants (86.1%) were currently using cannabis. Furthermore, over three-quarters of these women reported its benefits for symptoms including sleep disturbance and anxiety/mood problems. 

However, more clinical research is required to better establish the mechanisms through which cannabis and its derivatives may improve these symptoms in people going through menopause.

Final thoughts

Gender-specific health issues such as endometriosis and menopause can have a significant impact on those affected, both physically and emotionally. It is therefore vital that adequate treatment methods are applied that best suit each individual and their needs - whether that be conventional approaches such as HRT and surgery, or alternative treatments such as medical cannabis. 

As Dr David Tang, Clinical Director and medical cannabis prescriber at Releaf, notes:

“The growing awareness that female physiological differences can lead to the misdiagnosis of conditions, highlights the need for clinical approaches that better account for these variations. 

“Other conditions such as endometriosis can take up to seven years to be diagnosed, all the while, the patient is passed from pillar to post and started on a plethora of medication in the hope that distress is alleviated. 

“Experience now tells us that medical cannabis can be a particularly effective treatment for menstrual-related pain conditions.“

Cannabis-based medicines can now be prescribed by registered clinicians for a wide range of conditions, including many that specifically affect women and people who menstruate. Learn more about getting a medical cannabis prescription in the UK.