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Cannabinoids & Your Period
Written by: Genevieve R. Moore PhD
Aunt Flow’s in town. The English have landed. It’s shark week...
It’s that time of the month again — time to call in sick, cancel plans, curl up in bed with a hot water bottle, and try to distract yourself with a non-stop stream of movies and TV.
If this sounds like your monthly ritual, you are not alone. Up to 90% of reproductive-age women suffer from painful periods — the medical term for it is “dysmenorrhea” — and it can completely derail your daily life.
Cannabinoids & Suppositories Help
More and more women are reporting that CBD and THC products are the best tools they have for treating painful periods. But how do they stack up when compared to NSAIDs like Ibuprofen?
Quite well, it turns out, but it’s worth a deeper look at why they work — exactly how cannabinoids’ anti-inflammatory, pain-relieving, muscle-relaxing effects interact with your period.
This touches on the actual causes of pain & discomfort during your period, and how additional natural remedies can help combat these symptoms.
Move over NSAIDs and heating pads! Read on to discover why cannabinoids might become your new favorite companion when Aunt Flow comes to town...
Your Uterus: Prepping for a Visit
In people who have periods, the uterus diligently prepares itself all month.
First, your body’s increasing estrogen told your uterus to build up its endometrial tissue. Then, after you ovulated, and the boost of progesterone helped plump up that tissue with arteries and blood and all sorts of packaged goodies — prepping to give a warm welcome to an incoming embryo … or to set off a self-destructing time bomb.
Once your body discovers it won’t be hosting a guest, your progesterone levels decline — telling your uterus to roll up the welcome mat.
Your body takes back what it can from the endometrium, shrinking the tissue and strangling its spiral-shaped arteries. Without a proper blood supply, your endometrial tissue begins to suffocate and die, and you likely begin experiencing pangs of pain.
Without progesterone, the endometrium loses its protection from the pre-packaged time bombs: vesicles carrying tissue-dissolving enzymes. These vesicles begin to weaken, and once they’re unwrapped, they create a domino effect — killing neighboring cells and spilling open more vesicles in a chain-reaction that ruptures pools of blood caught in venous lakes. Dead tissue sloughs off, creating a field day for inflammation...
Prostaglandins: Inflaming the Uterus
While your progesterone was declining, nasty inflammatory chemicals called prostaglandins were increasing. Prostaglandins (particularly one called PGF2⍺) peak during menstruation, unleashing the following effects:
- Inflammation: certain prostaglandins trigger an inflammatory response, which leads to more pain and cell death.
- Pain sensitization: prostaglandins and other inflammatory compounds can actually prime pain-perceiving nerves to become more sensitive.
- Vasoconstriction: the prostaglandins rampant during menstruation cause blood vessels to constrict and suffocate endometrial tissue.
- Uterine contractions: PGF2⍺ tells the uterus’ smooth muscle to contract. This contraction chokes off blood supply to the endometrium — like a heart attack in your uterus. Women with higher prostaglandin levels also have stronger, more painful contractions and doctors are finally acknowledging that this pain can be as intense as heart attack pain.
- Heavy bleeding: Unusually heavy periods could result from excessive inflammation, which increases tissue damage. Women with heavy bleeding have higher levels of the enzyme the produces prostaglandins (COX-2), and medications to combat this process can decrease menstruation.
- Diarrhea: In addition to uterus contractions, prostaglandins also trigger smooth muscle contractions in the digestive tract — which might push your last few meals out a bit too soon.
(Note: some women claim that having sex helps to jump-start their periods — scientists believe that the prostaglandins in semen could contribute to this effect.)
We’re not trying to say that prostaglandins are unequivocally evil: They are essential for a healthy functioning menstrual cycle.
However, numerous studies indicate that women with higher levels of prostaglandins also have more painful or heavier periods — and treatments that lower prostaglandin levels can be highly effective.
NSAIDs Work, Sort Of
When their periods kick in, most women reach for an Ibuprofen or similar NSAID (Non Steroidal Anti-Inflammatory Drug). Why are NSAIDs the most frequently-prescribed treatment for menstrual pain?
NSAIDs work by inhibiting the enzyme responsible for producing prostaglandins (COX-2). This means that NSAIDs could potentially decrease all the symptoms aggravated by prostaglandins — including inflammation, contractions and pain.
Unfortunately, NSAIDs can also have unpleasant gastrointestinal side effects, because they inhibit another enzyme (COX-1). For this reason, NSAIDs should be used with moderation, and people with certain digestive issues might want to avoid them entirely.
CBD: a Better Alternative?
Recently, scientists discovered that — similar to NSAIDs — CBD also inhibits the prostaglandin-producing enzyme. However — unlike NSAIDs — CBD preferentially inhibits COX-2 over COX-1, which means its anti-inflammatory benefits come without the gastrointestinal side effects.
Added bonus: Not only does CBD inhibit the COX-2 enzyme, but both CBD and THC physically stop your DNA from producing so much of this enzyme in the first place (via the PPARγ receptor).
Additional Cannabinoid Benefits
By decreasing prostaglandin levels during your period, you can reduce inflammation, pain and cramps. However, you cannot entirely eliminate prostaglandins.
This means that you could benefit from combining a prostaglandin-reducing treatment with other treatments that target the discomforts caused by prostaglandins.
CBD and other cannabinoids can also treat painful menstrual cramps in the following ways:
- Anti-inflammatory: Cannabinoids have many anti-inflammatory activities beyond reducing production of inflammatory prostaglandins. For instance, THC activates endocannabinoid receptors (CB2) located on your immune system’s killer cells (macrophages). When these receptors are activated, they prevent macrophages from releasing inflammatory proteins (cytokines).
- Pain-relieving: Although prostaglandins and other inflammatory molecules can make pain-perceiving nerves more sensitive, cannabinoids fight back by desensitizing these nerves. Both CBD and THC target nerve receptors that help decrease the sensation of pain (TRPV1 and CB1, respectively). Additionally, not only does CBD desensitize TRPV1, but those soothing effects can spread to neighboring pain receptors.
- Muscle-relaxing: Menstrual cramps are exacerbated by contractions of the smooth muscle lining the uterus — and cannabinoids are widely recognized to relax smooth muscles. THC and CBD both target different receptors embedded in the muscle tissue to relax contractions.
- Vascular-relaxing: Blood vessels are also lined with smooth muscle, and when cannabinoids trigger this smooth muscle to relax, blood flow increases. Increased blood flow could help provide relief to oxygen-starved tissues, further decreasing painful cramps.
Natural Remedies for Cramps
- Apply heat: Hot water bottles may seem old-fashioned, but they can bring as much relief from menstrual cramps as NSAIDs — and oftentimes much faster. Heat increases blood flow to the area, which soothes the overworked muscles and delivers oxygen to oxygen-starved tissues. Some scientists also think that heat desensitizes the same pain receptors that CBD works on.
- Fish oil: Interestingly enough, multiple studies have demonstrated that daily fish oil supplements decrease pain and reliance on NSAIDs during periods. It turns out that prostaglandins are synthesized from omega fatty acids, and a diet high in omega-3 fatty acids could shift your body away from producing inflammatory prostaglandins.
- Magnesium: Do you ever crave chocolate around this time of the month? Women who take magnesium supplements during their periods have reduced pain and reduced inflammatory prostaglandin levels. Foods like chocolate, lentils and avocados are high in magnesium — so go ahead and feed the craving.
- Treat early: Many doctors suggest that it’s best to start taking painkillers an hour or more before the cramps start. This is true whether you’re using NSAIDs, CBD, or other cannabinoid blends. If you hold off treatment until you’re in excruciating pain, the prostaglandins will already be in full demolition mode and harder to bring under control.
- Discuss your treatment plan with a doctor: Sometimes painful cramps and/or heavy bleeding can be a symptom of an underlying problem like endometriosis (another painful condition that can be soothed by cannabinoids). We encourage you to talk with your doctor about your symptoms and treatment plan in order to rule out other health problems, particularly if your symptoms don’t improve with standard treatments. Your doctor can help you determine if there are surgical or hormonal treatments that could be more effective.
Cannabinoid Suppositories: Women are Finding Relief
Many women are shocked and surprised to experience how effective cannabinoids are at relieving menstrual cramps (especially cannabinoid suppositories).
But the science is pretty clear about why: CBD targets the cause — inflammatory prostaglandins — while also relieving the symptoms (especially with help from a little THC).
Perhaps this is why women have been using cannabis to treat period pain for millennia. Though there are increasing numbers of doctors and scientists who know why cannabinoids work to relieve menstrual cramps, many more of them are only just beginning to hear from their female patients about how well cannabinoids work for their periods.