Period pain. Uterus owners around the world know the dread that comes with that certain time each month. The stabbing pain and dull aches deep in your organs that won’t go away. Maybe you hop in a hot bath, camp out under fuzzy blankets with a heating pad, or pop some pain pills when you can no longer grin and bear it. Any way you approach it, it’s obvious that remedies for dealing with menstruation pain fall short.
But cannabis may be able to help. This multifaceted plant has been relied on as medicine for centuries, and there is historical evidence that hemp may have helped women deal with pain throughout their menstrual cycle.
But it’s not enough to smoke a joint and expect the cramps to disappear. You’ll want a specific combination of cannabinoids and terpenes, and what works for one person may not work for the next. But, if we look at the limited evidence and evaluate what cannabis users report to help with period pain, we can give some general recommendations for women to start with. The best strains for period pain are a Type I or Type II chemovar with a terpene profile that includes linalool, pinene, and beta-caryophyllene.
Understanding period pain
Before diving into how cannabis can help with menstrual pain, a quick refresher on the female hormone cycle. Unlike testosterone-based endocrine systems which have a 24-hour hormone cycle, estrogen-based endocrine systems operate on a (roughly) 28-day cycle. There are two parts to the cycle: the follicular (proliferative) phase and the luteal (secretory) phase, but it’s commonly broken into four stages.
Menstruation: also known as the bleeding phase, this is the first phase of the cycle. This phase is commonly associated with cramps, bloating, sore muscles and breasts, exhaustion, mood swings, and food cravings. You can thank low estrogen and progesterone for that. Follicular: menstruation falls under the follicular phase, but this phase continues through the end of bleeding up to the first day of ovulation. Rising levels of estrogen and progesterone can make you feel confident, capable, and creative. For most women, pain ends when the bleeding ends, and the second half of the follicular phase is typically pain-free. Ovulation: this is the stage of the cycle when the egg is released from the ovaries into the fallopian tubes, and your chance of getting pregnant is the highest. Estrogen starts to drop off during ovulation, and testosterone increases. Some women experience pain during ovulation, typically described as a dull ache on one side of the abdomen, around the ovary that just released the egg.Luteal: the luteal phase can last up to two weeks, and includes ovulation up to the end of your cycle (the first day of your period). During this time, hormone levels peak and then drop off, so you’ll feel different during ovulation than you will three days before your period. Many women experience PMS symptoms during the week before their period.
During menstruation and at the end of the luteal phase are when pain most commonly occurs, and when cannabis can be the most useful. Outside factors like stress, gastrointestinal inflammation, and certain foods can worsen period pain.
Historical use of cannabis for women’s health
Women have been dealing with period pain for… ever. While exactly how much pain is normal is up for debate, dysmenorrhea (pain during periods) is incredibly common. Women across the globe deal with cramps, sore muscles, sensitive breasts, and more on a monthly basis. Up to 91% of women report pain during their period, with 29% experiencing severe pain.
Modern medicine hasn’t offered much in the way of relief, outside of popping a few ibuprofen or cuddling up with a heating pad. This is a part of a larger systemic issue in medicine, where women’s pain is written off, ignored, and undertreated, particularly when it comes to reproductive health. So despite a lack of concrete scientific evidence, it’s not hard to wonder why some women turn to cannabis.
Cannabis has been used for centuries to help women cope with period pain. Queen Victoria used a hemp tincture to help with her period pain. Dr. Ethan Russo, a renowned cannabis scientist, published a paper in 2002 detailing historical uses of cannabis in women’s health. He notes that evidence of cannabis use dates back to at least the 7th century BCE when hemp seeds were mixed with beer and other ingredients to help with “staying the menses” as well as difficult childbirth. He also notes that among other ancient cultures, ancient Egyptians applied cannabis paste vaginally.
How cannabis can help with period pain
Many of the studies that exist on cannabis and women’s health deal primarily with the impacts of the plant on reproductive health. Few delve into how the plant could benefit people with estrogen-based endocrine systems. Some studies suggest that chronic exposure to cannabinoids may cause menstrual cycle disruption, but this is a topic of debate.
Like all the organs in your body, women’s reproductive organs have endocannabinoid receptors. Your endocannabinoid system (ECS) is responsible for regulating a variety of biological functions, including endocrine function, or hormone regulation.
The uterus, ovaries, fallopian tubes, cervix, vagina, and vulva all have ECS receptors, including the two most studied receptors, CB1 and CB2. CB1 receptors have been documented in the ovaries and endometrium while CB2 receptors have been documented in the ovaries, specifically on the ovarian cortex, ovarian medulla, and ovarian follicles.
A 2013 review of research on the ECS and women’s reproductive organs found that anandamide levels in plasma increase in the ovulation phase and the “entire endocannabinoid system (i.e. the receptors, endocannabinoids, and ECS enzymes) is active at the ovarian level.” The researchers also note that the ECS, particularly the CB1 receptor, plays an important role in embryo transfer. They concluded, “the endocannabinoid system may represent an important task for researchers dealing with diseases of the female reproductive system.”A 2016 study examined endocannabinoid levels in women with and without endometriosis, a condition that causes painful periods due to growth on the outside of the uterus. Researchers found that women with endometriosis had higher levels of endocannabinoids including anandamide, particularly in women who reported painful periods and pain after sex. Interestingly, CB1 expression was higher in women without endometriosis, suggesting women with endometriosis may have “a negative feedback loop regulation, which may impair the capability of these mediators to control pain.”A 2022 study explored how the ECS plays a role in the cellular function of the endometrium. Researchers noted that “endocannabinoids are abundantly expressed in the endometrium and influence endometrial cellular function. They concluded that “genes within the ECS are increasingly being recognized as targets to modulate endocannabinoid activity for multiple reproductive diseases including endometriosis, miscarriage, ectopic pregnancy, pre-eclampsia, and endometrial cancer.”
Dysregulation of the ECS is thought to be an underlying cause of many reproductive-based health issues, including PCOS and endometriosis, as noted in a 2019 review. Researchers concluded, “the ECS is intimately involved in the central and local control of female reproductive events.”
Given the importance of the endocannabinoid system in hormone regulation and the menstruation cycle, it makes sense that intentionally using cannabinoids like THC and CBD could provide some relief from pain, inflammation, and bloating.
How to choose cannabis for period pain
When trying to find the best strains to deal with period pain, it can be easy to get caught up in the names – will White Widow provide more relief than Bubblegum Kush? But strain names are an unreliable indicator of experience. There are no regulations at any state or federal level for naming cannabis plants, so a cultivator can call their plants whatever they like, regardless of the chemical makeup.
Indica and sativa labels are also fairly useless when it comes to predicting experience since these terms describe the plant type, not the chemicals in the nugs.
Type I: THC dominant, little to no CBDType II: a balance of THC and CBD Type III: CBD dominant, little to no THC
The best kind of cannabis for dealing with period pain is a Type I or a Type II strain, and which is best for you is a personal choice. Some people enjoy the euphoric, intoxicating effects of Type I cannabis to take their minds off the pain, while others are sensitive to high amounts of THC, and need CBD to provide that balance.
CBD versus THC for period pain
Both CBD and THC have well-documented anti-inflammatory and pain-relieving effects, which can help provide relief from period pain. THC has mood-boosting and euphoric effects, which can be helpful for dealing with mood swings that many women know all too well. THC also has well known anti-nausea effects, although CBD may provide this benefit to some women as well.
Periods can also impact sleep quality; THC generally helps people fall asleep, while CBD may help you stay asleep and feel more rested and awake during the day.
For some women, changes in hormones during menstruation can lead to increased levels of anxiety. While THC has a strong dose-dependent effect on anxiety and can make it worse, a 2019 review of CBD research for periods noted 79.2% of participants experienced decreased anxiety levels within a month of using CBD regularly.
The best way to use cannabis for menstrual pain
Inhaled cannabis, such as smoking or vaping, is the fastest delivery method and the most rapid-acting. If you’re dealing with crippling cramps, waves of nausea, or stabbing pain in your back, inhaling cannabis can provide the fastest results.
Topical cannabis products are one of the best ways to utilize cannabis to help deal with period cramps and other pain. Topical balms and salves may help relieve aching back muscles or tender breasts. Cannabis suppositories (inserted into the vagina) may also help relieve period cramps and pain, though the bioavailability of these products is still unknown.
Edibles are the slowest delivery method on this list, which can make them less desirable for dealing with excruciating period pain. But the long-lasting effects can provide relief for hours more than smoking or topical products.
Best terpenes for period pain
While the literature on cannabis-derived terpenes for period pain is limited, there is an abundance of studies on the terpenes in essential oils that we can draw from.
A 2012 study tested a blend of essential oils that included beta-caryophyllene on period pain. Researchers found the strength and duration of the pain decreased from one cycle to the next with the blend.A 2020 rodent study found that beta-caryophyllene reduced painful stimuli through CB2 activation.Researchers in a 2014 rodent study noted beta-caryophyllene was “highly effective in the treatment of long-lasting, debilitating pain states.”
In a 2021 study of linalool and pinene, scientists noted that linalool could influence “multiple neurotransmitters, inflammatory and neurotrophic signals” that are responsible for muscle movement and pain.In a 2013 study, 95 women massaged an essential oil blend that contained lavender or a placebo onto their abdomen during their period. Participants who used the oil blend reported lower pain levels and less excessive bleeding.A 2010 study explored the effects of a massage with lavender oil on period pain for 80 women, and found that the massage reduced pain at a “statistically significant rate.” The main terpene in lavender oil is linalool.Along with linalool’s anti-inflammatory and antihyperalgesic properties (reducing severe pain), this terpene can also mediate adenosine A1 and A2A receptors to help relieve pain.The 2012 study of blended essential oils also included linalool.
An analysis of 129 studies on pinene concluded that the terpene has “strong pharmacological effects” in reducing inflammatory responses.The 2021 study of linalool and pinene found that pinene can influence “multiple neurotransmitters, inflammatory and neurotrophic signals” that are responsible for muscle movement and pain.
Best strains for period pain relief
The best weed for period cramps is likely a Type I or Type II cultivar that includes a terpene profile with linalool, pinene, or beta-caryophyllene. Whether you prefer a high-THC variety or something more balanced is subject to personal preference and cannabis availability.
If you don’t have access to a Type II strain, as many people don’t, you can create your own by blending CBD flower with THC flower, or including a CBD tincture in your cannabis routine.