Ancient texts in Israel, China, Egypt, Persia, and Syria recommended cannabis for painful menstrual cramps, bloating, heavy bleeding, and even menopausal symptoms, urinary tract infections, and uterine hemorrhage after childbirth.

A recent scientific systematic review estimates that between 13% to 27% of women resort to cannabis for gynecologic conditions, mostly pain management, which go largely untreated. Studies find that most of them feel pain relief with cannabis, especially when using a combination of its components - CBD and THC together, rather than each one alone. The most common side effects are dry mouth and sleepiness, not to mention a “high” that is commonly associated with THC. Most women ingest or inhale cannabis, multiple times per week, at various dosages of THC and CBD that in extreme cases, reach even 70 mg and 2,000 mg respectively.

Pain-free coupled with a high seems like a perfect solution, doesn’t it? Especially now that legislation is more relaxed and cannabis more accessible. Well, I’m about to spoil the party with a word of caution: Women should not forget the potential dangers and adverse effects that long-term cannabis use can have on the female body, especially regarding reproduction.

Both Cannabis compounds THC and CBD, work via the body’s endocannabinoid system (ECS), which is well known for modulating pain, the immune system, and neural functions. The ECS, however, also strongly impacts fertility, reproduction, and hormonal functions in males and females, and is present in all organs of the reproductive system. In women, high levels of endocannabinoids have been shown to suppress hormones like the gonadotropin-releasing hormone (GnRH), estrogen, and progesterone. Simply put, an altered ECS expression is associated with reduced fertility, ectopic pregnancy, and spontaneous miscarriage. Depending on the dose, frequency, and how they are taken, certain cannabinoids, components of the cannabis plant, can reduce the levels of these hormones. Their use can have serious consequences such as some menstrual cycles skipping ovulation, or even worse, triggering miscarriages or affecting the capacity to produce milk in women who are nursing. Even small doses of THC may reduce hormonal levels within 60 minutes and for 24 hours, disrupting ovulation, which will only return to normal levels six months after stopping the investment of the drug.

Women, especially those still in their reproductive years, should be aware of these potential side effects, whether using cannabis recreationally or for pain relief. Cannabis is not an entirely benign plant. Also, keep in mind that most products available in the market aren’t regulated, and haven’t undergone rigorous trials to confirm safety for anyone consuming them.

However, there is one new product that may help. Gynica, an Israeli start-up built on decades of expertise in medical cannabis research, is focused on developing new evidence-based localized approaches to overcoming women’s pain.

Gynica’s research team is looking for new ways to use cannabinoids safely and effectively in solutions for disorders like endometriosis, painful menstruation (dysmenorrhea) and painful intercourse (dyspareunia), from which so many women suffer. Following extensive research, they have developed novel intravaginal formulations of cannabinoid-terpene combinations that work locally by reducing inflammation and pain related to menstruation and sex, without the adverse effects of taking them by inhalation or ingestion. So, they don’t act on other systems in the body. Following promising preclinical results, the company will soon start the first global clinical studies to evaluate the safety and efficacy of these new compounds in women. Hopefully, their outcome will be positive, and women suffering from a multitude of pains will have a new, safe, and effective alternative for relief.

Written by Dr. Sari Prutchi Sagiv, VP R&D, Gynica