Cannabis for Women's Health: Period Pain, Endometriosis & Menopause

Dysmenorrhea — the medical term for period pain — affects up to 90% of menstruating women at some point. For many, it's manageable with over-the-counter painkillers. For others, it's debilitating. Cannabis offers several mechanisms that may help.

Prostaglandins drive menstrual cramps by causing uterine muscle contractions. CBD has anti-inflammatory properties that can reduce prostaglandin production. THC binds to CB1 receptors in the uterus, potentially reducing the perception of cramping pain. Together, they address both the cause and the sensation of period pain.

A 2024 study tested high-CBD vaginal suppositories for menstrual-related pain — the first study of its kind. Participants who used the suppositories reported significant reductions in pain and discomfort, improved daily functioning, and reduced use of conventional painkillers. Crucially, increased suppository use was associated with greater symptom reduction, suggesting a dose-dependent response.

For period pain, the evidence suggests:

Endometriosis affects approximately 1 in 10 women in the UK, causes chronic pelvic pain, painful periods, pain during sex, and fertility problems. Conventional treatments — hormonal contraceptives, GnRH agonists, and surgery — work for some but fail for many. This is why an estimated 13-27% of women with endometriosis have tried cannabis for symptom management.

A 2026 prospective study followed women with endometriosis who were prescribed medical cannabis (CBD oil alone or combined with dried flower). Over 12 weeks, 'overall' pelvic pain scores dropped from 5.46 to 3.77 on a 10-point scale — a clinically significant improvement. 'Worst' pain decreased from 7.62 to 5.38. Quality of life scores improved dramatically, from 68.77 to 37.40 on the EHP-30 scale (lower is better).

A Canadian survey study found that both inhaled and oral cannabis were effective for endometriosis-related pelvic pain, gastrointestinal symptoms, and mood. Inhaled forms were preferred for rapid pain relief; oral forms (typically higher in CBD) were better for sustained symptom control and gastrointestinal issues.

The ratio of THC to CBD matters significantly for endometriosis. The same study found that products with higher CBD content were associated with better outcomes for gastrointestinal and mood symptoms, while THC-dominant products were preferred for acute pain. Balanced 1:1 products may offer the best of both worlds.

Menopause affects every woman differently, but common symptoms include hot flashes, night sweats, sleep disturbances, mood changes, brain fog, joint pain, and vaginal dryness. Hormone replacement therapy (HRT) is the gold standard treatment, but some women cannot or choose not to take it. Cannabis is increasingly being explored as an adjunct or alternative for specific symptoms.

Research on cannabis and menopause is in its infancy. A survey study found that women who used cannabis during menopause reported improvements in mood, sleep, anxiety, and pain — the same domains where cannabis shows benefit in other populations. However, no randomised controlled trials have specifically examined cannabis for menopause symptoms.

The endocannabinoid system's role in thermoregulation makes cannabis a theoretically interesting option for hot flashes. Anandamide (the 'bliss molecule') and 2-AG are involved in body temperature control, and disrupting the endocannabinoid system in animal models causes temperature dysregulation similar to hot flashes. Whether cannabis can modulate this in menopausal women has not been studied.

For sleep disruption during menopause — one of the most common and distressing symptoms — the same principles from the sleep guide apply: CBD (50-300mg) for anxiety-driven insomnia, low-dose THC (2.5-5mg) for sleep onset when needed, and CBN as a promising alternative.

Cannabis interacts with the menstrual cycle in ways that are not fully understood. THC and anandamide both bind to CB1 receptors, and endocannabinoid levels fluctuate naturally throughout the menstrual cycle. Some women find that their response to cannabis varies significantly depending on where they are in their cycle — more sensitive during certain phases, less responsive during others.

The most important safety consideration is pregnancy. THC crosses the placental barrier and can affect fetal brain development. NICE guidelines, the NHS, and every medical cannabis organisation advise against using THC-containing products during pregnancy or while breastfeeding. CBD is also not recommended during pregnancy due to lack of safety data.

Drug interactions are another key concern. Cannabis can interact with hormonal contraceptives, though the effect appears to be minimal. More significant interactions are possible with antidepressants, blood thinners, and anticonvulsants — all medications that women with chronic gynaecological conditions may be taking.