At the time when cannabinoids were being discovered isolated and explored medical research treated the human body male by default. Because of hormones, pregnancy risks, and other reasons women were excluded from many pivotal clinical trials and cannabis was no exception.
As cannabis legalization has grown worldwide, many researchers have noticed a striking
pattern: cannabis does not affect women the same way it does men.
The dosing amounts for the effects, the risks for dependence and the response of certain
conditions to cannabinoids seem to be split along the lines of sex. These are not anecdotal. They are firmly rooted in principles of metabolism, endocrinology and the physiology of reproduction. To use cannabis safely and effectively all these factors and more need to be considered.
Sex differences demand a knowledge of the endocannabinoid system and our endogenous signals like anandamide and enzymes that regulate everything from the way we experience pain, inflammation, mood and appetite. Estrogen’s presence (or lack thereof) across the stages of early development, puberty and adulthood change the landscape of our endocannabinoid system permanently.
With both the body and brain constrained by this system, psychiatric and mental health impacts are a reality. We see women showing higher rates of anxiety and depression disorders overall, and cannabis can either alleviate or worsen symptoms depending on dose and the individual.
Greater still, some research suggests women may progress faster from initial use to cannabis use disorder (CUD) compared to men, a phenomenon known as “telescoping”. Additionally, the risk for overuse may be dramatically different across the lines of sex. With women as a growing population of cannabis consumers the proper advice on what to consume and how to consume it could mean the difference between enjoyment and error.
Despite these risks, women may experience several distinct therapeutic advantages from
cannabinoids. For instance, endometriosis and pelvic pain involve inflammation, nerve pain and disordered immune signaling. Cannabinoid receptors are expressed in endometrial tissue. A 2023 review in the Journal of Clinical medicine shed light on the potential of cannabinoids in reducing pain, inflammation and pain relating to the symptoms of endometriosis 1 . Even surveys of patients suffering from endometriosis reduced pain, and decreased reliance on riskier pain medication (like opioids) when using cannabis-based therapies.
Even more intriguing, is how the timing of cannabis as a therapy plays a role. We know that estrogen peaks during the follicular part of the menstrual cycle. As a result, consuming cannabis during this time could enhance sensitivity to THC, while other phases could leave a female consumer with blunted effects. Ultimately, a cannabis dose or product that feels great one day could feel excessive or completely inadequate another day. While men’s responses are very consistent across days and weeks, personalized timing may need to be integrated into cannabinoid medicine for women.
The final chapter of cannabis and women’s health is still in process. Despite the historical
problems, the research is creating an intricate picture that cannot be contained in traditional frameworks.
For any woman wanting to explore cannabis, the most responsible approach involves
individualized assessment. This includes one’s reproductive goals, mental health history, history of cannabis use and other conditions. Understanding how cannabis interacts with the female body is not simply about one single stigmatized plant. It is about recognizing the specific needs and pitfalls of cannabis use in more than half of the population and embracing personalized healthcare when it comes to cannabis.
1. Farooqi, T., Bhuyan, D. J., Low, M., Sinclair, J., Leonardi, M., & Armour, M. (2023).
Cannabis and Endometriosis: The Roles of the Gut Microbiota and the Endocannabinoid
System. Journal of Clinical Medicine, 12(22), 7071.