Cannabis-Based Medicines in Women’s Health: Evidence & Knowledge Gaps

In the face of long NHS waiting lists and a lack of options in mainstream healthcare, many women are turning to alternative treatments to manage menstrual-related symptoms. 

NHS gynaecology waiting lists have more than doubled since 2020, with over 750,000 women currently waiting for a diagnosis and treatment. 

Against this backdrop, medical cannabis clinics are reporting an increase in women looking for support with perimenopause and menopause symptoms, as well as gynaecological conditions such as endometriosis and adenomyosis. Women are also significantly more likely to be impacted by anxiety, pain and sleep deprivation, which are some of the most common indications for which cannabinoids are used.

Alternaleaf recently launched the first clinical service focusing specifically on women’s health conditions. A poll of 500 NHS doctors conducted by the clinic found that three-quarters believed treatment options for women’s health conditions, such as endometriosis, PMDD and menopause, are too limited. Overall, 80% of GPs said they would be open to prescribing CBPMs for these conditions if they were part of the NHS toolkit. 

Observational research shows that many women report significant benefits from these treatments. But there’s still a lot we don’t know about their effects and how they work in women specifically. 

There is a growing database of real-world evidence from around the globe, reflecting the experiences of women using cannabis.

In a Canadian survey, over a third of women reported using cannabis to help them manage some of the common symptoms of menopause, including sleep, pain and anxiety. While separate research from The Menopause Society indicated that women over 50 are the fastest-growing group of cannabis consumers in the US.

While research specifically into the benefits of cannabis for perimenopause and menopause is limited, there are promising findings in studies investigating the use of cannabis in pain-related symptoms and gynaecological conditions like endometriosis. 

Results from one of the first studies of its kind found that CBD suppositories significantly reduced the frequency and severity of menstrual-related symptoms, as well as the ‘impact of symptoms on daily functioning’ and the need for other analgesics, compared to those using traditional painkillers.

A systematic review published in 2022 examined the results of several studies on adult women who used cannabinoids for gynaecological pain conditions, including chronic pelvic pain, vulvodynia, endometriosis and interstitial cystitis. They found that between 61 and 96 per cent of women reported pain relief.

In endometriosis patients based in Europe, cannabis was found to have a significant impact on well-being and quality of life, leading to ‘substantial improvements’ in symptoms. Data from Australian researchers suggest that the majority of patients using cannabis to manage symptoms of endometriosis find it to be superior to pharmaceutical medications.

The NHS is currently funding clinical trials into the effects of CBD in endometriosis, with researchers at the University of Edinburgh finding it is a “promising therapeutic agent” due to its  “analgesic, anti-inflammatory, immunomodulatory, anti-angiogenic, antiproliferative, and neuroprotective effects”. 

But we also need more robust clinical trials, specifically focused on the impact of cannabinoids in women.

There is still a lot we don’t know about the biological differences in how cannabis affects women. For example, some research has shown that female hormonal fluctuations may increase sensitivity to THC. But other studies found little difference in the effects of vaporised cannabis among men and women. 

Women remain underrepresented in clinical trials, and stigma and fear around consumption can prevent them from engaging in open dialogue with healthcare professionals.

Researchers in Australia found that over half of women using cannabis to manage symptoms of endometriosis were concerned about the negative impact of stigma associated with cannabis and how this might affect their day-to-day lives, with only a third telling their doctor about their consumption. 

Cannabis-based medicines show growing promise for managing symptoms and improving quality of life in women’s health conditions, particularly where conventional options are limited. 

But while real-world evidence is compelling, rigorous female-focused trials and open clinical dialogue are essential to ensure safe, informed and equitable access to care.

Dr Dani Gordon will explore the existing evidence for CBPMs in women’s health, highlighting emerging research and considering the implications for clinical practice, at the Cannabis Health Symposium on Tuesday, 25 November.

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