Men and women generally use medical cannabis at equal rates, with some variation between states. Just as there are some qualifying conditions that are more likely to affect men, there are others that are more likely to affect women. As it’s Women’s Month, today we’ll be focusing on conditions that mostly or exclusively affect women, and why medical cannabis may be useful. We’re focusing on arthritis, autoimmune disorders, cancers that mostly affect women, endometriosis and premenstrual syndrome (PMS).
Arthritis is a painful and debilitating condition that affects a great number of people across the world, and can cause a massive decrease in the quality of one’s life. Cannabis and cannabinoids (CBD in particular) could help arthritis because it:
- May help treat arthritic pain, which is associated with inflammatory, nociceptive and neuropathic pain.(Nociceptors are a type of receptor that exists to feel all and any pain that’s likely to be caused by the body being harmed.)
- Could be anti-arthritic and help repair old bones.
- May act as an anti-inflammatory and “lubricant” for joints affected by arthritis.
- The ideal CBD:THC ratio depends on the type of arthritis. Osteoarthritis may be better treated by a slightly higher CBD ratio (e.g. 3:1), whereas rheumatoid arthritis may require something closer to a 1:1 ratio, so more THC. This is anecdotal evidence, however.
- Terpenes like limonene, pinene, beta-caryophyllene, camphene and myrcene have anti-inflammatory properties, mitigating the symptoms of arthritis.
Approximately 1 in 4 people in the US will develop arthritis over their lifetimes. Arthritis of all kinds tends to affect women more than men – about 3 times more women than men suffer from arthritis. Women may also experience more widespread and greater levels of arthritic pain. Arthritis also tends to begin affecting women when they’re younger. There are some interesting reasons as to why this is the case, including:
- Hormones – the hormone estrogen protects cartilage from inflammation, and women lose that protection after menopause when estrogen levels drop.
- Joint stability – due to the above reason, women’s joints tend to move around more and are less stable within the joint, especially when they get older. This makes the joints more prone to injury.
- Genetics – osteoarthritis runs in the family, and researchers have found specific genetic links among women for hand and knee osteoarthritis.
The main drugs that are used to treat arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, corticosteroids and methotrexate. Corticosteroids and methotrexate can dampen the immune system and slow down the progression of arthritis. All three drugs can have severe side-effects, especially when used long-term, like reduced appetite, drowsiness, dizziness, headaches and gastrointestinal issues. Cannabis represents a far gentler alternative, and may be used to reduce or even replace entirely the need for such drugs
The benefits of medical cannabis for autoimmune disorders include:
- Reducing chronic pain, aches and swelling.
- May reduce the need for medications like naproxen, tramadol, amitriptyline and tofacitinib (Xeljanz).
- Keeping the immune system balanced.
- Most of our immune system rests in the stomach and gastrointestinal (GI) tract. As there are a huge number of endocannabinoid receptors in the gut, preventing inflammation and restoring gut microbiota may be the ideal way to control many types of autoimmune disorder.
There are many types of autoimmune disease, including type-1 diabetes, Crohn’s disease and rheumatoid arthritis. For most types of autoimmune disease, women are more likely to suffer from them compared to men. The gender difference is particularly prominent for lupus, where 9 out of 10 cases are women, but in general the rate of autoimmune disease development is approximately 3 women to 1 man.
There are two main reasons given for this: 1) testosterone, which reduces the number of B cells, a type of lymphocyte that releases harmful antibodies; and 2) women’s stronger immune systems, which, while beneficial for keeping some types of cancer and viruses like COVID-19 at bay, also has the unfortunate side-effect of increasing the chances of having an overactive immune system.
This is where cannabis comes in. It is well known that cannabinoids can inhibit pro-inflammatory cytokine production (cytokines being a category of signaling molecules that mediate and regulate immunity & inflammation). Inflammation isn’t necessarily a bad thing, but if it happens too much, it can be painful and damaging. Reducing cytokine production can therefore be of immense use.
Cannabinoids can also increase the presence of some types of anti-inflammatory cytokines named interleukins, meaning that more anti-inflammatory proteins are released into the body. Overall, CBD and THC are potent anti-inflammatories and immunomodulators (compounds that can help regulate or normalize the immune system).
Those who have an overactive immune system tend to get severe inflammation issues. For Crohn’s, it’s inflammation of the gastrointestinal tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. With autoimmune-related multiple sclerosis (MS), it’s an inflamed central nervous system (CNS). In type-1 diabetes, it’s pancreatic inflammation, which can damage the cells that produce insulin. In rheumatoid arthritis, it’s the inflammation of bones and joints, causing swelling. As for lupus, it’s a widespread inflammatory disease that affects the whole body.
Regardless of the type of autoimmune disorder, cannabis and cannabinoids can prove useful as they can dampen an overactive immune system and reduce inflammation.
There are several reasons why cannabis is useful in the treatment of cancer, including:
- Treating the side-effects of chemotherapy and radiotherapy, including chronic pain, insomnia, anxiety, nausea, lack of appetite and cachexia (wasting syndrome).
- There is some preclinical research suggesting that cannabinoids may increase chemotherapy’s efficacy.
- Those with autoimmune disorders and other conditions that cause widespread long-term inflammation are more likely to get cancer. Cannabis can help reduce inflammation.
- Terpenes like beta-caryophyllene (which is a cannabinoid as well), pinene and humulene have significant antibacterial and anti-tumoral properties as well, and may also increase the efficacy of some chemotherapy drugs (e.g. paclitaxel).
- Cannabinoids may be used to “instruct” cancerous cells to stop growing, or even induce apoptosis (death and elimination of cancerous cells).
- Whole plant cannabinoid-based medications are significantly better than isolated cannabinoids in treating tumors.
- Cannabis can be useful for treating the main three subtypes of breast cancer – hormone-sensitive breast cancer, including the most aggressive ones: HER-2 positive breast cancer and triple-negative breast cancer.
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There are three kinds of cancer that predominantly or exclusively affect women: breast, ovarian and cervical. Worldwide, breast cancer is the leading type of cancer in women, accounting for 25% of all cases, with a survival rate of around 80-90% for most kinds of breast cancer. However, due to its prevalence, breast cancer is the leading cause of cancer-related deaths amongst women.
As for ovarian cancer, it is the seventh-most common cancer and the eighth-most common cause of death from cancer amongst women, and has a 5-year survival rate of 49%. Cervical cancer is both the fourth-most common cause of cancer and the fourth-most common cause of death from cancer in women, and is a particularly aggressive cancer where five-year survival rates in the US is around 68% in the US, but can be as low as 50% in poorer countries.
The efficacy of cannabis for treating cancer depends very much on the type of cancer that needs treating. This is because not all types of cancer are cannabinoid-responsive. Cancers that are cannabinoid responsive have endocannabinoid receptors of their own. Phytocannabinoids (plant-derived cannabinoids) can be used as a treatment by effectively attaching themselves to ECRs, and instructing them to stop growing or even kill themselves entirely.
There are instances where cannabinoid treatment should be avoided when it comes to cancer. Those undergoing immunotherapy should not use cannabis, as the immunomodulatory effects of cannabinoids may interfere with the treatment. It is also important to match the cannabinoid treatment (i.e. the THC:CBD ratios, as well as other minor cannabinoids). To quote from cancer charity Saving Sophie:
“Research has shown that PR+, HER2-positive, and triple-negative breast cancers can be effectively treated with cannabis. In these specific instances it was found that a high THC to CBD ratio is effective, often around 4:1. Cancers that involve estrogen, may actually spread in response to large amounts of THC. In this case lower ratios of THC to CBD is preferable, at least a 1:1, but ideally a 1:3 ratio according to doctors.”
Please note that the above quote does not constitute medical advice, and more clinical trials are needed to say whether the above ratios are accurate. It must also be noted that THC is very much needed in order to treat most cancers effectively.
Medical Cannabis for Endometriosis
Cannabis can help treat endometriosis because:
- It is full of anti-inflammatory cannabinoids and terpenes that can help treat chronic pain.
- THC may help act not only as a painkiller, but also help prevent endometrial growth.
- Women in Australia have reported that cannabis helps with their symptoms.
Endometriosis is a condition where tissue similar to the lining of the womb (endometrium) starts to grow in other places, such as the ovaries and fallopian tubes. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions – abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. This can cause severe pain, especially during menstrual periods. Fertility problems also arise in half of those affected by endometriosis, as can memory problems. 10% of women worldwide (176 million) have endometriosis.
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There are several reasons why cannabis can help treat PMS, including:
- May relieve breast pain and tenderness, which is caused by an increase in the production of progesterone during the luteal phase of the menstrual cycle.
- Some products may be particularly useful for PMS. Cannabinoid-laced tampons reduce and possibly treat cramps and lower back pain.
- May reduce migraine.
- Acne is a common feature of PMS, and cannabis may help treat it.
- Cannabinoids such as CBD may help act as a mood stabilizer, whilst terpenes such as linalool and limonene may work as a stress-buster.
- Helps treat insomnia.
- TRPV1 (aka vanilloid receptors, which are the human body’s thermometer) and calcium ion channels are said to be associated with menstrual bleeding, and desensitizing it may help beat any pain associated with PMS.
Premenstrual symptom (PMS) is a common condition that affects around 1 in 20 women. Symptoms include bloating, fatigue, irritability, cramps, back pain, headaches and nausea. Usually, the most common treatments prescribed include an iron-rich diet, exercise, ibuprofen and, on occasion, antidepressants.
Cannabis can help replace the need for medications like ibuprofen and treat headaches and nausea as well. Cramps, depression/anxiety and back pain may also be treated using cannabis and CBD, making cannabis potentially very useful for the treatment of PMS, especially as there are so few medications out there that treat such a wide range of symptoms simultaneously. This is one example of cannabis being a pharmacy in a plant.
Cannabis for Women: Overall
There are some things that women should recognize when it comes to the effects of cannabis (in particular THC) as well, including:
- Women are more sensitive to the effects of THC due to differences in muscle mass and fat tissue distribution between males and females – women have more fat tissue, and so retain THC in their system for longer.
- Due to this sensitivity to THC, women may get greater analgesic (painkiller) effects from cannabis, and will likely need to use less THC to treat anxiety and depression.
- Cannabis use may increase women’s sex drive. Interestingly, it’s the opposite for men.
- Women’s endocannabinoid receptors are more sensitive to cannabis compared to men’s. This means that the interactions between the endocannabinoid system and the brain level of dopamine – the neurotransmitter of “pleasure” and “reward” – are sex-dependent, with cannabis use releasing more dopamine in women.
- Cannabis may reduce fertility. Female eggs exposed to THC have an impaired ability to produce viable embryos.
Despite these concerns, cannabis represents a great adjunct or alternative to harsher therapies and medications. After all, there are many pharmaceutical drugs that are much worse, especially when it comes to long-term use (think sedatives, opioids or NSAIDs). Cannabis is generally far more well-tolerated by the human body, and safe and careful use of whole plant medications can help mitigate many of these negatives.
If you think medical marijuana might help you and you suffer from one or more of the above conditions, speak to one of our doctors here at Leafwell today!