Can Cannabis Help With PMS?
Proponents of cannabis have long been outspoken about its medicinal benefits (e.g. pain/nausea relief), but some potential uses of the plant are more surprising—and very intriguing. Psychiatrist Dr. Julie Holland, a psychopharmacology specialist who has run a private psychiatric practice in Manhattan for more than two decades, has found that the effects of cannabis may be particularly adept at treating hormonal and emotional issues that are common among women. Cannabis, Holland explains, could be the solution to treating monthly PMS symptoms, painful cramps, irritability, insomnia, depression, and anxiety, as well as symptoms of perimenopause. The most underrated benefit of cannabis according to Holland? Its anti-inflammatory effect. Holland is quick to point out that more research on therapeutic cannabis use is merited—still, her current take on its womanly uses (see below) is compelling, especially given that post-election, medicinal cannabis laws have been passed in twenty-eight American states, and adult use of the drug is now legal in eight. (For more from Holland on alternative therapies, check out her latest book, the colorfully titled, Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy.)
A Q&A with Dr. Julie Holland
Your background is in psychopharmacology—how did you realize that cannabis could be used as an alternative treatment for emotional and hormonal issues, including those associated with PMS?
I didn’t fully appreciate cannabis’s ability to help women until I was doing research for The Pot Book, a non-profit project that helps to fund much-needed therapeutic cannabis research. After that, I started asking my patients about their cannabis use and learned many of them were using it for cramps, and some for PMS. In general, women are much more likely to be diagnosed with depression and anxiety than men, which means they are being prescribed antidepressants more than men are. Cannabis can potentially help with many symptoms that women who take antidepressants (as well as those who don’t) experience—including irritability, insomnia, depression, and anxiety.
Q Do you have to actually get high to reap the benefits? A No. THC, or tetrahydrocannabinol, is the substance in the cannabis plant that’s responsible for the “high” feeling; while it makes up the majority of the plant, there are THC-free preparations available. The other major component of the cannabis plant is CBD, or cannabidiol, which tamps down the effects of THC; and with CBD-only preparations, you won’t get that altered feeling. CBD acts as an anti-inflammatory and antioxidant agent, and a muscle relaxer. It’s thought to decrease anxiety and have a calming effect. (THC, on the other hand, can sometimes make you more anxious, not less.)
Q In your book Moody Bitches, you talk a lot about our bodies’ built-in endocannabinoid system. Can you explain how it works and how cannabis, in all its various forms, interacts with our cannabinoid receptors? A Stress and inflammation are inextricably linked, and the key to combating both lies in a system called the endocannabinoid system, which is made of cannabis receptors throughout the body and internal cannabis-like molecules. When stress nearly knocks you overboard, your internal cannabinoid system helps to right the ship. Even if you’ve never smoked a joint, your brain and body use cannabis-like molecules to make you resilient to stress, similar to the way your endorphin system provides you with natural pain relief. These cannabinoids tamp down inflammation and reactivity in the body, maintaining your metabolism, immune functioning, learning and growing processes. The endocannabinoid system is involved in nearly everything we do: eating, sleeping, exercising, having sex, giving birth, and nursing. Cannabis and naturally occurring cannabinoids in the body can help counter the effects of stress and enhance resilience. Not only are cannabinoids anti-inflammatory, but you can think of the whole endocannabinoid system as an anti-inflammatory system. Cannabinoids alter immune reactions in the body and in the brain, influencing white blood cells and cytokine production. Immune cells can synthesize their own endocannabinoids, or they can be influenced by administrated cannabinoids, as many immune cells throughout the brain and body have cannabinoid receptors on their cell surfaces. Anandamide, our main internal cannabis molecule, helps to tamp down the stress response and return our hormones and nervous system to a normal balance, or homeostasis. Higher anandamide levels are associated with better stress tolerance. When cortisol is released, anandamide levels rise, trying to put things back in order. This is an example of the endocannabinoid system “righting the ship” after it’s been rocked.
Q For most women, cycle-related issues are two-fold: PMS (mood swings, heightened anxiety, irritability, etc.) and then physical cramps—can cannabis help with both? A Yes: CBD can help with anxiety and THC can help with mood swings, irritability, and low resilience (your ability to handle stress). Both can help relax the uterine muscle where cramps occur, and alleviate many PMS symptoms—but if you don’t like the altered feeling of THC, you can get a lot of PMS relief just using CBD.
Q Can cannabis also help women struggling with abnormally severe cramps or those diagnosed with endometriosis? A Yes. Though there aren’t double-blind studies to prove this, there are certainly anecdotal reports galore of people using cannabis to treat their severe cramps. Some women get nauseous when their cramping is bad, and obviously cannabis has a long track record of reducing nausea.
Q What about cannabis for perimenopause symptoms (anxiety, insomnia, low libido, weepiness, etc.)? A This symptom cluster associated with perimenopause can be relieved with cannabis (although, again, there are not—yet—double-blind, placebo-controlled studies that examine these effects). Also, there are phytoestrogens in cannabis that may help to supplant estrogen waning in perimenopause.
Q What are the different options for intake, and do you find one to be more effective than others? A Primarily there is inhalation and oral, although for cramps you could make the case that vaginal suppositories or lotions applied to the pelvic area (below the belly button) would be helpful. Smoking or vaporizing will bring on relief the quickest, and it will be easier to adjust the dosage because the effects don’t last as long. For edibles, it is very important to start with a very low dose and wait a full two hours before deciding whether to ingest more, as it can take this long to feel the effects of cannabis when eaten. The effects also last much longer when cannabis is eaten.
Q Any side effects we should keep in mind? Any other benefits? A Yes: Pot can make you sleepy, hungry, horny, anxious, irritable, forgetful, amotivated, and more. Every strain is a different combination of cannibinoids that can each affect you in a different way than someone else, so there is a lot of variability. Start low and go slow until you know how you respond. The main benefit people underestimate is cannabis’s anti-inflammatory effects. This can help with autoimmune illnesses and anything inflammation-based, like arthritis. Also, cannabis is a muscle relaxer that can help with the spasticity seen in Multiple Sclerosis. It can help to treat migraine headaches as well as more chronic pain, too.
Q For those of us living in states where medicinal cannabis isn’t yet readily available, any tips for mitigating PMS symptoms? A Foods high in tryptophan—a building block of serotonin, which is lower during during PMS—can be helpful: bananas, milk, lentils, and turkey, especially dark meat. These foods can help raise tryptophan levels, while vitamin B6 is needed to convert the tryptophan into serotonin. The calming properties of calcium may help; magnesium is used for muscle relaxing, and caffeine for energizing and diuresing. Pineapple and asparagus are natural diuretics that can help with bloating.
Dr. Julie Holland has had a private psychiatric practice in Manhattan for more than two decades. She also ran the the psychiatric emergency room of Bellevue Hospital for nine years—the basis of her memoir, Weekends at Bellevue. A psychopharmacology specialist, Holland’s other books include: Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy and The Pot Book: A Complete Guide to Cannabis.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.