Painful periods have plagued women of all backgrounds for millennia. Yet for something that’s so frequently experienced, the scientific evidence on how to alleviate this pain is remarkably inconclusive. The most common way to manage period pain is via the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal birth control. But it’s estimated that NSAIDs don’t work for about 18% of women, and some women can’t take hormonal birth control due to a family history of certain cancers.
Women who are unable to find relief from period pain by conventional means must explore alternative avenues of pain management. This is where cannabis’s powerful anti-spasmodic and pain-relieving properties come in. Marijuana has been used in women’s health for centuries, and as the modern cannabis industry continues to grow, more women are using it to address pain during menstruation.
In addition to cannabis, women can take a variety of other approaches to manage period pain. These methods have varying degrees of scientific backing or are traditional folk remedies passed down from generation to generation. This doesn’t mean these alternative strategies don’t work—it just indicates that more research is needed to explore all of the ways women around the world deal with this universal health issue.
Many of these methods have worked anecdotally for women. It just takes time and a little bit of experimentation to find out what works best for your body.
During menstruation, molecules called prostaglandins stimulate contractions in the uterus. These contractions cut off oxygen to the organ, resulting in cramping, pain and heaviness in the abdomen that can radiate to the lower back, hips and inner thighs. This type of menstrual pain has a medical name: dysmenorrhea.
There are two types of dysmenorrhea:
Pain from primary dysmenorrhea is what women typically associate with being on their period. Pain usually begins one to two days before the start of menstruation and can last up to 72 hours—though in some women, pain can start at ovulation and continue until the last day of bleeding.
Pain from primary dysmenorrhea can be mild to severe; it can be accompanied by nausea, fatigue and diarrhea. For about 20% of women, pain from dysmenorrhea is so severe that it interferes with daily activities.
Secondary dysmenorrhea is pain during menstruation that’s due to a disorder in the reproductive organs—examples include endometriosis, uterine fibroids and ovarian cysts. In these types of cases, pain usually starts earlier in the menstrual cycle and can last longer than pain associated with primary dysmenorrhea.
Painful periods are a complex, lengthy topic, so for this article, we’ll focus on pain from primary dysmenorrhea.
As with many medical conditions, what you eat can play a role in the severity of your painful period symptoms. A study conducted among university students in Iran looked at women who reported having painful periods and those who didn’t. They found significant differences in the nutrition between the two groups.
The researchers suggested eating foods that reduce the synthesis of prostaglandins—those pro-inflammatory molecules that cause uterine contractions—could help relieve pain from dysmenorrhea.
Foods rich in magnesium and fiber could fit this bill. A 2017 pilot study in India found that blood magnesium levels were lower in women who experience pain during their periods than women who don’t.
Consuming anti-inflammatory foods and supplements, like omega-3 fatty acids and vitamin E, may also help with reduce period pain. Omega-3s in particular may interfere with the body’s production of prostaglandin.
In one double-blind, randomized clinical trial of 100 university students, those who were given omega-3s in the form of fish oil, vitamin E or both in combination had less menstrual pain than those given the placebo. The study also noted the group that took both supplements experienced the most pain reduction.
Similar results have also been found with vitamin B1. A double-blind, placebo-controlled clinical trial of 240 students found that consumption of 100 mg of vitamin B1 a day over two months reduced period pain.
It’s also thought that meat, dairy and salty foods promote the production of prostaglandins, so avoiding those foods, especially during your periods could help manage pain.
The same Iranian study found that dysmenorrhea is less prevalent in women who exercise regularly. Exercise reduces stress levels and increases blood flow to the pelvic area, disrupting the accumulation of prostaglandins and delaying the onset of pain, according to researchers.
Studies also note that stress can play a factor in how much pain women experience during their periods. So, taking steps to reduce stress during this time of the month is also key. Overall, exercise is most effective if it’s a regular part of your daily routine.
Cannabis and women’s health have been linked for centuries: Women in medieval Europe made hemp-based salves to rub on sore breasts. Meanwhile, Queen Victoria was famously prescribed cannabis by her physician to help with menstrual pain.
In spite of cannabis’s past applications in women’s health, there’s no research on cannabis as a treatment for painful periods. However, this shouldn’t discourage women who are searching for alternatives.
“The pain-relieving and anti-inflammatory properties of cannabinoids are not specific to menstrual pain, but can be generalized to pain and inflammation throughout the body,” says Christine Skibola, co-founder of cannabis brand Cosmic View, international cancer researcher and former school of public health professor at UC Berkeley and the University of Alabama, Birmingham.
Christine says that cannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD) have shown significant promise in basic pain experiments. She adds that CBD and cannabidiolic acid (CBDA) can inhibit COX enzymes—molecules involved in the production of those pesky prostaglandins, the main culprit of menstrual cramps.
It’s hard to subject acupuncture to the Western gold standard of double-blind, randomized, placebo-controlled trials: It’s a technique that’s inherently difficult to placebo, and like cannabis, its effects are individualistic. Because of this, acupuncture isn’t given much credibility in helping with menstrual pain (or pain, in general), though there are some studies that suggest that it can.
A study published in PLOS One performed four different types of acupuncture on four groups of women with dysmenorrhea over a three-month period. By the end of this period and in the nine-month follow up, all groups had a significant reduction in pain.
There are many theories as to how acupuncture works; it might:
Studies also indicate that acupuncture affects the endocannabinoid system, the network of receptors located throughout your body that are responsible for the effects of cannabinoids like THC and CBD. These studies suggest that acupuncture also stimulates production of not only the body’s natural opioids, but also the body’s natural cannabinoids.
The Internet did a collective eye roll when Gwyneth Paltrow featured vaginal steaming in her lifestyle magazine Goop, provoking responses like: “Gwyneth Paltrow defends vaginal steaming against medical science.” That said, in cultures around the world, it’s tied closely to vaginal health and wellness. And it’s one way women address painful periods.
Vaginal steaming is an old-world health technique that’s practiced in Africa, Asia and Central America. A woman sits over smoke or steam of a particular set of herbs for 15 to 45 minutes. The steam and heat are said to move up towards the cervix and uterus, promoting blood flow, which can loosen leftover debris, like blood clots. There are also other effects, depending on the types of herbs used. \t “It's a similar thing that [happens with] exercising or heat therapy or vasodilation—which is what the THC in cannabis does; it promotes blood flow to the tissue, optimizes tissue health and helps the uterus with its natural cleansing mechanism,” says Kiana Reeves, a birth and postpartum doula and operations manager at Foria, a cannabis company that focuses on women’s health.
Kiana acknowledges that there’s no research on vaginal steaming—it’s not exactly the type of treatment likely to receive funding. But Kiana, who also owns a company that focuses on women’s pelvic health, says that she gets positive feedback from women who engage in the practice.
“What the case studies [show] is that women who have experienced very dark, spotty painful periods, after five days of steaming in a row and regular upkeep on a steam regimen, start to get fresh red menses for five days straight,” she says.
Vaginal steaming isn’t without its controversies. Conventional gynecologists often caution against the practice because there’s no research on the topic. This hasn’t stopped women from trying it. If you’re thinking of using vaginal steaming as a way to manage dysmenorrhea, Kiana advises working with a holistic physician or functional medicine specialist.
“I think it's really interesting how complex [women’s reproductive] systems are, and we have to be aware of that,” she says. She adds that the best way to manage painful periods is to take a holistic approach—there’s no silver bullet for period pain.
“The trick,” says Kiana, “is to bring cannabis in as a wellness tool along with diet, along with the proper exercise and other tools that have been traditionally used.”
Photo credit: Hadis Safari