Feb 25, 2014

The Female : Cannabis Relationship

IMAGE: “Daydream,” Andrew Wyeth

Women have long kept their health lore confined to their close female communities.  Until the late 19^th century, birthing was the domain of women and they carried this, as well as other women’s health knowledge, forward.  Natural birth control (often herbs) had to keep secret.  There is lore that women once segregated themselves at the time of menses, and there in seclusion they found comfort from and companionship with other women.

Before scopolamine and epidurals, ibuprofen and anti-depressants, women likely used Cannabis and many other botanical medicines for pain in labor as well as for a host of other female issues.

There are written records dating back to 3000 BCE indicating the use of Cannabis for treating female health issues such as migraine, nausea and vomiting of pregnancy, augmenting labor, hemorrhage, heavy menses, uterine pain and contractions, “sore breasts,” to enhance milk flow, gonorrhea, urinary tract infections, easing painful menstrual cramps, assisting in long labors and for “melancholia” (what we know as PMS?).

Many of these therapeutic uses of Cannabis were included in the Dispensatory of the United States (Wood and Bache 1854) where it was referred to as “Indian hemp.”  All parts of the plant were used: orally, inhaled, intra-nasally, juiced, topically, vaginally, and rectally.

These historical uses have been some what explained by contemporary science elucidating the endocannabinoid system (eCS). This system functions in the reproductive tissues (as well as most other tissue in the human body), where it plays a role in ovulation, implantation, development of the embryonic nervous system, in the contractile fibers of the uterus, endometrial tissue, and in the bladder and lower urinary tract. The endocannabinoid anandamide (AEA) is present in breast milk; levels of AEA fluctuate across the female cycle, and have been shown to elevate during ovulation and labor.

Flashing forward to 2013, Cannabis is reported to be the most widely used “illicit” drug by women in pregnancy. However, the majority of contemporary studies are framed as studies of drugs of abuse. There is often difficultly in teasing out the precise effects of Cannabis alone, as often the participants report the concomitant use of alcohol and/or tobacco when reporting Cannabis use.

Due to the contemporary demonization of Cannabis, no prospective trials have been performed to evaluate the therapeutic value in women’s health.  Of course, the regulatory status of Cannabis has prevented such trials from happening, and yet, a massive “uncontrolled’ clinical trial continues, conducted by the people, where the individual results are largely un-described.  This is particularly true for women’s health issues, and I have little doubt (based on patient interviews and anecdotes) that contemporary women continue to use Cannabis for a range of their physical and mental health disturbances.

The best place to start in contemporary research is to study the “natural history” of widespread Cannabis use as a therapy.  Ethnomedicine is defined as “studying a local healing system of beliefs and practices among a specific group”.  My collaborators and I have adapted this definition to describe a “plant-centric” healing system rather than a place-centric approach.

One way to learn from such a specific group is to ask them questions! We have developed an International Ethnomedical Survey tool to gather factual information regarding Cannabis use from the users: How often and how much? In what form? Effects? What does it help? How does it hinder? Who are the people who use Cannabis and what is quality of life among users?

On first analysis of 1158 responders to our online survey from 27 countries, we found that women are quite under-represented (35% of responders).  Given the secrecy, shame, and misconceptions about Cannabis therapy and women, this is not surprising. However, for my interest in women and women’s health, it is a wake-up call.

Today, women are losing custody of their children  ....

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