Medical marijuana is being used more and more every day throughout the world to treat different ailments and symptoms. In Florida, many different conditions can qualify a patient for their medical marijuana card. If you are ready to see if medical marijuana is right for you, schedule an exam with one of our Medical Marijuana Doctors.
From epilepsy to PTSD to irritable bowel syndrome and everything in between, medical marijuana is offering relief. But why exactly is it offering relief, and do hormones cause any type of impact on the relief you get? It turns out your body produces natural cannabinoids, called endocannabinoids, that play a vital role in maintaining your health.
Research has shown that cannabis affects men and women differently, with notable sex differences in both the acute and long-term effects of cannabis use. Understanding these sex differences is crucial, as it can inform more personalized approaches to cannabis use and treatment. This article will provide an overview of the current state of knowledge on sex differences in cannabis use and its effects, highlighting the importance of considering sex as a biological variable in cannabis research.
The Endocannabinoid System
It is no surprise that medical marijuana is offering relief to people because of the body’s endocannabinoid system. The endocannabinoid system (ECS) is a unique communications system in the brain and body that affects many important functions, including how a person feels, moves, and reacts. It consists of endocannabinoids, receptors that endocannabinoids/cannabinoids bond with, and the enzymes that break them down.
Within the human body, different systems work in unison to maintain the state of homeostasis. Homeostasis, which is the process of maintaining a healthy equilibrium of all of these systems, is the overall goal of the ECS. The endocannabinoid system works to maintain this balanced state by using cannabinoid receptors that can be found within other systems. When an imbalance is detected, the body will naturally synthesize endocannabinoids to interact with these receptors, which in return will stimulate a response that will work to maintain homeostasis once again.
However, in some cases, the body does not generate enough endocannabinoids. This could lead to what Ethan Russo, M.D., Director of Research and Development of the International Cannabis and Cannabinoids Institute, has theorized as Clinical Endocannabinoid Deficiency (CED). His theory, first posed in 2001 and then published in 2016, states that CED could be the cause of many different ailments, such as migraines, fibromyalgia, irritable bowel syndrome, and other treatment-resistant syndromes.
Dr. Russo suggests that a person having these deficiencies could explain why supplementing cannabinoids from medical marijuana was effective in offering symptom relief. While more research needs to be done, this theory can open the door for more ways to treat different conditions.
Cannabis Affects Women Differently
One system in particular that shares a link with the ECS is the endocrine system. The endocrine system uses hormones to control and manage energy levels, reproduction, growth and development, homeostasis, and response to stress, injury, and environmental factors. It consists of the pancreas, hypothalamus, sex organs, and the thyroid, adrenal, and pineal glands.
These glands play a role in communication between the parts of the body that are responsible for producing hormones.
Generally speaking, women are more strongly affected by marijuana than men. For instance, cannabinoids contribute to better pain relief in women, and they also elevate female rodents’ sexual behavior. In comparison, it suppressed libido in the male rats. Men are also more susceptible to the “munchies” effect.
Women have higher tolerances for THC for a few reasons. One is that THC is lipophilic, meaning it attaches to fat cells, and women tend to have higher body fat percentages than men. This means that higher amounts of THC are going into the fat cells and being stored there rather than being absorbed into the bloodstream. As a result, not as much THC enters the receptors in the brain, which gives the “high” effect. Another reason is due to a hormone that is more prevalent in women than in men: estrogen.
Gender differences in cannabis use and its impacts on health and treatment are important to understand. Recognizing these differences can inform better regulatory practices and safe usage guidelines, especially as societal norms around cannabis evolve.
Estrogen and Marijuana
The ECS and estrogen have direct and indirect interactions with each other. One thing the endocannabinoid system impacts is the release of estrogen. Women have higher estrogen levels than men, and during their reproductive cycle, these levels fluctuate. With that being said, it is important to note that certain hormones—like estrogen – can affect the body’s absorption of cannabinoids.
In different regions of the brain, the number of CB1 receptors fluctuates depending on the level of estrogen present. Estrogen also increases the level of anandamide, an endocannabinoid, resulting in an increase in the strength of the endocannabinoid system. Thus, making sense that THC’s effects are the strongest whenever estrogen levels are peaking.
CB1 receptor function and endocannabinoid activity fluctuate throughout a woman’s menstrual cycle. The amount of anandamide circulating increases during the follicular phase of the cycle and is highest during ovulation. According to various studies, it appears that the ECS plays a significant role in the regulation of the menstrual cycle and fertility. [5]
A recent study conducted by Professor Rebecca Craft of Washington State University confirms that the female body absorbs marijuana differently depending on estrogen levels. [6] Specifically, during estrus faze, or the part of the cycle when a woman ovulates, there was an apparent spike in drug sensitivity. During this phase, your ovaries produce more estrogen which then, in turn, increases sensitivity levels, including that of THC.
Another thing to note is that during Professor Craft’s study, in just over ten days, the female rats became more tolerant to the effects of THC than the male rats. This could mean women are more likely to build up a tolerance to marijuana than men are. The study also observed that marijuana did not disrupt the female rats’ reproductive cycle. [5]
Cannabis Addiction and Withdrawal in Men and Women
Gender differences also apply to the trajectory of cannabis addiction and withdrawal symptoms. Research has shown that women progress faster from first use to seeking treatment for cannabis use disorder. That means women are more likely to become dependent and experience rapid onset of negative consequences.
When it comes to cannabis withdrawal, women experience more severe symptoms than men. This includes more emotional distress, stronger cravings, and physical symptoms like nausea and stomach pain. Quitting cannabis can be tougher for women. Men report more sleep-related symptoms during withdrawal, including insomnia and vivid dreams.
Interestingly, while men are more likely to use cannabis and become dependent on it over time, women seek treatment after fewer years of use and less cumulative use. That means women may be more sensitive to cannabis, or their cannabis use is driven by different factors than men, like underlying mental health conditions or social pressures.
Reproductive Effects of Cannabis on Men and Women
Cannabis use can affect reproductive health in both men and women but in different ways. For women, there is evidence that cannabis can disrupt the menstrual cycle and lead to irregular periods or difficulty getting pregnant. The impact on fertility is more concerning for women who use cannabis regularly, as the drug can alter the hormones that regulate ovulation.
Cannabis use during pregnancy is also a big concern. It’s the most commonly used illicit drug among pregnant women, and research has linked it to various adverse outcomes, including lower birth weight, preterm birth, and increased risk of neonatal health problems. We need to educate women about the risks of cannabis use during pregnancy and the long-term developmental consequences for their children.
In men, cannabis use can also affect reproductive health, particularly sperm production and quality. Some studies have shown that chronic use can lower sperm count and affect sperm motility, but more research is needed to fully understand the effects. More research is needed to understand how cannabis affects male fertility and long-term reproductive health.
Conclusion and Future Research Directions
As cannabis becomes more legal and part of medical treatment, we need to understand the sex and gender differences in its effects. The research already suggests we need more targeted studies to look into how cannabis works differently in men and women.
Future research should consider factors like hormonal fluctuations, genetic predispositions, and social influences to get a better understanding of how cannabis affects each sex. Objective measures like polysomnography (used to monitor sleep architecture) could give us more insight into how cannabis affects sleep patterns, which is important given the increasing use of cannabis for insomnia and other sleep disorders.
As public health approaches to cannabis use evolve, clinicians, policymakers, and the general public need to be aware of these sex differences. Only by acknowledging and addressing these differences can we ensure men and women can use cannabis responsibly.
If you suffer from one of the many conditions that qualify a person for medical marijuana and you are ready to take the next step to obtain the relief you deserve, schedule an exam with one of our Florida Marijuana Doctors now, or speak with a DocMJ Patient Care Coordinator at (888) 908.0143.
Dr. Rothman is a diplomate of the American Board of Obstetrics and Gynecology. He has received multiple special awards and recognitions, including Physician of the Year, from the Pinellas County Medical Association (2014 – 2015) and the President’s Service Award from the Pinellas County Medical Society.
He attended medical school at State University of New York Upstate Medical Center in Syracuse, New York, where he also completed his Obstetrics and Gynecology residency. In addition to practicing medicine, Dr. Rothman’s professional career includes being an Assistant Professor at the University of South Florida and Clinical Instructor at the University of Tampa’s College of Nursing.
Dr. Rothman received his Florida Medical Marijuana Physicians Certification in 2016 and was one of the first recommending physicians through DocMJ in the state and is loved by many of those early patients today.