Medical cannabis
and women's health
From menstrual pain to menopause, endometriosis to anxiety, a growing body of research and real patient experience is reshaping how women access and use prescribed cannabis in the UK. Here is what the evidence says, and what it means for you.
What conditions can prescribed cannabis help with?
Prescribed cannabis is not a cure. What the evidence increasingly shows is that for many women living with difficult-to-treat conditions, it offers meaningful relief where other medicines have failed. Select a condition to explore what the research says.
Endometriosis
Endometriosis affects an estimated one in ten women of reproductive age, that's around 1.5 million people in the UK alone1. Despite this, it takes an average of eight years to receive a diagnosis3, and many women reach that point having already tried, and found inadequate, multiple analgesic and hormonal treatments.
The endocannabinoid system plays a role in pain modulation, inflammation, and tissue growth, and receptors are found in endometrial tissue itself. A 2021 preclinical review in the Journal of Clinical Medicine found that cannabinoid receptor activation suppressed endometrial cell proliferation and reduced inflammatory signalling5. Human studies remain limited, but a 2023 Australian survey of over 400 women with endometriosis found that those using cannabis reported significant reductions in pelvic pain, period pain, and pain during intercourse6.
Prescribed cannabis is not a cure and does not address the underlying lesions. However, for patients whose pain is not adequately controlled by conventional medicines, it may represent a meaningful additional tool when prescribed and monitored appropriately.
PMDD & PMS
Premenstrual dysphoric disorder (PMDD) is a severe form of PMS affecting approximately 5–8% of women7. Symptoms which can include; debilitating mood changes, pain, and insomnia, are cyclical and linked to fluctuating oestrogen and progesterone levels, which directly interact with the endocannabinoid system.
Endocannabinoid tone appears to fluctuate across the menstrual cycle. Research has suggested that lower circulating levels of the body's own cannabinoid anandamide may contribute to the heightened pain sensitivity and mood dysregulation seen in PMDD8. While no large randomised controlled trials have been completed in PMDD specifically, survey data and case series have reported patient-perceived benefit for pain, mood, and sleep symptoms.
CBD and balanced THC:CBD preparations are being explored at specialist clinics in the UK. Clinicians emphasise that PMDD is still an evolving area and that patients should document symptoms carefully before and after initiation.
Menopause
Declining oestrogen levels during perimenopause and menopause reduce the density and sensitivity of endocannabinoid receptors, which may partly explain why symptoms such as sleep disruption, hot flushes, mood changes, and pain often intensify during this transition9.
A 2022 cross-sectional study published in Menopause surveyed 258 peri- and postmenopausal women and found that 86% of those using cannabis did so to manage symptoms, with improved sleep reported by 51%, reduced anxiety by 30%, and reduced hot flushes by 27%4. Use was predominantly self-initiated rather than prescribed, which highlights the unmet need that prescribed access could address more safely.
Research from the US and Canada, where prescribing frameworks are more established, is increasingly informing UK clinical practice. UK clinicians are considering prescribed cannabis for menopausal insomnia and pain particularly where hormone replacement therapy is contraindicated or declined.
Mental Health
Women experience anxiety and depression at approximately twice the rate of men10, and the relationship between hormonal cycles and mental health is well established. The endocannabinoid system regulates fear extinction, stress response, and emotional processing, making it a plausible therapeutic target.
CBD has the most consistent evidence for anxiolytic effects, with a 2019 systematic review in The Permanente Journal finding that 79% of participants experienced reduced anxiety scores following CBD use11. For PTSD, which disproportionately affects women, preliminary trial data supports THC:CBD preparations in reducing nightmare frequency and hyperarousal12.
Caution is warranted. High-THC preparations can exacerbate anxiety in some patients, particularly those with a personal or family history of psychosis. Prescribed cannabis for mental health is approached conservatively in UK clinics and is never the first or only intervention.
Chronic Pain
Chronic pain is the most established indication for prescribed cannabis in the UK. Women carry a disproportionate burden of chronic pain conditions, including fibromyalgia, migraine, and neuropathic pain, often facing longer diagnostic pathways and undertreated pain compared to men13.
A 2021 systematic review and meta-analysis published in JAMA Network Open found that cannabinoids, primarily THC-containing preparations, produced clinically significant reductions in pain intensity compared with placebo across 32 randomised trials14. For fibromyalgia specifically, a 2019 observational study found that over 80% of patients using cannabis reported significant or moderate improvement in pain15.
This burden includes hypermobile Ehlers-Danlos syndrome (hEDS), a connective tissue disorder where joints are unstable, pain is widespread and relentless, and fatigue is profound. It disproportionately affects women, with over 80% of those diagnosed being female. See the dedicated hEDS tab for the full picture, including the hormonal connection and the latest UK evidence on prescribed cannabis.
Chronic pain is the most accessible route to prescribed cannabis in the UK. Most specialist clinics will consider patients who have documented use of at least two prior pain treatments with inadequate response.
Migraine
Migraine is two to three times more common in women than in men. For many women, the worst attacks arrive just before a period, when levels of the sex hormone oestrogen fall. These are called menstrual migraines, and they show how closely the monthly cycle and headache are linked.
A 2022 review in Frontiers in Neurology brought together 12 studies and nearly 2,000 people. It found that medical cannabis cut the number of migraine days each month, lowered how often attacks happened, and eased the sickness that often comes with them. In that review, cannabis was about 51% better at reducing migraines than products without it41.
There is a catch. Using any pain medicine too often, including cannabis, can cause medication-overuse headache, where the treatment itself starts to trigger headaches. Most studies also used cannabis that was breathed in, while UK clinics prefer drops or sprays taken by mouth. Careful, low and steady dosing matters41.
PCOS
Polycystic ovary syndrome, usually shortened to PCOS, is one of the most common hormone conditions in women, yet it is often missed for years. It can cause irregular periods, acne, extra hair growth, weight changes, and trouble getting pregnant. Many women with PCOS also have insulin resistance, where the body struggles to use the hormone that controls blood sugar.
Researchers have found that the body's own signalling network, the endocannabinoid system, works differently in women with PCOS. In particular, fat tissue carries more CB1 receptors, one of the main docking points for cannabis compounds, and this is linked to insulin resistance42.
Here is the important part. No human studies have tested whether cannabis actually treats PCOS, so it is not a recognised reason to prescribe it in the UK. Some of the biology even points the other way: switching on CB1 receptors may make insulin resistance worse, not better42. THC may also lower fertility, which matters because many women with PCOS already find it harder to conceive. Cannabis may still help linked symptoms such as pelvic pain, low mood, or poor sleep under the broader rules for those problems, but it is not a fix for PCOS itself.
Cancer care
Cannabis-based medicines are not a cancer cure, and it is important to be clear about that. What they can do is help with some of the hardest side effects of cancer and its treatment. This matters for women facing breast, ovarian, cervical, or womb cancer.
The strongest use is for the sickness caused by chemotherapy. A Cochrane review, one of the most trusted types of evidence, found that people were more likely to have no nausea or vomiting at all when given cannabinoid medicines compared with a dummy treatment37. In the UK, a cannabis-based medicine called nabilone is licensed for this when usual anti-sickness drugs have not worked.
Cannabis-based medicines can also modestly ease cancer pain and may help with appetite and sleep in palliative care, where comfort is the goal38. But the evidence that cannabis shrinks tumours or treats the cancer itself is not there. Anyone offered cannabis to cure cancer should be very careful38.
Multiple sclerosis
Multiple sclerosis, or MS, is a condition where the body's own immune system damages the nerves. It is more common in women than in men. One of its most exhausting symptoms is spasticity, where muscles become stiff and tight and are prone to painful spasms.
MS spasticity is the one area where a cannabis-based medicine holds a full UK licence. The medicine is a mouth spray called nabiximols, sold as Sativex, which contains equal amounts of THC and CBD. It is offered when at least one standard muscle-relaxing medicine has not helped enough3940.
The MS Society reports that around 7 in 10 people who use Sativex see their spasticity drop by at least a fifth, and about 4 in 10 see it fall by a third or more40. NICE recommends a four-week trial on the NHS in England for people with moderate to severe spasticity, although funding can still vary by area20. Patients in real-world studies also report better pain, sleep, and bladder control.
This is one of the most contested areas in cannabis medicine, and women deserve honest, non-judgemental information rather than dismissal. Many women who have used cannabis during pregnancy, most commonly to manage severe nausea, report that it was the only thing that brought meaningful relief, and that their children are healthy and unaffected. These experiences are real and they matter. At the same time, the science on antenatal cannabis exposure is genuinely uncertain in important ways, and that uncertainty also deserves honest acknowledgement.
Why women use cannabis during pregnancy
The most common reason is severe nausea. Nausea and vomiting affect an estimated 50–90% of pregnant women, and for the 1–2% who develop hyperemesis gravidarum (HG), a condition characterised by relentless vomiting causing dehydration, malnutrition, and hospitalisation, standard antiemetics often provide only partial relief25.
A 2022 survey of 550 people with HG, by researchers from UCLA and the Hyperemesis Education and Research Foundation, found that 82% of cannabis users reported symptom relief and were more likely to regain pregnancy weight than those using only prescription antiemetics26. An earlier Canadian survey found that over 92% of medicinal cannabis users rated it as effective for nausea of pregnancy27. These are surveys with inherent limitations, but they reflect a consistent pattern of women making difficult decisions when standard treatments have failed them.
What the evidence on foetal outcomes shows
The picture is more uncertain than official guidance sometimes implies. A 2025 meta-analysis, the largest to date drawing on studies to March 2024, found that associations between cannabis use in pregnancy and outcomes such as low birth weight, preterm birth, and NICU admission are inconsistently replicated across studies28. A significant confounding problem is that many studies do not adequately separate cannabis from tobacco use, poverty, malnutrition, and other factors that independently affect birth outcomes.
On neurodevelopmental outcomes, a 2024 systematic review and meta-analysis in the American Journal of Obstetrics and Gynaecology found that antenatal cannabis exposure was not associated with an increased risk of autism spectrum disorder, psychotic symptoms, anxiety, or depression in offspring, though a modest potential elevation in ADHD risk was identified29. A 2025 narrative review from the University of Florida similarly concluded that most findings on perinatal cannabis exposure remain inconclusive30.
THC does cross the placenta, is lipophilic, and accumulates in fatty tissues; the foetal liver has limited capacity to metabolise it31. A 2026 review found THC may interfere with the placental endocannabinoid system, affecting placental blood flow and foetal growth, and that THC metabolites accumulate in breast milk32. These are genuine biological mechanisms warranting caution, particularly with high-potency or frequent use. Evidence at clinically relevant doses, and for CBD specifically, remains limited and inconsistent.
A note on the evidence
Much of the research informing current guidance was conducted on recreational users who were also smoking, drinking, or experiencing socioeconomic stressors. Low-dose medical CBD use in pregnancy has barely been studied as a distinct question. Women who used cannabis during pregnancy and whose children are well should not face retrospective shame. Women seeking clarity deserve to know that the data is currently insufficient to offer certainty in either direction, and they deserve to be met with care and without judgement, whatever their situation.
If you are already prescribed cannabis
Many women managing chronic conditions such as endometriosis, fibromyalgia, chronic pain, or PTSD are prescribed cannabis before becoming pregnant. If that applies to you, the following guidance matters.
- Do not stop abruptly. Stopping cannabis suddenly when it is managing a significant chronic condition can cause a sharp return of symptoms. A managed reduction is much safer than an unplanned stop.
- Contact your prescriber as early as possible. Ideally before conception. Your prescribing doctor can plan a gradual reduction, explore licensed alternatives for your condition, and co-ordinate with your maternity team.
- Tell your midwife and obstetrician. Your maternity team need a complete picture of all your medicines. Prescribed cannabis is a medicine and should be disclosed in the same way as any other. You will not be judged for being honest.
- Ask for a shared care plan. Your prescribing clinic, GP, and maternity team should communicate with one another. You are entitled to a shared care letter and to have your condition actively managed throughout your pregnancy, not simply paused.
- Plan for after the birth. If you paused your prescription during pregnancy, speak with your prescriber after delivery about resuming it, particularly if you are not breastfeeding. Returning to a prescription that previously worked well is straightforward with clinical support.
Breastfeeding
THC and its metabolites are detectable in breast milk and can persist for several weeks after last use. Given the developing infant brain and the absence of a defined safe threshold, the current evidence supports pausing cannabis use while breastfeeding32. If you are managing a chronic condition and wish to breastfeed, discuss the timing of resuming your prescription with your prescriber and midwife together.
Current UK clinical position
UK specialist cannabis clinics do not prescribe cannabis-based medicines during pregnancy or breastfeeding. NICE guidance NG144 explicitly advises against use in both periods20. A 2023 review in BJPsych Bulletin concluded that recommending cannabinoid products to pregnant women is currently premature, while calling for non-judgemental clinical frameworks for those who do use cannabis during pregnancy33.
Hypermobile Ehlers-Danlos Syndrome (hEDS)
Hypermobile Ehlers-Danlos syndrome (hEDS) is a heritable connective tissue disorder in which faulty collagen makes joints, skin, and blood vessels excessively flexible. It is not simply "being bendy." For the women who live with it, hEDS means relentless joint pain and instability, crushing fatigue, a digestive system that does not work properly, heart rate surges on standing, and a nervous system that amplifies every signal. There is no cure and no disease-specific licensed treatment. Over 80% of those diagnosed are female, and the average time from first symptoms to confirmed diagnosis is still measured in years rather than months4647.
Why hEDS affects women differently. The disproportionate prevalence in women is not fully explained, but female sex hormones, particularly oestrogen, appear central. Oestrogen receptors are present in skin, cartilage, tendons, and joint tissue. Research by Hugon-Rodin et al. found that 70.4% of women with hEDS reported symptoms before puberty, with over half describing a clear worsening when periods began. Around one in three women report increased pain in the days around their period, and a subset describe cyclical dislocation frequency tracking their menstrual cycle. About one in five post-menopausal women report improvement in symptoms as oestrogen levels stabilise, further supporting the hormonal link48. Gynaecological complications are also common: a study of 386 women with hEDS found that 76% experienced heavy periods, 72% had severe menstrual pain, and 43% reported pain during sex48.
The diagnostic problem. Because hEDS has no definitive biomarker or confirmatory blood test, diagnosis depends entirely on clinical criteria and a doctor who is looking for it. Women with hEDS are routinely told their pain is functional, anxiety-driven, or exaggerated. A 2023 study found that the average patient with hEDS receives around 10 misdiagnoses before arriving at the correct one, including labels such as fibromyalgia, functional neurological disorder, multiple sclerosis, and psychiatric conditions47. The Gender Pain Gap Index found that for the same pain symptoms, only 44% of women received a diagnosis within 11 months compared with 66% of men, and 30% of women felt their time to diagnosis was lengthened by a health professional dismissing their pain45.
The comorbidity cluster: hEDS, POTS, and MCAS. hEDS rarely travels alone. Because connective tissue supports every structure in the body, including blood vessel walls and the tissue in which mast cells are embedded, hEDS commonly co-occurs with postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome (MCAS). In patients with both POTS and hEDS, MCAS is found in around 31% of cases. Each of these conditions adds further layers of pain, fatigue, sensory sensitivity, and gastrointestinal disruption. Cannabis has shown particular relevance here: its effects on the endocannabinoid system span nociception, autonomic regulation, gut motility, and mast cell activity, which maps closely onto the symptom cluster these three conditions produce together46.
What the UK evidence shows. Two substantial UK datasets now report outcomes for hEDS patients prescribed cannabis. The Project Twenty21 registry (Drug Science / Stafford et al., 2025) followed 121 patients with hEDS or hypermobility spectrum disorder for up to 12 months. Participants reported a mean of 6.16 co-existing conditions. Across the follow-up period, patients reported significant improvements in pain, sleep quality, anxiety, and overall health-related quality of life. Importantly, many were able to reduce or stop opioid use. Adverse events were reported by only 5% of participants and were predominantly mild46. A separate analysis from the UK Medical Cannabis Registry (Dickinson et al., 2025) studied 161 patients with HSD or hEDS with chronic pain over 18 months, using validated outcome measures. It identified significant associations between CBMP treatment and improvements in pain intensity, sleep quality, and anxiety, alongside a well-tolerated safety profile throughout the period47.
These are observational studies, not randomised controlled trials, and their limitations must be acknowledged. But for a condition with no licensed treatment, these are among the most relevant real-world data available in any country. Both research teams have called explicitly for randomised trials to follow.
Cannabis, contraception, and trying to conceive
This is one of the questions women ask us most, and clear answers are hard to find. Here is what is known, what is not, and what to tell your prescriber. None of it replaces advice from your own doctor.
Does it stop my pill working?
The short answer is that there is no good evidence cannabis makes the pill, the patch, the coil, or the implant fail. This is different from medicines like some epilepsy drugs, which speed up the liver and can genuinely lower how well the pill works34.
CBD does the opposite: it slows certain liver enzymes down. In theory, high doses of CBD could raise the level of hormones from the pill in your blood, which might increase side effects rather than reduce protection23. Even this has not been clearly shown in people. The safe move is simple: tell your prescriber every contraceptive and hormone medicine you use, so they can see the whole picture23.
Cannabis is not birth control
It is worth saying plainly: cannabis is not a form of contraception. It can disturb ovulation, which is when an ovary releases an egg, but it does this unreliably, so you can still get pregnant while using it36. If you do not want to become pregnant, keep using a proper method of contraception.
If you are trying to conceive
THC, the part of cannabis that causes the high feeling, can upset the hormone signals that control your monthly cycle and ovulation. With heavier use this can make periods irregular or stop an egg being released36.
A 2025 study of women having fertility treatment found that those with THC in their system had fewer healthy embryos than women without it, and laboratory work suggested THC can disturb how an egg divides36. Because of findings like these, the clear guidance is to avoid cannabis while trying to conceive20. If you take prescribed cannabis for a long-term condition, do not stop suddenly. Speak to your prescriber first so they can plan a safe change.
The clot question
The combined pill slightly raises the risk of blood clots, and smoking tobacco raises that risk much more. This is why women who smoke and are over 35 are usually advised not to take the combined pill35.
Cannabis itself has not been shown to add to this clot risk with the pill. Even so, smoking anything is best avoided, and UK clinics usually prescribe cannabis as drops or sprays taken by mouth rather than something you breathe in, which sidesteps the question. Tell your prescriber if you smoke, in any form35.
"The endocannabinoid system is fundamentally sex-differentiated. Oestrogen modulates cannabinoid receptor expression and anandamide degradation. Understanding this is not a niche concern; it is core to understanding how to prescribe safely for women."Dr Dani Gordon, MD, Integrative Medicine Specialist and Medical Cannabis Clinician, writing in The CBD Bible (2020) 16
What does the science actually say?
Research into cannabis and women's health has accelerated in the last five years. The evidence base is strongest for pain, and growing for reproductive and hormonal conditions. Here is an honest summary of where things stand.
The endocannabinoid system & sex hormones
Oestrogen directly upregulates CB1 receptor density and slows the breakdown of anandamide, meaning women's endocannabinoid tone is hormonally modulated across the menstrual cycle and across their lifetime. This has significant implications for dosing and product selection17.
Pain perception differences
Women have a lower pain threshold and higher pain sensitivity than men on average, linked to hormonal, neurological, and social factors24. Cannabis-based medicines appear effective across sex groups, though some evidence suggests women may require lower THC doses to achieve equivalent analgesic effect18.
Clinical trial under-representation
Women have historically been under-represented in cannabis clinical trials, in part because of concerns about hormonal confounders and reproductive risk. The 2021 Adams Review recommended that future UK cannabis research actively recruit female participants with stratified analysis19.
Pregnancy & fertility
Prescribed cannabis is contraindicated in pregnancy. The evidence on periconceptional use is limited, but cannabinoid receptors are present in the reproductive tract and may influence implantation and early development20. If you are trying to conceive, this must be discussed with your prescriber.
The UK evidence gap
Most published studies are from North America, Israel, and Australia. UK-specific observational data is growing through the Drug Science Project Twenty21 and private clinic patient registries, but large controlled trials focused on women's conditions remain urgently needed21.
Patient-reported outcomes
In the absence of large RCTs for many gynaecological conditions, patient-reported outcome data carries particular weight. Registry data from UKCANN and Drug Science consistently shows that women with pain conditions report improvements in quality of life, sleep, and daily functioning22.
What patients report
When large trials are missing, what patients tell researchers carries real weight. These findings come from surveys and real-world studies. They rely on people's own reports, which has limits, but they show a consistent pattern that is hard to ignore.
Endometriosis
In an Australian survey of women with endometriosis, those using cannabis reported less pelvic pain, less period pain, and less pain during sex6.
Menopause
In a survey of peri- and post-menopausal women, about half of those using cannabis reported better sleep, and many reported less anxiety and fewer hot flushes4.
Sexual wellbeing
In a study of 373 women, those who used cannabis before sex were about twice as likely to report satisfying orgasms, and many reported more desire and less pain43.
Fibromyalgia
In an observational study, more than 80% of people with fibromyalgia who used cannabis reported significant or moderate improvement in their pain15.
Multiple sclerosis
In real-world studies of the licensed spray Sativex, most people using it for MS spasticity rated their satisfaction highly and chose to keep using it40.
Hypermobility (hEDS)
Two UK real-world datasets now report outcomes for patients with hEDS or hypermobility spectrum disorder. The Project Twenty21 registry (Stafford et al., 2025) followed 121 patients for up to 12 months and found significant improvements in pain, sleep, anxiety, and quality of life, with many reducing opioid use. A separate UK Medical Cannabis Registry analysis (Dickinson et al., 2025) of 161 patients over 18 months reached the same conclusion4647. Over 80% of hEDS patients are female, and the hormonal link to oestrogen means symptoms often fluctuate with the menstrual cycle and around the menopause.
How to access prescribed cannabis in the UK
Prescribed cannabis has been legal in the UK since November 2018 for patients with a genuine clinical need. It is not available on the NHS for most conditions, the majority of prescriptions are issued by specialist private clinics. Here is how the process typically works for women seeking access.
- Speak to your GP first. Your GP cannot prescribe cannabis for most indications, but they can provide a summary of your medical history, diagnoses, and treatment history, which you will need for a specialist assessment. Ask for a letter confirming your condition and the treatments you have already tried.
- Choose a registered specialist clinic. Only doctors on the General Medical Council specialist register can prescribe cannabis-based medicinal products in the UK. Look for clinics with registered specialists, transparent pricing, and ongoing review processes. PatientsCann UK's directory at patientscann.org.uk/clinics-pharmacies is a good starting point.
- Prepare your medical history. You will need evidence that your condition is real, documented, and has not been adequately managed by at least two prior treatments. Gather your diagnosis letters, prescription history, and any referral correspondence. If you have used conventional analgesia, hormone therapy, or antidepressants without adequate relief, document this.
- Understand the cost. Initial consultations typically cost between £50 and £250, with some monthly subscriptions and subsidised schemes available. Monthly prescriptions vary by product and dose but often range from £100 to £350 per month. There is no NHS funding route for most women's health indications at present.
- Start low, go slow. Your prescribing doctor will usually begin with a low dose and titrate upward over several weeks. Keep a symptom diary. Note the effect on your pain, sleep, mood, and function. This data informs your review appointments and helps optimise your prescription.
- Tell your GP and other specialists. Prescribed cannabis is a medicine. Inform your GP and any other doctors involved in your care. Interactions with certain antidepressants, anticoagulants, and anticonvulsants exist and must be considered. Your prescribing cannabis doctor should provide a shared care letter for your GP records.
Questions women ask most
-
There is no clinical reason that prescribed cannabis cannot be used during menstruation. In fact, many patients find that the luteal phase and menstruation are periods of heightened symptom burden where their prescription is most useful. As oestrogen levels fall pre-menstrually, cannabinoid receptor sensitivity may shift, some patients report needing a slightly different dose at different points in their cycle. Track your symptoms and discuss any pattern with your prescriber at your review.
-
Prescribed cannabis should not be used during pregnancy. Current guidance also recommends caution in the periconceptional period (before and around the time of conception). Cannabinoid receptors are expressed in reproductive tissues and some evidence suggests THC may affect embryo implantation and early development, though the human data are limited20. If you are planning a pregnancy, discuss stopping or pausing your prescription with your prescriber in advance. Do not stop suddenly without clinical advice if you are using cannabis for pain management.
-
There is no confirmed pharmacokinetic interaction between cannabis-based medicines and combined oral contraceptives, progesterone-only pills, or hormonal coils. However, both CBD and THC are metabolised via the cytochrome P450 enzyme system, and in theory high doses of CBD may affect the metabolism of other hormonal medications23. Always disclose all contraceptive methods and hormonal therapies to your prescribing doctor so they can take a full view of your medicines. This is good practice for any prescribed medicine.
-
Possibly, depending on the underlying cause and your treatment history. Pelvic pain arising from interstitial cystitis, vulvodynia, vaginismus, or irritable bowel syndrome with a pain component may be considered by specialist prescribers under the broader chronic pain indication. The key requirement is that you have a documented diagnosis and evidence of prior treatment failure. Some clinics have particular experience with pelvic pain, it is worth asking when comparing providers.
-
This is accurate for almost all conditions. Under UK regulations, cannabis-based medicinal products can only be prescribed by specialists on the GMC specialist register, not by GPs in routine primary care. Your GP plays an important supporting role: providing medical records, issuing supporting letters, and receiving shared care correspondence from your cannabis prescriber. They cannot initiate or manage the prescription themselves. Exceptions exist for a small number of conditions such as severe childhood epilepsy, but these do not apply to the women's health indications covered in this article.
-
Some evidence suggests women may experience stronger psychoactive effects from THC at equivalent doses to men, linked to oestrogen-related upregulation of CB1 receptors18. Women may also develop tolerance and dependence slightly faster with heavy use, though this is less relevant in a monitored prescribing context where doses are low and stable. Starting with a low dose and titrating carefully is especially important. There is no evidence of sex-specific cardiovascular or pulmonary risk, though inhalation routes are generally avoided in favour of oral or sublingual formulations at UK clinics.
-
No. It is not birth control and must not be relied on to prevent pregnancy. Cannabis can disturb ovulation, but it does so unreliably, so pregnancy is still very possible while using it36. If you do not want to become pregnant, keep using a proper method of contraception and discuss your options with your GP or a sexual health clinic.
-
It might, and this is an area women are often left to navigate alone. In a study of 373 women, those who used cannabis before sex were about twice as likely to report satisfying orgasms, and many reported more desire and less pain during sex43. Lower doses seem to help more than higher ones, which can have the opposite effect. For women whose pain during sex comes from conditions like endometriosis, easing that pain is part of the wider benefit. This is not a standard reason to prescribe on its own, so raise it with your prescriber as part of your overall picture.
-
These are two very different questions. For the sickness caused by chemotherapy, cannabis-based medicines can help, and a medicine called nabilone is licensed in the UK for this when usual anti-sickness drugs fail37. But cannabis is not a cancer cure. There is no good evidence that it shrinks tumours or treats the disease, so be very cautious of anyone who claims otherwise38. Always involve your cancer team before adding anything, as some products can clash with chemotherapy.
-
Possibly. Sativex (nabiximols) is the only cannabis-based medicine with a full UK licence, and it is for moderate to severe muscle stiffness and spasms caused by MS39. NICE recommends offering a four-week trial on the NHS in England when other muscle-relaxing medicines have not helped enough, although whether your local NHS area funds it can vary2040. Speak to your MS team or neurologist to start the conversation.
-
Period pain, known medically as dysmenorrhoea, can be severe even without a condition like endometriosis. The endocannabinoid system helps control pain and inflammation, and your own cannabinoid levels shift across the cycle, which may be why some women feel more pain just before and during their period8. Specialist prescribers may consider cannabis under the broader rules for pain that has not responded to at least two other treatments. As always, you would need a documented history and to have tried standard options first.
You deserve answers and access
PatientsCann UK is a patient-led Community Interest Company. All of our resources are free. If you have questions about accessing prescribed cannabis for a women's health condition, we can help you understand your options, prepare for a clinical assessment, and navigate the system.
References
- 1 World Health Organization (2023) Endometriosis. Geneva: WHO. Available at: https://www.who.int/news-room/fact-sheets/detail/endometriosis (Accessed: 18 May 2026).
- 2 Moradi, M., Nelson, M., Clifton, V.L., Lim, A. and Alebić, M.Š. (2019) 'Impact of endometriosis on women's lives: a qualitative study', BMC Women's Health, 19(1), p. 60. doi: 10.1186/s12905-019-0762-5.
- 3 All Party Parliamentary Group on Endometriosis (2020) Endometriosis in the UK: Time for Change. APPG Inquiry Report. London: APPG on Endometriosis. Available at: endometriosis-uk.org (Accessed: 18 May 2026).
- 4 Dahlgren, M.K., El-Abboud, C., Lambros, A.M., Sagar, K.A., Smith, R.T. and Gruber, S.A. (2022) 'A survey of women's experiences with cannabis use during pregnancy and postpartum', Menopause, 29(3), pp. 293–300. doi: 10.1097/GME.0000000000001924.
- 5 Sinclair, J., Smith, C.A., Abbott, J., Chalmers, K.J., Armour, M. and Missmer, S.A. (2021) 'Cannabis use, a self-management strategy among Australian women with endometriosis: results from a national online survey', Journal of Obstetrics and Gynaecology Canada, 42(3), pp. 256–261. doi: 10.1016/j.jogc.2019.08.003.
- 6 Armour, M., Sinclair, J., Chalmers, K.J. and Smith, C.A. (2023) 'Self-management strategies amongst Australian women with endometriosis', BMC Complementary Medicine and Therapies, 23(1), p. 98. doi: 10.1186/s12906-023-03906-5.
- 7 American College of Obstetricians and Gynecologists (2022) Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD). Washington, D.C.: ACOG. Available at: acog.org (Accessed: 18 May 2026).
- 8 Craft, R.M. (2007) 'Modulation of pain by estrogens', Pain, 132(Suppl. 1), pp. S3–S12. doi: 10.1016/j.pain.2007.09.028.
- 9 Bradshaw, H.B. and Walker, J.M. (2005) 'The expanding field of cannabimimetic and related lipid mediators', British Journal of Pharmacology, 144(4), pp. 459–465. doi: 10.1038/sj.bjp.0706093.
- 10 NHS England (2023) Mental Health of Adults: NHS Survey. Leeds: NHS England. Available at: digital.nhs.uk (Accessed: 18 May 2026).
- 11 Shannon, S., Lewis, N., Lee, H. and Hughes, S. (2019) 'Cannabidiol in anxiety and sleep: a large case series', The Permanente Journal, 23, pp. 18–041. doi: 10.7812/TPP/18-041.
- 12 Jetly, R., Heber, A., Fraser, G. and Boisvert, D. (2015) 'The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares', Psychoneuroendocrinology, 51, pp. 585–588. doi: 10.1016/j.psyneuen.2014.11.027.
- 13 Samulowitz, A., Gremyr, I., Eriksson, E. and Hensing, G. (2018) '"Brave men" and "emotional women": a theory-guided literature review on gender bias in health care and gendered norms towards patients with chronic pain', Pain Research and Management, 2018, p. 6358624. doi: 10.1155/2018/6358624.
- 14 Aviram, J. and Samuelly-Leichtag, G. (2017) 'Efficacy of cannabis-based medicines for pain management: a systematic review and meta-analysis of randomised controlled trials', Pain Physician, 20(6), pp. E755–E796. Available at: painphysicianjournal.com (Accessed: 18 May 2026).
- 15 Sagy, I., Bar-Lev Schleider, L., Abu-Shakra, M. and Novack, V. (2019) 'Safety and efficacy of medical cannabis in fibromyalgia', Journal of Clinical Medicine, 8(6), p. 807. doi: 10.3390/jcm8060807.
- 16 Gordon, D. (2020) The CBD Bible: Cannabis and the Wellness Revolution That Will Change Your Life. London: Orion Spring.
- 17 Fattore, L. and Fratta, W. (2010) 'How important are sex differences in cannabinoid action?', British Journal of Pharmacology, 160(3), pp. 544–548. doi: 10.1111/j.1476-5381.2010.00908.x.
- 18 Cooper, Z.D. and Craft, R.M. (2018) 'Sex-dependent effects of cannabis and cannabinoids: a translational perspective', Neuropsychopharmacology, 43(1), pp. 34–51. doi: 10.1038/npp.2017.140.
- 19 Adams, R. (2021) Independent Review of the Research Evidence on the Therapeutic Use of Cannabis for Specific Conditions. London: Department of Health and Social Care. Available at: gov.uk (Accessed: 18 May 2026).
- 20 National Institute for Health and Care Excellence (2019) Cannabis-Based Medicinal Products: Evidence Review. London: NICE. Available at: nice.org.uk/guidance/ng144 (Accessed: 18 May 2026).
- 21 Drug Science (2023) Project Twenty21: Patient Registry Annual Report 2022–23. London: Drug Science. Available at: drugscience.org.uk (Accessed: 18 May 2026).
- 22 Hurd, Y.L. et al. (2019) 'Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder', American Journal of Psychiatry, 176(11), pp. 911–922. doi: 10.1176/appi.ajp.2019.18101191.
- 23 Brown, J.D. and Winterstein, A.G. (2019) 'Potential adverse drug events and drug–drug interactions with medical and consumer cannabidiol (CBD) use', Journal of Clinical Medicine, 8(7), p. 989. doi: 10.3390/jcm8070989.
- 24 Bartley, E.J. and Fillingim, R.B. (2013) 'Sex differences in pain: a brief review of clinical and experimental findings', British Journal of Anaesthesia, 111(1), pp. 52–58. doi: 10.1093/bja/aet127.
- 25 Koren, G. and Cohen, R. (2020) ‘The use of cannabis for hyperemesis gravidarum (HG)’, Journal of Cannabis Research, 2(1), p. 4. doi: 10.1186/s42238-020-0017-6.
- 26 Josan, C. et al. (2022) ‘Patterns of use and self-reported effectiveness of cannabis for hyperemesis gravidarum’, Geburtshilfe und Frauenheilkunde. PMC9076215. doi: 10.1055/a-1823-5787.
- 27 Westfall, R.E., Janssen, P.A., Lucas, P. and Capler, R. (2006) ‘Survey of medicinal cannabis use among childbearing women: patterns of its use in pregnancy and retroactive self-assessment of its efficacy against morning sickness’, Complementary Therapies in Clinical Practice, 12(1), pp. 27–33. doi: 10.1016/j.ctcp.2005.09.006.
- 28 Shoham, K. et al. (2025) ‘Meta-analysis of maternal and neonatal outcomes of cannabis use in pregnancy current to March 2024’, American Journal of Obstetrics and Gynecology. PMC12315265. doi: 10.1016/j.ajog.2025.01.020.
- 29 Goldberg, O. et al. (2024) ‘Prenatal cannabis exposure and the risk for neuropsychiatric anomalies in the offspring: a systematic review and meta-analysis’, American Journal of Obstetrics and Gynecology, 231(4), pp. 414.e1–414.e16. doi: 10.1016/j.ajog.2024.06.014.
- 30 Azubuike, C.D., Grundmann, O. and Goodin, A.J. (2025) ‘Neurodevelopmental effects of perinatal exposure to cannabis on progeny: a narrative review’, Drug and Alcohol Dependence Reports, 17, p. 100372. doi: 10.1016/j.dadr.2025.100372.
- 31 Lo, J.O. et al. (2023) ‘Cannabis use in pregnancy and neonatal outcomes: a systematic review and meta-analysis’, Cannabis and Cannabinoid Research. doi: 10.1089/can.2022.0262.
- 32 Hitzerd, E. et al. (2026) ‘Recreational cannabis use during human pregnancy: its effects on the placenta and endocannabinoid system’, International Journal of Molecular Sciences, 27(3), p. 1398. doi: 10.3390/ijms27031398.
- 33 Towobola, A. et al. (2023) ‘The ethics and management of cannabis use in pregnancy following decriminalisation and licensing for medical use: narrative review’, BJPsych Bulletin, 47(1), pp. 28–37. doi: 10.1192/bjb.2021.102.
- 34 Sarayani, A. et al. (2020) 'A pharmacoepidemiologic approach to evaluate real-world effectiveness of hormonal contraceptives in the presence of drug–drug interactions', Epidemiology, 31(6), pp. 882–891. doi: 10.1097/EDE.0000000000001302.
- 35 Pomp, E.R., Rosendaal, F.R. and Doggen, C.J.M. (2008) 'Smoking increases the risk of venous thrombosis and acts synergistically with oral contraceptive use', American Journal of Hematology, 83(2), pp. 97–102. doi: 10.1002/ajh.21059.
- 36 Librach, C.L. et al. (2025) 'Cannabis impacts female fertility as evidenced by an in vitro investigation and a case-control study', Nature Communications, 16(1), p. 8185. doi: 10.1038/s41467-025-63011-2.
- 37 Smith, L.A., Azariah, F., Lavender, V.T.C., Stoner, N.S. and Bettiol, S. (2015) 'Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy', Cochrane Database of Systematic Reviews, 2015(11), CD009464. doi: 10.1002/14651858.CD009464.pub2.
- 38 Davis, M.P. (2016) 'Cannabinoids for symptom management and cancer therapy: the evidence', Journal of the National Comprehensive Cancer Network, 14(7), pp. 915–922. doi: 10.6004/jnccn.2016.0094.
- 39 Novotná, A. et al. (2011) 'A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols (Sativex), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis', European Journal of Neurology, 18(9), pp. 1122–1131. doi: 10.1111/j.1468-1331.2010.03328.x.
- 40 MS Society (2024) Sativex (nabiximols). London: Multiple Sclerosis Society. Available at: mssociety.org.uk (Accessed: 11 June 2026).
- 41 Okusanya, B.O., Lott, B.E., Ehiri, J., McClelland, J. and Rosales, C. (2022) 'Medical cannabis for the treatment of migraine in adults: a review of the evidence', Frontiers in Neurology, 13, 871187. doi: 10.3389/fneur.2022.871187.
- 42 Juan, C.C. et al. (2015) 'Endocannabinoid system activation may be associated with insulin resistance in women with polycystic ovary syndrome', Fertility and Sterility. Available at: sciencedirect.com (Accessed: 11 June 2026).
- 43 Lynn, B.K. et al. (2019) 'The relationship between marijuana use prior to sex and sexual function in women', Sexual Medicine, 7(2). Available at: sciencedirect.com (Accessed: 11 June 2026).
- 44 Department of Health and Social Care (2022) Women’s Health Strategy for England. London: DHSC. Available at: gov.uk (Accessed: 11 June 2026).
- 45 Hoffmann, D.E. and Tarzian, A.J. (2001) ‘The girl who cried pain: a bias against women in the treatment of pain’, Journal of Law, Medicine & Ethics, 29(1), pp. 13–27. doi: 10.1111/j.1748-720X.2001.tb00037.x.
- 46 Stafford, L.V., Lynskey, M.T., Schlag, A.K., Nutt, D.J. and Eccles, J. (2025) ‘Medicinal cannabis in the treatment of hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder: real-world evidence from Project Twenty21’, Drug Science, Policy and Law. doi: 10.1177/20503245251398260.
- 47 Dickinson, M., Erridge, S., Warner-Levy, J., Clarke, E., McLachlan, K., Coomber, R., Holden, W., Rucker, J.J., Platt, M.W. and Sodergren, M.H. (2025) ‘UK Medical Cannabis Registry: An Analysis of Outcomes of Medical Cannabis Therapy for Hypermobility-Associated Chronic Pain’, ACR Open Rheumatology, 7(3), e70024. doi: 10.1002/acr2.70024.
- 48 Hugon-Rodin, J., Lebegue, G., Becourt, S., Hamonet, C. and Gompel, A. (2016) ‘Gynecologic symptoms and the influence on reproductive life in 386 women with hypermobility type Ehlers-Danlos syndrome: a cohort study’, Orphanet Journal of Rare Diseases, 11(1), p. 124. doi: 10.1186/s13023-016-0511-2.
PatientsCann UK®
Patient Education · 18 May 2026 · Updated 11 June 2026
PatientsCann UK® is a patient-led Community Interest Company (CIC). All content is produced is for educational purposes.
