For too long, menstrual pain has been treated as something to “push through.” Yet for many people experiencing dysmenorrhea (painful menstrual cramping) it is not mild or temporary. It can interfere with work, school, caregiving, relationships, sleep, mood, productivity, and overall quality of life.
As Women’s Health Month comes to a close, it is worth asking why conditions that affect so many people are still under-recognized in research, clinical care, and medical cannabis policy?
Emerging research on cannabinoid-based vaginal suppositories is beginning to validate what some patients have reported for years, that localized cannabis and CBD products may offer meaningful support for menstrual-related pain and associated symptoms. At the same time, the limited research base reminds us that much more needs to be studied and that women’s health conditions deserve to be taken seriously in both science and state medical cannabis programs.
Menstrual pain is common, disruptive, and often minimized
Dysmenorrhea is commonly defined as painful uterine cramping associated with the menstrual cycle. A newly published real-world outcomes report notes that dysmenorrhea is one of the most common gynecological concerns, with estimates ranging widely from 16% to 95% of women depending on the population studied and how symptoms are measured. The report also notes that menstrual pain can negatively affect family relationships, attendance at work or school, social activities, productivity, and quality of life.
Despite this impact, menstrual pain is often normalized. Many people delay seeking care, are dismissed when they do, or are left to rely on over-the-counter options that may not provide enough relief. Current treatment options for dysmenorrhea commonly include non-steroidal anti-inflammatory drugs, oral contraceptives, heat, exercise, relaxation techniques, and other supportive approaches. While these can be helpful for many, they do not work for everyone and may come with side effects or limitations.
This is where cannabinoid-based approaches have entered the conversation, not as a magic solution, but as an area of growing interest that deserves careful, credible study.
Why cannabinoids may matter for menstrual-related pain
The endocannabinoid system is involved in many processes relevant to reproductive health, pain, inflammation, mood, and tissue signaling. The newly published manuscript notes that the uterus, ovaries, fallopian tubes, and placenta “are rich in” cannabinoid receptors, including CB1 and CB2 receptors, which are involved in reproductive processes. CB1 receptor activity may support relaxation of uterine smooth muscle, while CB2 receptor activity may help modulate inflammatory responses related to menstrual pain.
CBD may also interact with non-cannabinoid receptor pathways, including TRPV1 receptors, which are involved in pain and inflammation signaling and are found in endometrial and cervical tissues.
This does not mean that every cannabinoid product will help every person. Product formulation, route of administration, cannabinoid content, dose, timing, other medications, and individual health history all matter. But the biology gives researchers a reasonable basis to ask whether localized cannabinoid products may help with menstrual-related pain.
Outcomes on whole-plant CBD suppositories
The aforementioned report evaluated whole-plant CBD suppositories for menstrual pain and related symptoms. Importantly, the report states that the findings were collected as part of a real-world program evaluation, not under Institutional Review Board oversight, and are not intended to represent formal clinical research. These findings should be viewed as promising real-world outcomes data, not as a definitive clinical trial.
The program followed 79 participants who prospectively recorded daily symptoms across two menstrual cycles: one cycle without suppository use and one cycle using suppositories. The product evaluated was a whole-plant, full-spectrum suppository containing 50 mg CBD, 1.4 mg naturally occurring THC, trace minor cannabinoids, and the added terpenes beta-caryophyllene and humulene.
The encouraging results showed that the Menstrual Distress Questionnaire (MEDI-Q) Total Score decreased by 32.41%, from 16.99 to 11.48, and the Menstrual Symptom Score decreased by 33%, from 8.38 to 5.62. Both changes were statistically significant.
Pain scores also dropped substantially. Across 286 suppository uses among the 79 participants over the 7-day cycle, average pain decreased from 5.85 to 2.58 on a 0–10 pain scale, representing a 55.9% reduction.
Participants also reported improvements in cramps, focus, mood, headaches, and nausea, especially during the first several days of menstruation. The report found the most pronounced improvement in menstrual cramps, with mood, nausea, headaches, and focus also improving during days 1–5.
Another notable finding was reduced reliance on other pain management strategies. Between the non-suppository cycle and the suppository cycle, participants reported a 70% reduction in medication use, along with reductions in heating pad use, exercise used for pain management, and other interventions.
In terms of timing, 87% of reported suppository uses were associated with relief within 60 minutes. Relief lasted more than four hours for 30% of uses, three to four hours for 32%, and two to three hours for 24%.
The product was generally well tolerated in this program evaluation. Out of 287 suppository uses, 4% included reports of “feeling high,” 4% included reports of negative effects, and 1.7% included reports of allergic reactions. Among the 79 participants who completed the study, 93% agreed or strongly agreed that they experienced less pain while using the product, and 85% agreed or strongly agreed that it improved their overall quality of life.
These findings are meaningful, but they should be interpreted with appropriate caution. The study was open-label, did not include a placebo group, was not blinded, followed only two menstrual cycles, and included a participant population that was predominantly white and between ages 31 and 50. The authors concluded that more robust, placebo-controlled studies with more diverse populations are needed.
How this fits with other research
This real-world outcomes report builds on another 2024 study published in npj Women’s Health, which evaluated a high-CBD vaginal suppository for menstrual-related pain and discomfort. That survey-based, quasi-experimental study assessed a commercially available 100 mg broad-spectrum CBD suppository and found improvements in menstrual-related symptoms compared with treatment as usual.
Together, these two publications suggest that cannabinoid suppositories may be a promising area of investigation for menstrual-related pain. They also show why the details matter. One study evaluated a broad-spectrum high-CBD product with no detectable THC, while the newer real-world report evaluated a full-spectrum, whole-plant product with CBD, naturally occurring THC, minor cannabinoids, and terpenes. These are not identical interventions, but showcase how science is beginning to catch up with women’s lived experiences. Future research should continue to compare formulations, doses, routes of administration, safety, side effects, and patient-reported outcomes.
The access gap: women’s health conditions and medical cannabis policy
Across the United States, medicinal cannabis use laws vary dramatically. The National Conference of State Legislatures maintains a broad overview of state medical cannabis laws and notes that medical cannabis programs differ significantly by state, including what conditions qualify and whether programs are comprehensive or limited to low-THC/high-CBD products.
However, women’s health conditions are often not centered in medical cannabis policy discussions. Rarely are state-state qualifying conditions noted for female-specific diagnoses such as dysmenorrhea, endometriosis, chronic pelvic pain, ovarian cysts, uterine fibroids, or other gynecologic conditions. In some states, patients may only qualify if their symptoms fit broader categories such as chronic pain, severe nausea, PTSD, or another approved diagnosis. That creates an uneven system where someone’s access may depend less on the severity of their symptoms and more on the wording of their state’s qualifying-condition list.
Some states, however, have begun to make progress. In January 2025, the Illinois Department of Public Health approved four new conditions for treatment through the state’s medical cannabis program: endometriosis, ovarian cysts, uterine fibroids, and female orgasmic disorder.
Why patient-reported outcomes matter
Patient experience often reveals gaps that formal research has not yet caught up to, especially in areas that have historically been underfunded or under-prioritized.
Realm of Caring has long emphasized the importance of observational research and real-world evidence. When people share their experiences through structured data collection, they help researchers and healthcare professionals better understand how cannabinoid therapies are being used, what outcomes patients are reporting, what side effects may occur, and where more rigorous clinical studies are needed.
This is especially important in women’s health. As Realm of Caring discussed in our previous blog, Breaking the Silence: Evidence-Based Cannabis Medicine for Women, conditions such as menstrual pain, endometriosis, menopause-related symptoms, pelvic pain, and sexual health concerns have too often been left out of mainstream cannabis research and policy conversations. The more patients participate in research, the stronger the evidence base becomes for education, clinical guidance, and policy change.
Practical considerations before trying cannabinoid suppositories
For those considering cannabinoid suppositories for menstrual discomfort, education and safety come first.
Not all products are the same. A CBD isolate product, broad-spectrum CBD product, and full-spectrum product may have different effects. Vaginal and rectal administration may also feel different than oral or inhaled routes. Some products may produce systemic effects, including intoxication, depending on formulation, dose, individual sensitivity, and THC or terpene content.
It is also important to review product quality. Consumers should look for third-party testing, clear labeling, cannabinoid content, contaminant testing, ingredient lists, and transparent manufacturing practices. People who are pregnant, trying to become pregnant, breastfeeding, taking medications, managing complex health conditions, or experiencing severe pelvic pain should speak with a qualified healthcare professional.
Severe menstrual pain should not be ignored. It may be a sign of an underlying condition such as endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, or another medical concern. Cannabinoids may help some people manage symptoms, but they should not replace evaluation for persistent, severe, or worsening pain.
Moving women’s health from overlooked to understood
The emerging research on cannabinoid suppositories for menstrual pain is promising. The newly published real-world outcomes report found meaningful reductions in pain, menstrual symptoms, medication use, and other pain management interventions among participants using whole-plant CBD suppositories. But the bigger message is that women’s health should not have to fight for legitimacy.
Realm of Caring is here to help individuals navigate those questions with free, research-informed support. Whether you are exploring cannabinoid therapy for menstrual pain, endometriosis, menopause-related symptoms, sleep, anxiety, or another health concern, our care team can help you ask informed questions, understand product considerations, and talk with your healthcare provider.
