Menstrual pain—If you know, you know.

It can be mild or excruciating—like knives slicing through your insides, your lower midsection and back gripped in pain. I spent my early adolescence and college years taking an insane amount of Advil Liqui-Gels (still waiting on that stomach ulcer), often repeatedly pressing a heating pad against my lower abdomen to just somehow get the heat and relief to travel directly to my uterus.

That kind of targeted dulling of the pain is what I find in cannabis. For the last seven years, cannabis is the closest I’ve come to a real, lasting sense of relief.

This probably goes without saying, but cannabis hasn’t faced the kind of double-blind, placebo-controlled trials other drugs have.

“We don’t even have enough studies to show that CBD gets through the skin, for example, into the bloodstream,” said Dr. Melanie Bone, an obstetrician-gynecologist in West Palm Beach, Fla. who specializes in cannabis.

Still, women have turned to cannabinoids for relief from menstruation symptoms for millennia. Cannabis’ main active ingredients—THC and CBD—interact with nerve cell receptors to mellow inflammation, pain, muscle spasms, and balance mood. The human brain, pelvis, and reproductive organs—male and female alike—are chock full of these CB1 and CB2 receptors.

“You give someone CBD cream, and they have pain management. But we haven’t really established how that happens,” Dr. Bone said.

Of course, everybody is different. And pain is such an abstract, impossible-to-measure thing.

Concretely, I’ve been using cannabis for this sort of pain relief for about seven years, constantly asking for new product suggestions at dispensaries. I’ve tried creams, balms, patches, sprays, edibles, tinctures, and for this article, even a suppository (never wanted to try them before). This is what I’ve found, in my experience, works best.

Products reviewed in this article:

Leafly Pick: Spray

Dr. Kerklaan Therapeutics Natural Pain Spray

The Dr. Kerklaan Therapeutics topical lineup set against white. (drkerklaan.com) BAS Infused Products (PRNewsfoto/BAS Research)
Dr. Kerklaan Therapeutics (drkerklaan.com) BAS Infused Products (PRNewsfoto/BAS Research)

This spray is my all-time favorite product for menstrual pain relief. About three years ago, I walked into a dispensary in Silver Lake looking for Papa & Barkley transdermal patches. They didn’t have them but the guy behind the counter suggested this—he told me his girlfriend uses it for cramps. I was skeptical because I had tried so many other things that never worked. And the spray wasn’t cheap—around $50 at the time.

After trying it, however, I was a believer. The pain in my lower belly eased away, giving me a sense of relief so many other products have failed to deliver. This spray can reach up to around $70 with California’s heavy tax, depending on the store. However, it ends up being cheaper than transdermal patches for me. I had a 60 ml bottle (containing 60 mg THC) that lasted well over a year, and I can get multiple uses out of it during one menstrual cycle.

Dr. Andrew Kerklaan, founder and president at Dr. Kerklaan Therapeutics, worked as a chiropractor for 20 years. He often treated patients suffering severe menstrual pain or even endometriosis, he said, targeting “really tight muscles, muscle tension, lower back pain, and abdominal discomfort” through stretching, spinal work, and other chiropractic treatment. But once medical cannabis became legal in Canada, where he’s based, he started looking into it.

“I was really amazed at the kind of scientific physiological research as to how cannabinoids CBD or THC can help with muscle tension and pain perception and inflammation,” Kerklaan said. “I started to share that with patients and saw some amazing results with them.”

The brand also has a PMS cream available, which Kerklaan said his wife helped him develop. It has a “more soothing or calming” vanilla profile as opposed to the eucalyptus and peppermint in the spray, he said.

The science of cannabinoids versus periods

Medical experts and researchers suspect the endocannabinoid system, and its effects on hormones offer therapeutic opportunities.

For example, Dr. Bone flagged a certain type of hormone overproduction for which cannabinoids may promote homeostasis.

“THC and CBD interact with receptors both centrally in the brain, and peripherally in the pelvis,” Bone said. “One good reason why I think cannabis can help with menstrual cramps is, for example, what causes menstrual cramps? Often it’s the prostaglandins produced in the pelvis.”

These lipids are produced during menstruation, and a higher number of them has been associated with inflammation and more severe uterine contractions, as explained in a study published last year in the International Journal of Environmental Research and Public Health.

“The prostaglandin pathway shares a lot of similarities with the cannabis pathways. And so it seems to me that the cannabinoids (THC and CBD) can set out reactions that end up decreasing the number of prostaglandins in the pelvis,” Bone said, describing this theory as “a pretty common thought about the way it might work.”

Transdermal patches

Papa and Barkley Releaf Patch 1:3 THC rich

A product picture of a Papa and Barkley relief patch package. (Courtesy Papa & Barkley)
Weird period from COVID vaccination? Get releaf. (Courtesy Papa & Barkley)

The first time I used this patch, it felt like the pain in my lower abs was literally being melted away. Like a massage to my insides. This is my go-to when my cramps are super extreme—when Advil, smoking cannabis, a warm shower, and a heating pad is all just not cutting it. It’s a slow-release transdermal patch intended to give 12 hours of pain relief. I stick it onto my lower abdomen, and it can usually get me through an 8-hour workday.

Since I have a pretty high tolerance, I purchase the 1:3 THC-rich ratio—they offer varying CBD: THC ratios in their products. If you have a tolerance on the lower side, or just don’t want to be feeling too high, you should probably opt for the 1:1 CBD: THC ratio, said Sara Kern, a brand spokesperson. She said the patches are a fan favorite for cramps.

Papa & Barkley plans to release products specifically marketed and formulated for menstrual pain relief, hopefully sometime next year, said President and Chief Product Officer Guy Rocourt.

“We are looking to add products like suppositories, which are very effective when it comes to things like endometriosis,” Rocourt said.

Leafly reviewers’ best weed strains for menstrual cramps

Endometriosis—a condition in which tissue similar to the lining of the uterus grows in other parts of the body—can leave one with particularly painful, even debilitating menstrual cramps among other side effects.

This patch usually retails for around $15. Dispensaries around Southern California, where I live, sell it for around $13 to $20. So it’s not the most affordable option since it’s a one-time use deal. But, for me, it really works.

Mary’s Medicinals transdermal patch


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