CBD cocktail as effective as ibuprofen in reducing menstrual pain
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Flow Formula, a botanical blend containing CBD, was as effective as ibuprofen in relieving menstrual pain symptoms, according to results of a randomized, placebo-controlled, double-blinded trial.
Data show that 5% to 10% of ovulating women with moderate menstrual symptoms and 5% or less with severe menstrual symptoms report that these symptoms affect their daily lives, according to researchers.
Allen Morgan MD, a reproductive endocrinologist and infertility specialist in Lakewood, New Jersey, told Healio Primary Care that he developed Flow Formula (cannabidiol botanical blend, Maxine & Morgan) after his daughter developed an ulcer from using NSAIDs for severe menstrual cramps.
Besides CBD, the product contains turmeric, ginger, cramp bark, fennel seed and valerian root. According to Morgan, the ingredients were selected based on data from previous randomized controlled studies.
For the current analysis, Morgan and colleagues from the Hackensack Meridian Health Jersey Shore University Medical Center and Morgan Fertility and Reproductive Medicine randomly assigned 71 women to receive the cannabidiol botanical blend, ibuprofen or placebo for the first 4 days of three menstrual cycles. Among the participants, 51 completed numeric rating scales for pain before and after receiving the study drug, as well as a quality-of-life survey and questionnaire about symptom severity.
The results, which were presented at the virtual American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting, showed that women who received the cannabidiol botanical blend reported similar reductions in pain scores compared with those who received ibuprofen. On day 1, the cannabidiol botanical blend was significantly more effective than ibuprofen and placebo in reducing nausea, according to the researchers. By day 3, the cannabidiol botanical blend was significantly more effective in reducing cramping, irritability and moodiness than the other two treatments. No adverse events were reported.
Regarding safety, Morgan said that WHO’s worldwide review on CBD in 2017 indicated that adverse events tied its use are “limited” and usually include tiredness and diarrhea. The report also indicated that CBD has no “effects indicative of any abuse or dependence potential” and that there is “no evidence of ... any public health-related problems associated with the use of pure CBD.”
“There is an alternative to nonsteroidal anti-inflammatories that is easier on the tummy and reduces the symptoms of premenstrual syndrome and menstrual symptoms,” Morgan said.
References:
Cheng C, et al. Is a CBD botanical blend beneficial for Menstrual Symptoms? Presented at: American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting; April 30-May 2, 2021 (virtual meeting).
Kraemer GR, Kraemer RR. J Womens Health. 2009:doi:10.1089/jwh.1998.7.893.
Johnson SR. Clin Obstet Gynecol. 1998;doi: 10.1097/00003081-199806000-00022.
WHO. Cannabidiol (CBD). Pre-Review report. https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf. Accessed May 10, 2021.
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Although understanding the science behind CBD is limited and the placebo effects are huge, it is reasonable to offer CBD knowing its role in the management of other pain. The side effects are minimal, so it is worth a try if patients are interested (and if what they are choosing is not expensive.)
I would recommend physicians ask their patients what they are using for their painful periods, since many are likely using CBD and we will not know unless we ask. We also need to continue to do the usual workup for causes of the pain and explain the rigorous science behind FDA-approved medications.
Legislative Chair, Illinois Section of the American College of Obstetricians and Gynecologists
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This is an interesting study.
The findings suggest that CBD supplementation may be as effective for reducing menstrual pain and nausea as ibuprofen. However, it is important to note that (to my knowledge) this is not a published study that has been peer‐reviewed (conference abstracts do not undergo the rigorous review that a journal would employ).
Until the study has been published in a scholarly journal and undergone peer review of the methodology, analyses and interpretation of the outcomes, I would not make too much of this. Nonetheless, there is literature to suggest that CBD could impact menstrual pain, so the findings by Morgan and colleagues are encouraging, and it will be interesting to see if they are published.
Visiting professor of health psychology, Princeton University
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