Many products containing CBD claim to help women with various health issues, including sleep, mood, symptoms of PMS or menopause, and sexual pleasure. Currently, very little evidence supports these extravagant promises, and there are concerns about the quality and safety of CBD products. Dr. Sarah Lichenstein is leading a study on how CBD may affect behavior and the brain to determine how it affects women and if it affects women and men
Why are women using CBD products — and do they work?
Cannabidiol (CBD) oil and other products containing CBD are being touted as a natural, organic remedy for a wide range of women’s health concerns. Sellers of these products make many claims: CBD has calming effects on sleep, mood, and anxiety; eases hot flashes and improves bone density by balancing hormonal changes of menopause; and has anti-inflammatory properties that clear skin, cure acne, and calm rosacea. It’s promoted for PMS symptoms like bloating and mood swings. And CBD-infused lubricants claim to boost arousal and enjoyment of sex. So, how much of this is true?
First, what is CBD?
CBD is a major ingredient in cannabis plants (like hemp and marijuana). It comes in different strengths and forms, often as CBD oil, but also in pills and powders. It can be absorbed through the skin, ingested, or inhaled. (Vaping it, however, may not be safe, as this blog post and web page from the CDC explain.)
Unlike marijuana, pure CBD products don’t make you feel high. A different ingredient in marijuana called THC makes people feel high.
Does CBD have proven benefits?
So far, there’s not much evidence on the medical benefits of CBD, partly because laws on marijuana made it difficult to study. Until we learn more, it’s wise to keep in mind that few high-quality studies have been done.
- In 2018 the FDA approved a drug derived from CBD to treat rare forms of childhood epilepsy. This medication was shown in randomized clinical trials to reduce the frequency of seizures (see here and here).
- A few studies have found CBD may improve anxiety, but the studies were small and of poor quality (see here and here).
- Some laboratory research on human cells suggests CBD may have anti-inflammatory effects on oil-secreting glands in the skin. This might have implications for acne and other inflammatory skin disorders, but further research is needed to confirm this. And while CBD in skin products is unlikely to harm you, most dermatologists agree that there are more effective and better-studied medications and treatments for acne and inflammatory skin disorders.
Other potential benefits of CBD aren’t clear. No high-quality research shows that CBD improves sex drive, decreases pain, treats depression or mood disorders, decreases PMS symptoms like bloating and cramps, or relieves symptoms of menopause like hot flashes. This may change as more studies are done, but for now, the jury is out.
Are CBD products safe?
The short answer is this: pure CBD seems to be safe for most people. However, we don’t have rigorous studies and long-term data to prove whether or not a wide range of CBD products are safe for everyone. For example, there is no evidence to suggest that CBD is safe during pregnancy or breastfeeding, or for people who are immunocompromised.
Because CBD products aren’t regulated by the FDA in the way that drugs are, there is huge variation in quality and, quite possibly, safety. In 2017–2018, counterfeit CBD oil was found that contained synthetic cannabinoids and led to a poisoning outbreak in Utah.
Testing shows purity and dosage can be unreliable in many products. One study found less than a third of the products tested had the amount of CBD shown on the label. Another study of 84 CBD products bought online showed that more than a quarter of the products contained less CBD than stated. In addition, THC (the component that can make you feel high) was found in 18 products.
Does CBD cause side effects?
CBD can cause side effects like dry mouth, diarrhea, reduced appetite, and drowsiness. Additionally, it can interact with certain medicines, such as blood thinners and antiseizure drugs. If you would like to start using CBD products, it’s best to first talk to your doctor.
There are a lot of extravagant product claims out there about the benefits of CBD for women, but little high-quality research supports them. CBD oil and other CBD products aren’t well regulated. It’s possible what you are buying is counterfeit or contaminated. Before using CBD — especially if you plan to vape or ingest it — first talk with your doctor or healthcare provider to learn whether it could be safe and helpful for you.
About the Authors
Rose McKeon Olson, MD , Contributor
Rose McKeon Olson, MD, is a resident physician in internal medicine at Brigham and Women’s Hospital. She has special research interests in gender-based violence, social medicine, and global health equity. See Full Bio
Eve Rittenberg, MD , Contributor
Eve Rittenberg, MD, is assistant professor of medicine at Harvard Medical School and a primary care internist at the Fish Center for Women’s Health at Brigham and Women’s Hospital. Her interests include women’s health, trauma-informed care, … See Full Bio
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I am a 55 year old woman who has suffered with neuropathy since 2004 (amplified by a trauma in 2011); as well as a sciatic nerve issue and other complication since my trauma. One thing I found out (very quickly!), many of the drugs (natural or not) are either recomended for short term relief and used very long term, or the probable cause of added, often more sever, side effects. I don’t believe, for me personally, any medication that has the potential to do more harm than good, especially when it can only treat symptoms and not the cause, would be ideal, unless there is ‘no other option’ or perspective hope. Limited and controlled ecersizes along with diet, seem to have worked best for me personally; but, yes it is very difficult many days. However, I plan to watch my grandchild grow-up, and I plan to do that watching with as clear a mind as possible for today and tomorrow. Side-effects of CBD have been relatively unstudyed or unpublished for lack of verification. That is not promising. All of that being said, I am sure for some people CBD oil could be a God send of relief, most especially for some seizure and cancer patients.
Cannabis Sativa and Hemp are two different plants. Marijuana is not a plant, it’s a slang term used by rhetoric spewing racists seeking to profit from a new prohibition. How can you publish this when you clearly don’t know the basics?
As a woman with a cervical level spinal cord injury, who has experienced many benefits through the use of CBD … this article had absolutely no relevance to its title.
How Does CBD Affect Women? WHRY Fills Gaps in the Science of an Exploding Market
WHRY is launching a study on how CBD may affect behavior and the brain to determine how it affects women and if it affects women and men differently.
Google the three-letter acronym “CBD,” and you will receive 177 million results. For comparison, a search for “FBI” produces 213 million hits, “IBM,” 305 million, and “FDR,” just 51.3 million. Do you know what CBD is? More important, do you know what it does?
CBD is short for cannabidiol, a seemingly non-intoxicating compound of the cannabis plant, as opposed to tetrahydrocannabinol (THC), the major psychoactive component responsible for the drug’s euphoric effect.
CBD is the main active ingredient in a growing category of products sold in all 50 states with little regulation. The substance can be found in nasal sprays, food supplement powders, skin patches, suppositories, capsules, chocolates, coffee, beer, gummies, lollipops, macaroni and cheese, hummus, honey, jelly beans, cereal, gum, popcorn, peanut butter, massage oil, lotions, face masks, deodorant, pet treats, and bath bombs.
In 2019, more than 64 million Americans reported trying CBD, the majority of whom are female.
Manufacturers of these products have claimed they can help alleviate anxiety and pain, promote sleep, and treat depression, post-traumatic stress disorder, and more. But there is little research to support these claims or the safety of regularly using such products over time. Currently, the U.S. Food and Drug Administration has only approved the use of CBD to treat two rare, severe forms of epilepsy.
Now, with a grant from Women’s Health Research at Yale, Dr. Sarah Lichenstein is leading a study on how CBD may affect behavior and the brain to determine how it affects women and if it affects women and men differently.
“The majority of research on the neurological effects of CBD in healthy adults derives from a single small study conducted entirely on men,” said Lichenstein, Assistant Professor of Psychiatry at Yale School of Medicine. “If we are to make sure these products are safe and effective — and, if so, determine correct dosing — it is important to complement what has been done in men to understand how CBD affects the brain in women.”
In collaboration with Drs. Sarah Yip and Ayana Jordan, Dr. Lichenstein is focusing on CBD’s potential to treat anxiety disorders, the most common reason cited by CBD users for their interest in these products and a condition that is twice as prevalent among women than men. One in three women will meet the criteria for an anxiety or related disorder in their lifetime. In addition to direct negative impact on well-being, these disorders increase the risk of other significant harmful effects, including interpersonal difficulties, major depression, and suicide, as well as higher health care costs and higher rates of unemployment.
“We know that other substances used by women to manage anxiety, such as tobacco smoking, were once portrayed as non-addictive,” said WHRY Director Carolyn M. Mazure, Ph.D. “Yet smoking is in fact addictive and harder to quit for women compared to men.”
Currently, the most common medical treatment for anxiety disorders are benzodiazepines, medications which are twice as likely to be prescribed to women as men. These medications have been associated with a significant risk of abuse and fatal overdose when combined with alcohol or opioids.
“CBD presents a potentially promising alternative to benzodiazepines for treating anxiety, but there is a huge mismatch between the way these products are being marketed and the state of the science,” Lichenstein said. “We need to know much more about what CBD is doing, how it might operate in women, and if this is different in women and men — particularly as millions of Americans are already using it.”
Needed Research on CBD, Behavior, the Brain, and Women
Dr. Lichenstein’s study seeks to determine brain mechanisms behind how CBD affects the behavior of women, building on currently limited evidence showing that a single dose of CBD affects functional brain responses in healthy men and evidence that sex may influence how cannabis and its constituent compounds affect these responses.
“Most of what we know about how CBD acts on the brain comes from research on animals,” Lichenstein said. “There is evidence it acts on many different neural systems through diverse mechanisms of action, which makes it interesting to study. But also hard to pin down.”
Study participants will take either the FDA-approved CBD oral solution known commercially as Epidiolex or a similarly appearing and tasting but inert placebo. They will then undergo tasks proven to reliably induce low levels of stress in most healthy individuals while inside of a magnetic resonance imaging (MRI) scanner. Researchers will gather data on self-reported measures of anxiety and subjective and physiological effects following the administration of CBD or the placebo while observing and recording activation of the insula and amygdala, areas of the brain associated with stress and anxiety.
Crucially, all participants will be female, providing necessary data to compare with existing male data and to prepare applications for additional external funding for a larger study that can directly compare the effect of CBD on women and men.
Dr. Lichenstein anticipates that CBD’s effects on the insula and amygdala — and associated reduction in perceived anxiety — could be greater in women than in men.
“Women seem to have more exposure from the same dose of CBD,” Lichenstein said. “Preliminary data suggest that women reach peak concentrations more quickly and reach higher concentrations than men.”
However, it is also possible that greater exposure among women could interfere with CBD’s effects on anxiety based on preclinical studies suggesting that neurobiological channels may block the effects of CBD at higher doses and are modulated by the female sex hormone estradiol.
“If there is a point at which higher doses trigger a neurobiological mechanism that blocks the anti-anxiety effects of CBD, that could very likely lead to different effects for women and men,” Lichenstein said.
Such differences, if found in the brain and through an observed effect on anxiety reduction, would indicate the need to establish sex-specific dosing recommendations for CBD.
“We don’t know if or where a dosing cutoff exists for humans in terms of safety or reducing anxiety,” Lichenstein said. “We need research in people with anxiety disorders and research on dosing over long periods of time. But first, we need to take this initial, essential step toward understanding what exactly happens to the behavior and in the brains of women when using this popular but largely unexamined substance.”