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This Is Your Period on Drugs

Throughout history, the mystery of menstrual pain has been treated with cocaine, liquor, and even opium. Now, cannabis is taking center stage.

It’s not hyperbolic to say that most menstruating people experience pain along with their periods. Research has indicated that more than 80 percent of people with periods have experienced cramping or other discomfort during that time of the month, and about half experience regular pain with each cycle.

To treat the pain — whether it’s primary (caused by uterine contractions) or secondary (caused by other factors, like polyps, cysts, or something more serious) — many people turn to over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, naproxen sodium, or a combination, like Midol, which offers several formulas that include caffeine and multiple drug cocktails. This is one of the more accessible and easy ways to seek relief, though these medications are certainly not a certain cure; one study last year found that only about 31 percent of women and girls who took an anti-inflammatory for their period pain got any relief.

Even when these drugs do work, taking them every month for, oh, let’s say 50 years has plenty of drawbacks. Over time, just about every kind of drug for pain can become less effective and even wear on the liver.

As a result, some may seek a more herbal remedy for their cramps.

In 2016, Whoopi Goldberg — yes, that one — co-created a line of cannabis-infused products specifically for the purposes of treating menstrual pain. Goldberg and her business partner, Maya Elisabeth, took advantage of new legalization laws on the West Coast and created Whoopi & Maya, a company offering cannabinoid-infused wares including oils and edibles.

The new Wild West of cannabis has previously been viewed as a male-dominated field, but as more and more women stake their claim, this exploration into the connection between pot and periods is growing. And while the approach is novel — and the idea of creating products specifically for treating menstrual pain without harsh chemicals is certainly welcome by many who are tired of popping pills every month — the instinct (to treat pain with feel-good substances) itself is most certainly not.

Cannabis — as well as many other drugs, including opium and cocaine — has been used to treat menstrual cramps for centuries, going back to the introduction of the herb into British medicine in the 1840s.

Dating back to the dawn of medicine, male doctors (because of course they all were male back then) have tried to find ways to relieve the sometimes mild, sometimes debilitating pain that accompanies menstruation. They’ve prescribed rest and exercise, heat and ice, topical treatments, and even suppositories — all for a sensation that the doctors themselves had never felt.

The Mystery of Dysmenorrhea

How does a 17th-century doctor provide treatment for a mysterious chronic illness that has no symptoms (other than the bleeding) and no clear cause? In the case of menstrual pain — also referred to as dysmenorrhea, both then and now — this question has vexed the medical community for centuries.

Because for centuries the overlap between “people who menstruate” and “people who practice medicine” was nonexistent, medical professionals, faith healers, and village quacks — again, all male — were all shooting in the dark.

In medical journals from the 19th century, doctors theorized that painful periods may have something to do with the shape or placement of the uterus or ovaries (a “misplaced” uterus was a common diagnosis) or the size of the cervix. Removal of the ovaries was sometimes recommended, as was inserting chemicals —such as a “cotton tent soaked in iodized phenol,” an acid that’s found in some numbing agents and used in fertilizers and the manufacturing of plastics.

Still, some women found their pain treated with even more painful procedures, including lancing or sounding of the cervix with a “wire curette” or another equally brutal device. Also listed in the medical journals as potential cures for menstrual pain: “hot douches,” “purgatives,” exercise, and cauterization with silver nitrate.

Another popular theory was that menstrual blood was getting backed up in the uterus, causing the discomfort, though this was contentious. One lecture given in 1890 noted that “it seems obvious at first sight that the cause of the pain is the plugging of the canal by the membrane, but further consideration shows this to be only partially, if at all, correct.”

“Further consideration” in this case meant numerous experiments wherein the doctor passed objects through the cervix to determine whether there was “any collection of blood.” The pain and the size or “vent” of the cervix were not, it was determined, related.

Another theory was that menstrual pain was actually psychosomatic. Rather than being caused by an actual physical malady, the monthly cramping, aching, and general discomfort resulted from a psychological disorder brought on by one’s female organs or body parts (see: the etymology for the word “hysteria”). For this, women were often sent to mental health experts for treatments including talk therapy, antidepressants, and sedatives. None of these fully addressed the pain of a period, though, and doctors and patients alike continued to look for relief.

A Very Dope Period

As they poked and prodded and hunted for a reason for periods to be so painful, the best that doctors could do in many cases and for many centuries was to provide palliative care, which often came in the form of commonly occurring herbal remedies, powerful narcotics, heavy doses of liquor — even cocaine.

In Transactions of the American Gynecological Society, Volume 4, published in 1880, we see evidence of a number of drugs used to treat period pain, including cannabis and “narcotic rectal suppositories.”

Cannabis, in fact, was a common prescription for period pain — and had been for decades. In Breverton’s Complete Herbal, Terry Breverton described the use of cannabis in modern medicine dating back to 1842:

In Victorian times it was widely used for a variety of ailments, including muscle spasms, menstrual cramps, rheumatism, and the convulsions of tetanus, rabies and epilepsy; it was also used to promote uterine contractions in childbirth, and as a sedative to induce sleep.

Opium, too, was used frequently — so frequently, in fact, that some doctors began looking for alternatives. Writing in The American Journal of Obstetrics and Diseases of Women and Children, Volume 21, a Dr. J.N. Friedman stated that women affected by painful periods would often turn to the “habitual use of opium” when “helpless” doctors have no other recourse but removal of the ovaries. Instead, he suggested, doctors prescribe gelsemium, a supplement derived from a flowering plant that works as a painkiller but can also swiftly lead to lethal toxicity.

Cocaine was used to relieve the pain associated with cramps, menstruation, and labor, particularly in the early stages. A 1917 paper on “painless childbirth” describes employing a “tampon soaked in a freshly prepared solution of 2 per cent cocaine,” as recommended by the British Medical Journal.

Cannabis: Way better than opium.

Of course, none of these drugs were illegal at the time. Cannabis, opium, and even cocaine, all of which had been used by early humans for a variety of purposes, remained largely available for medicinal, recreational, and even edible purposes until well after the turn of the 20th century.

Opium, specifically, was viewed as a kind of cure-all for many years, until the U.S. federal government targeted its manufacture and use in medicine — not due to safety concerns, but because it had become a symbol of Chinese influence on American society.

Another problem with opium was that it was too enjoyable. Women who used it may have found relief for their pain — in addition to pleasure in other areas, including sex. As Diane L. Ahmad notes in The Opium Debate and Chinese Exclusion Laws in the Nineteenth-Century American West, “America’s values might be threatened with the use of medicinal-opium.”

Plenty of other drugs — and roots and herbs and other chemicals — have also historically been used to try to treat “female troubles.” And because capitalism is a powerful driver of innovation, the continual experimentation and demand have spurred generations of entrepreneurs to create tonics, potions, lotions, and other compounds to sell, promising relief.

Excerpt from “Pinkham’s Pamphlet,” wherein a woman sings the praises of serving her daughter a stiff drink each month.

One of the most famous period-specific products of the 20th century was Lydia E. Pinkham’s Vegetable Compound. Pinkham, a schoolteacher and abolitionist living in Massachusetts in the middle of the 19th century, brewed her alcohol-based tincture for “female complaints” at home. The treatment contained a number of herbs and roots that had long been used in folk medicines and by Native Americans, including “false unicorn” and milkweed — and it was so popular with her friends and neighbors that she eventually began to sell it.

Pinkham’s products were said to aid much more than just cramps. The pamphlets that Pinkham distributed (which also contained recipes and homemaking ideas) included letters from women hailing her goods for the successful treatment of everything from infertility to constipation.

The company still exists today, though the products are a bit different. Chiefly, the FDA required the packaging to be clearly labeled, revealing that the vegetable compound was basically a high-proof liquor with some roots and herbs included.

Many of the drugs marketed as “for women” weren’t just to relieve pain; some were actually covert abortifacients. Playing to the aforementioned idea that menstrual cramps were the result of “blockage,” products like Dr. Hardy’s Woman’s Friend stated that they could “prevent miscarriage” while also assuring the user that it could help “pass the critical periods of life.”

Dr. Lyon’s French Periodical Drops, which were marketed as a “perfectly harmless” remedy for basically any kind of uterine pain, were advertised in magazines and newspapers for years. According to the literature, they could help relieve pain, cure morning sickness, and aid in any “irregularities.”

“Desired results.” Source: NYSHistoricNewspapers.com

However, according to the Kansas Board of Health’s biennial review for the year 1909, the tincture wasn’t particularly honest in its marketing.

In addition to containing a high volume of alcohol, the formula was simply “an aromatic solution of ergot and oil of savin”—both toxic ingredients known to cause uterine contractions.

Modern Times and Medical Marijuana

Mentions of cannabis as a potential treatment for dysmenorrhea are frequent in the medical journals of the late 19th and early 20th century. In prominent journals, including the Lancet and Progressive Medicine, as well as textbooks, cannabis is hailed as a way to relieve pain without the side effects of other chemicals, like coal tar. It’s mentioned as “certainly preferable to opium” in one 1908 journal.

However, as cannabis became highly racialized in the 20th century in the United States, it became associated less with pain relief and more with societal ills. Used as a weapon against marginalized people — specifically, African-Americans and Latinx folks — cannabis has remained largely the same, though its public perception has changed dramatically.

Only in the past decade, with new advancements in medical marijuana research and relaxation or repeal of the laws that criminalize recreational use, have users felt comfortable enough to come out, so to speak, about what the drug has done for them.

Specifically, menstruating people have been more open about the fact that just as cannabis offered a safer alternative to opium, cocaine, or even liquor, it’s also a preferable option over today’s opioid painkillers and over-the-counter medications.

However, as Whoopi Goldberg told Marie Claire in an interview, the burgeoning legal-weed market still hasn’t managed to catch on to period pain in a big way because, she says, “the people who are running it are pretty much all dudes, so they don’t know anything about periods…If you had women running the weed market, I think there’d be lots of different products. I know periods. I know how horrible they are, and I know enough people who suffer from them that I really want to speak to them so they can carry something in their pocketbook for relief.”

The reception for Goldberg’s products has been warm, particularly since so many people with periods have learned to just live with the pain: “The world still doesn’t fully recognize the pain we women go through,” wrote BuzzFeed’s Lara Parker, who tried the Whoopi & Maya products for her endometriosis. And while the cannabis-infused products weren’t a “cure-all,” Parker noted that she “was pleasantly surprised when they actually did make my period more comfortable.”

There are still few women in the cannabis industry (though the tide is shifting) and relatively few products readily available — especially for folks who live in states with strict marijuana laws. But the demand certainly seems to be there, in large part because people with periods have been putting up with weird and ineffective solutions for centuries and are willing to try just about anything for some relief.

Since the dawn of medicine, doctors have tried to find ways to relieve the sometimes mild, sometimes debilitating pain that accompanies menstruation.

Dysmenorrhea is still a shadowy figure in the medical community — doctors are pretty sure they know that contractions primarily cause cramps, though actually curing them is elusive — but hard drugs aren’t the go-tos any longer.

Instead, it’s painkillers, heating pads, and calling in sick. If you have a particularly cool doctor, thanks to a wave of women getting involved in the explosive cannabis industry, you may also get a scrip for illicit (or formerly illicit, if you live in states like California, Colorado, or Washington) substances to ease those painful periods.

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