Clinical Guideline: Cannabis Effects on Women's Fertility, Contraception, Menopause, and Pelvic Pain | Research

The takeaway

A Canadian clinical guideline provided evidence-based recommendations on cannabis use across women's lifespans, covering fertility, contraception, menopause, and pelvic pain, using GRADE methodology.

Obstetricians and gynecologists; family medicine physicians; midwives; women considering cannabis use during reproductive years.

First major guideline addressing cannabis across women's lifespan health stages

What the researchers found

The guideline addressed cannabis effects on hormonal regulation, reproductive health, sexual function, perimenopausal and menopausal symptoms, and chronic pelvic pain. It emphasized trauma-informed care, non-stigmatizing approaches, and the need for evidence-based dialogue between providers and patients.

Why it matters

Women of reproductive age are among the fastest-growing cannabis user groups, yet clinical guidance on women-specific health effects has been lacking. This guideline gives clinicians an evidence-based framework for conversations that many are currently having without guidance.

The numbers in context

Search covered 2018-2021. Used MeSH terms for cannabis combined with women's health terms (estrogen, contraception, fertilization, menopause, dysmenorrhea, endometriosis, etc.). GRADE methodology applied for recommendations.

How the study worked

Clinical guideline developed by the Society of Obstetricians and Gynaecologists of Canada. Systematic search of PubMed, EMBASE, and grey literature (2018-2021). Evidence graded using GRADE approach. Covered fertility, contraception, menopause, and pelvic pain.

What this study cannot tell us

Canadian healthcare context may not generalize to all settings. The 2018-2021 search window may miss older foundational studies. Many recommendations are based on low-quality evidence given the limited research in women-specific cannabis effects.

How to read the evidence

Strong: formal clinical guideline from a national medical society using GRADE methodology and systematic literature search.

When this study was published

Published in 2022.

The bigger picture

This is one of the first major clinical guidelines specifically addressing cannabis across the spectrum of women's health concerns. It fills a critical gap as cannabis use during pregnancy, fertility treatment, and menopause becomes more common.

Questions still open

Will similar guidelines be developed in other countries? How should the guideline be updated as new evidence emerges? Would cannabis-specific screening tools for women's health settings improve care?

Common questions

Does cannabis affect fertility?

The guideline reviewed evidence that cannabis may affect hormonal regulation and reproductive health. Specific recommendations were provided using GRADE methodology, though much of the underlying evidence was rated as low quality.

Should women tell their doctor about cannabis use?

Yes. The guideline emphasized that providers should ask about cannabis use in a non-stigmatizing, trauma-informed way. Open dialogue allows for better care decisions, especially regarding fertility, pregnancy planning, and symptom management.

Read the original research

Guideline No. 425a: Cannabis Use Throughout Women's Lifespans - Part 1: Fertility, Contraception, Menopause, and Pelvic Pain.

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 44(4), 407-419.e4

View on PubMed ↗Publisher’s paper ↗

Citation

Robert, Magali; Graves, Lisa E; Allen, Victoria M; Dama, Sumeet; Gabrys, Robert L; Tanguay, Robert L; Turner, Suzanne D; Green, Courtney R; Cook, Jocelynn L. (2022). Guideline No. 425a: Cannabis Use Throughout Women's Lifespans - Part 1: Fertility, Contraception, Menopause, and Pelvic Pain.. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 44(4), 407-419.e4. https://doi.org/10.1016/j.jogc.2022.01.012