How Cannabis Affects Men and Women Differently: A Scoping Review | Research

The takeaway

Growing evidence shows cannabis produces different behavioral effects in males and females, driven by sex-based differences in the endocannabinoid system, but most cannabis research still fails to adequately analyze sex as a variable.

Anyone interested in how biological sex influences cannabis effects, and researchers designing cannabis studies.

Sex differences found in sensitivity, tolerance, and withdrawal

What the researchers found

This scoping review synthesized evidence on sex-specific behavioral responses to cannabis. The literature reveals that sex differences exist in cannabis sensitivity, tolerance development, withdrawal severity, and various behavioral outcomes. These differences appear to be mediated by hormonal influences on the endocannabinoid system, particularly estrogen's effects on CB1 receptor expression and endocannabinoid tone.

Why it matters

As cannabis legalization expands, understanding sex-specific effects becomes increasingly important for both public health messaging and clinical applications. Much of what we know about cannabis effects comes from male-dominated research, potentially missing important differences in how women respond.

The numbers in context

The review covers multiple domains of sex differences but notes that many studies still do not adequately report or analyze sex-specific outcomes.

How the study worked

Scoping review focused on tetrahydrocannabinol (THC) as the principal psychoactive constituent. Examined preclinical and clinical literature on sex differences in cannabis use patterns, behavioral effects, and endocannabinoid system function.

What this study cannot tell us

Scoping review provides breadth but not the statistical rigor of a systematic review. Predominantly focused on THC, with less coverage of CBD and other cannabinoids. Much of the mechanistic evidence comes from animal studies. Clinical data on sex differences remain limited.

How to read the evidence

Moderate: broad scoping review synthesizing preclinical and clinical evidence, though not a systematic review with formal quality assessment.

When this study was published

Published in 2025.

The bigger picture

The push to include sex as a biological variable in research (mandated by NIH since 2016) is slowly changing the cannabis research landscape. This review highlights just how much remains unknown about sex-specific responses and underscores the importance of designing future studies that can detect these differences.

Questions still open

Should cannabis dosing recommendations differ by sex?
How do hormonal fluctuations across the menstrual cycle affect cannabis response?
Do sex differences in cannabis effects change with age or menopause?

Common questions

Does cannabis affect men and women differently?

Yes. Research shows sex-based differences in cannabis sensitivity, how quickly tolerance develops, withdrawal severity, and various behavioral effects. These differences appear linked to hormonal influences on the endocannabinoid system.

Why might women respond differently to cannabis than men?

Estrogen influences CB1 receptor expression and endocannabinoid tone, which can alter how THC is processed and experienced. Hormonal fluctuations may also affect cannabis sensitivity throughout the menstrual cycle.

Read the original research

Sex-specific responses to cannabis exposure: Implications for behavior and beyond.

Brain research bulletin, 230, 111530

View on PubMed ↗Publisher’s paper ↗

Citation

Rogers, Sophia; Seelke, Adele M H; Mederos, Sabrina L; Bales, Karen L. (2025). Sex-specific responses to cannabis exposure: Implications for behavior and beyond.. Brain research bulletin, 230, 111530. https://doi.org/10.1016/j.brainresbull.2025.111530