Marijuana Use for Women: To Prescribe or Not to Prescribe

The marijuana policy varies greatly worldwide. Marijuana use is illegal in most countries. Nevertheless, the medical potentials of marijuana have been increasingly uncovered, and its use by women is increasing. Objectives: Herein we aimed to share some of our perspectives on the hot important topic: marijuana use for women. Methods: We reviewed publications indexed in PubMed reporting the benefits and harms regarding the medical use of marijuana for women and its impact on offspring. Results: For non-pregnant women with some long-lasting conditions refractory to regular management, marijuana could be prescribed as potential new hope with acceptable safety profile based on current evidence. However, the side-effects especially long-term consequences are cautionary. For instance, for adolescents and young women, cannabis might affect their neuronal development and increase stroke risk. Notably, cannabinoids might promote proliferation of breast cancer cells. The potential harms should be carefully weighed against the benefits associated with cannabis. Cannabis use in pregnant or lactating women increases the risks of offspring exposures, and should be mostly avoided. Prenatal marijuana exposure might affect fetal growth and be teratogenic. The psychoactive cannabinoid tetrahydrocannabinol (THC), a partial agonist of human endocannabinoid system, could cross placental barrier, and adversely affect fetus brain development. THC could also affect the maturation of multiple neurotransmitter systems. The neurobehavioral consequences include impaired arousal and psychomotor functions at birth and disturbed sleep and higher-order executive functions in childhood. For mothers, the short-term and long-term side-effects, withdrawal syndromes, and use disorder associated with use of marijuana especially high-potency cannabis could all adversely affect their ability to care children and thus child development and safety. However, if the disease itself more dramatically tortures maternal behavior which could otherwise be alleviated by marijuana, then the use could somehow be justified. Conclusions: Benefits and risks for both the patient and the offspring especially in the long term regarding marijuana use should be carefully weighed for each specific case. Standardized dosing and duration of treatment need to be determined. Recommendations should be made by physicians with expert training and after careful patient evaluation for fully informed patients, whose preference should be respected. Legislations should encourage more active basic, translational, and clinical studies.