Is it Safe to Use Cannabis and Birth Control Together?
With cannabis legalization expanding across the United States, people may use cannabis, or marijuana, for a variety of reasons. They can use cannabis or cannabinoid products to lessen PMS symptoms or for sexual benefits.
What should people know when it comes to reducing pregnancy risk, safer sex and the effects of cannabis on birth control?
What's the deal with marijuana and birth control?
Cannabis is the most commonly used drug in the world (excluding alcohol, tobacco and caffeine). Roughly 48.2 million people used marijuana at least once in the United States in 2019, according to the Centers for Disease Control and Prevention (CDC).
Women of reproductive age appear to be increasing their use of marijuana, a 2019 study suggested.
Studies on marijuana’s effects on reproductive health as a whole are limited and offer no definitive empirical link that marijuana use weakens birth control efficacy or somehow makes it unsafe.
However, specific types of cannabis and hormonal birth control come with varying symptoms, and the type of weed or form of birth control may exacerbate side effects.
For starters, marijuana comes from the cannabis plant. Tetrahydrocannabinol (THC) is a psychoactive substance associated with the high someone feels when consuming cannabis.
Higher doses of THC can cause unpleasant symptoms, including:
- Impaired movement or senses
The other active ingredient in the cannabis plant is cannabidiol (CBD), which does not contain THC. Cannabidiol has been used for its anxiety-reducing and pain-relieving benefits.
THC and CBD have different effects and could impact birth control use in varying ways.
Can you smoke weed on birth control?
While there is scant research about cannabis and birth control, there are studies that suggest smoking cigarettes with birth control is unsafe. There are contraindications to smoking cigarettes and using certain methods of birth control, such as oral contraceptives.
Smoking on hormonal oral birth control, such as combined oral contraceptives, can increase your risk of cardiovascular events, such as heart disease and stroke, and blood clots, according to Mayo Clinic.
It's natural, then, to wonder whether smoking marijuana elevates health risks like smoking cigarettes does. No research links the two, but cannabis side effects could increase the risk of cardiovascular events.
THC increases the heart rate for up to three hours after smoking, which could increase the chances of a heart attack, according to the National Institute on Drug Abuse. More research is needed on the side effects of smoking cannabis with hormonal birth control and cardiovascular risk, and whether or not the risk is similar to that of nicotine.
What are the potential side effects of birth control and marijuana use?
"Although there is no definitive evidence about the risks associated with using marijuana and birth control together, some studies suggest that combining the two could lead to an increased risk of side effects," said Himali Maniar, M.B.B.S., an OB-GYN at Nisha Women's Hospital and IVF Centre in Mumbai. "These may include nausea, headaches, bloating and changes in appetite. In addition, cannabis use has been linked to a higher likelihood of yeast infections or bacterial vaginosis when taking combined oral contraceptives."
Marijuana may shorten the luteal phase of a menstrual cycle by affecting hormones, a 2018 study indicated. Maniar explained that the endocannabinoid system, a network of signals and receptors that is responsible for homeostasis, plays a key role in regulating hormonal balances that affect reproductive health, such as the menstrual cycle.
“Cannabinoids from marijuana have been shown to bind to CB1 receptors, which are found in the uterus and can have an effect on hormones. Studies suggest that marijuana use can increase levels of the hormone progesterone, leading to a shorter luteal phase and possibly delaying ovulation. It is also believed that cannabis can reduce egg quality and decrease fertility when used over long periods of time,” Maniar said.
In some people, birth control methods can cause mood disturbances, such as anxiety. How THC affects anxiety is variable, but it is thought to increase anxiety in higher doses and decrease it in lower doses.
Estrogen may increase sensitivity to marijuana, such as easing discomfort, which could be helpful for some people, a 2013 study suggested. But it also could increase other side effects such as anxiety. Higher estrogen could also lead to a higher risk of stroke.
Birth control does not impact the ability to get pregnant in the future, but Maniar added that some research suggests that cannabis may influence fertility in both men and women, leading to an increased risk of side effects or issues with conception.
How can you combine safer sex and cannabis?
There's also an increase in available sexual wellness products that use either THC or CBD as lubricants or oils. Some people may opt for CBD to increase libido and decrease anxiety.
"Topically applied cannabis and suppositories have helped numerous folks with pain with penetration," said Ashley Manta, a sex educator and coach in the Los Angeles area.
But when it comes to mixing certain sexual wellness products with birth control, your method matters.
"Many genital-focused products like THC-infused oil or weed lube are made of oil and unable to be used with latex condoms and barriers. One needs a non-latex option that’s compatible with oil, like nitrile," Manta said.
Combined oral contraceptives are more than 99 percent effective, according to the NHS. The most common cause of failure for the birth control pill is user error, such as forgetting to take it. It bears mention that considering the possible impacts of marijuana and birth control together, a common side effect of marijuana is forgetfulness.
"Cannabis can impact short-term memory so it's good to set an alarm or leave yourself a note," Manta said.
The bottom line
Consult with your doctor about which birth control is right for you. It's also wise to ask your provider how marijuana could affect your birth control or elevate symptoms.
If you happen to notice increased birth control symptoms while ingesting THC, it might be wise to decrease cannabis usage and talk to your provider about switching methods.
While more research on how marijuana could impact birth control and reproductive health is needed, a clinical trial on the potential relationship between CBD and oral contraceptives is underway.