CBD and Pregnancy

19 Nov 2020 I attended a virtual conference put on by the FDA Office of Women’s Health. The biggest take away is that the science on the effects of CBD and other cannabinoids on women’s health is pretty sparse.

A big reason is that cannabis is a Schedule I substance according to the Federal government. That means it is very hard to conduct a clinical study on cannabis – only the National Institute of Drug Abuse can approve a study site at the moment. CBD is no longer a Schedule 1 substance, thanks to the 2018 Farm Bill. So, there are many clinical studies being conducted on CBD at the moment, and we will have more information in years to come. But the current big population experiment is happening now – will science be able to catch up?!

One example of a question not answered – Is it safe for pregnant women to take CBD?

Let’s break this down.

1) What is in the CBD product? Very few products have actually been chemically characterized. How much CBD is in it? How much THC? Are there other cannabis constituents that might affect the activity of the product? Either through altering absorption or having activity of their own? This question is mostly unanswered and it is fundamental to the following questions. if you don’t know what you are taking, then knowledge will not progress, as it is hard to correlate any benefits or harms that might occur with an unknown substance.

2) Why is the woman taking the product? Do they want pain relief? Relief from nausea and vomiting? Or want to get high? Most of the doctors in the conference just flat out were of the opinion that CBD is not safe to take during pregnancy.  One female doctor pointed out that the Rx remedies for nausea and vomiting are assumed to be safe – but in fact, they are not that well studied either! Maybe it might be helpful to find out why the woman is taking CBD and see if there is an alternative that is known to be safer…Chances are women will not tell their doctor, who usually has a paternalistic attitude. When doctors asked the women if they were asking cannabis, the initial answer was “no” but this sometimes turned to “yes” if the doctor discussed potential safety concerns.

3) The studies that indicated harm from taking cannabinoids during pregnancy were all conducted with THC. There is little doubt that THC has an effect on neurological parameters and may influence neurological development. But, what about CBD? Answer, we do not know. Midwifes are reported to think that CBD is safe for pregnant women. Why do they think so?  If taking a CBD product, what is the quality of that product? How much THC does it contain?

4) Rodent studies show that CBD does not affect female reproduction, but in high doses appears to have effects on their male offspring – reducing the size of testis and reducing the number of sperm. So, this looks bad for sons of women who take large amounts of CBD. But, a remark from a female doctor stayed with me.  She said that men are continually making sperm so they can just refrain from use of THC and/or CBD for a period of time and their sperm levels increase. Whereas if the eggs in the ovaries are damaged – that is game over for reproduction for that woman.

Science is being left flat footed here because of regulatory and political agendas. We have a right to expect more!