Sex Differences in Cannabis Use

Cannabis remains the most commonly used illicit drug worldwide and, with the rise of decriminalisation and legalization of marijuana for medical and recreational use, it is expected this will increase even further. There are, however, notable differences in the prevalence of cannabis use and rates of addiction between males and females. Men, for example, are almost four times more likely to try cannabis and to use higher doses, more frequently. Females, however, are more likely to progress faster towards a Cannabis Use Disorder (CUD) and tend to suffer more severe withdrawal symptoms.

A recent overview of research, published in Frontiers in Behavioural Neuroscience, has examined how different sex hormones, like testosterone, estradiol and progesterone, influence the system in the brain that responds to chemicals found in cannabis. 

Studies, which have primarily been carried out using rats, have found that the different sex hormones influence the binding capability of cannabinoid receptors, which control the activity of neurotransmitter systems. Neurotransmitters, such as dopamine, are involved in the pleasure sensation, which is associated with drug use and linked with addiction. 

Additionally it has been shown that the female hormone estradiol influences control of movement, behaviour and processing of sensory information - all behaviours sensitive to the effects of drug abuse - through alteration of the endocannabinoid system. It has also been shown that levels of cannabinoid receptors fluctuate during the menstrual cycle and when females age, a phenomenon which also occurs with estradiol levels. This has lead researchers to suggest females may be more vulnerable, at a biological level, in developing addiction-like behaviours.

The interaction between cannabinoids and sex steroids is highly complex and researchers are still speculating about the different associations. Initial findings suggest, however, that there are biological differences to the sensitivity of cannabis and therefore gender-tailoring treatment may be beneficial.