With Movember 2020 in full swing, there is once again a focus on men’s health issues: prostate cancer, testicular cancer, and mental health. Movember exists to shine a light on conditions that often go undiscussed—even among men. Statistically speaking, men are much less likely to seek medical advice than women, especially for mental health concerns.
But even if men put off heading to the doctor’s office, they are much more likely than women to try medical cannabis in an effort to treat these conditions. In the RYAHData platform, and elsewhere, men are more likely to use cannabis than women.
In honor of Movember, it’s time to investigate where men’s health issues and medicinal cannabis intersect.
The Difference Gender Makes: A Male Perspective on Cannabis
In every epidemiological report available, men consistently are more familiar with cannabis than their female counterparts. From within RYAHData, where 35,069 men reported between Jan 1, 2018 and Oct 27, 2019 the story is no different – with 55 percent of sessions reporting from male patients.
Before adopting the plant for therapeutic applications, men also tend to have higher levels of experience than women, presumably from previous recreational use. Between January 2018 and the fall of 2019, 77.8 percent of men reporting in RYAH Data had moderate to daily experience with the plant. Women were less likely to report similar levels of previous experience with the flower.
Perhaps because of the higher level of experience and overall use of the plant, men also have an increased risk of cannabis abuse disorder (CUD). CUD is a mental health disorder revolving around “nine pathological patterns classified under impaired control, social impairment, risky behavior or physiological adaptation,” according to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).
The rate of CUD among men is nearly double that of women. However, the research on this topic is not entirely understood. With more women experimenting with cannabis thanks to changing social norms and increased legalization, their risk of CUD may also increase. The World Health Organization estimates the prevalence of CUD is between 0.4 percent and 3.4 percent among men, with rates peaking between the ages of 20 and 24.
When it comes to product preferences, male consumers tend to prefer concentrates and inhaled methods of consumption like smoking and vaporization. One could easily assume an affinity for concentrates means men prefer potent strains, but in reality, men enjoy a variety of cannabinoid profiles (just like women). A preference for concentrates doesn’t translate to stronger strains. According to RYAHData, men appreciate variety, including both cannabidiol (CBD) rich and tetrahydrocannabinol (THC) rich products.
Are there differences in experiences between the genders? Animal models have shown that there are some slight differences in effects between male and female groups. These results have not yet been replicated in human trials, but they are striking. Men have a different spread and, perhaps, a different concentration of CB1 receptors in their brains than women. As a reminder, the CB1 receptors are the receptors responsible for the effects of THC. It’s possible that a slightly different CB1 network determines a difference in effects.
Therapeutic Applications of Cannabis for Men’s Health Conditions
Men and women rely on medical cannabis for remarkably similar health concerns. Both sexes use flowers for anxiety, stress, depression, pain, and insomnia, in nearly identical ways. Insights provided by RYAHData suggest men are more likely to rely on medical cannabis to address the symptoms of attention disorders. Otherwise, there is a striking similarity between conditions treated by men and those by women.
Being as it’s Movember, there are three health issues of particular importance this month:
- Prostate cancer
- Testicular cancer
- Men’s mental health (Suicides)
In these three areas, where does medical cannabis fit into treatment, prevention, or palliative care?
Prostate cancer is the second most common cancer among men behind skin cancer. It’s most commonly a diagnosis among an older demographic, with the majority of cases diagnosed after the age of 65. Early stages of the disease are almost entirely treatable, with the average five-year survival rate close to 100 percent. This rate drops significantly in the later stages of the disease.
Cannabinoids are getting a lot of attention for their anti-tumoral properties. But, to date, no clinical trials are putting these properties to the test. All research is currently in the early stages of study, including the study of cannabis specifically for the treatment of prostate cancer. In-vitro and in-vivo models “support the clinical testing of CBD against prostate carcinoma,” as per the authors of “Non-THC cannabinoids inhibit prostate carcinoma growth in vitro and in vivo: pro-apoptotic effects and underlying mechanisms.”
In this 2013 study published in the pages of The British Journal of Pharmacology, the research team explored the effects of cannabis extractions on prostate carcinoma cell lines. Their findings indicate CBD was of particular value as a pro-apoptotic agent capable of promoting pancreatic cancer cell suicide.
Testicular cancer is less common, with less than 10,000 new diagnoses in the U.S every year. It may appear at any age, but the average age of diagnosis is 33 years old. Testicular cancer tends to happen at a much younger age than prostate cancer. Instances of the disease are on the rise in the U.S, although the prognosis and survival rates are generally quite good.
Researchers understand much less about the role of cannabinoids for the treatment of testicular cancer than they do with prostate cancer. There is a growing indication that heavy cannabis use may actually increase the risk of testicular cancer, based on several long-term studies.
According to the meta-analysis compiled by the National Academies of Sciences and published in 2017, “There is modest evidence that cannabis use is associated with one subtype of testicular cancer.” These findings were associated with heavy or chronic cannabis smokers. There was no control for the method of consumption, dose, or cannabinoid profile. Which means there is much more to learn about these results.
Beyond the early-phase studies on the anti-tumoural potential of cannabinoids, cannabis is already quite established as a conjunctive therapy to lessen the adverse side effects of chemotherapy. As “The Effects of Dosage-Controlled Cannabis Capsules on Cancer-Related Cachexia and Anorexia Syndrome in Advanced Cancer Patients: Pilot Study” found, patients reported “improvement in appetite and mood as well as a reduction in pain and fatigue” when using cannabis as a co-therapy with conventional chemotherapy treatments.
What about cannabis and depression? Approximately 9 percent of men report experiencing depression and anxiety daily in America and are four times more likely than women to take their own life. The dramatic statistical difference in suicide rates is what makes men’s mental health a top concern in Movember.
When it comes to mental health concerns among men, the relationship with cannabis is complicated. According to the data pulled from RYAHData, men report anxiety and depression as the top reasons for medicinal cannabis use. However, several longitudinal studies have found links between chronic use and an increased risk for depressive disorders. There is much to learn about cannabis use for the treatment of depression, as the correlation isn’t entirely clear.
The determinations made by the authors of “The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies, were largely inconclusive. The authors of this 2014 publication declared, “There is a need for further longitudinal exploration of the association between cannabis use and developing depression, particularly taking into account cumulative exposure to cannabis and potentially significant confounding factors.” Again, none of the studies within this meta-analysis controlled for quality, dose, or cannabinoid profile.
The Intersection of Men’s Health and Medicinal Cannabis
With men more comfortable with cannabis in both medicinal and recreational settings, the plant will no doubt continue to offer an important alternative to treatment of male health conditions. It’s already frequently used for mental health issues, such as depression, anxiety, and attention disorders, even if the relationship isn’t entirely understood. There is also hope that the early work on cannabinoids for prostate cancer may develop into promising new clinical studies.
Still, medicinal use of the plant doesn’t come without risks for men. The benefits of cannabis seem notably dose dependant. According to the research reviewed here, health risks increase with heavy or chronic use.
Too much, and too frequently, and the risks related to use increase. Real therapeutic value seems to come from measured, dose controlled use.