Author ORCID Identifier


Date of Award


Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Yankey

Second Advisor

Dr. Okosun

Third Advisor

Dr. Armstrong-Mensah


ABSTRACT Introduction: The escalating prevalence of marijuana use among women of reproductive age in the United States has raised concerns about its potential impact on reproductive health. The World Health Organization identifies cannabis as the most widely cultivated, trafficked, and abused illicit drug globally, with around 147 million individuals, constituting approximately 2.5% of the world's population, admitting to annual cannabis consumption. In the U.S. marijuana use is decriminalized in most States and holds the distinction of being the most frequently used psychoactive substance, emphasizing the urgency of investigating its impact on reproductive health among the population. Aim: Menstrual irregularities can be a sign of reproductive health challenges. This thesis aims to investigate the association between marijuana use and menstrual irregularities (as a proxy for reproductive health) among U.S. women aged 20 to 44 years. Methods: The analysis employs descriptive statistics and logistic regression (alpha = 0.05). using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. Menstrual irregularities, defined as the absence of regular periods in the past 12 months, serve as the main dependent variable, while marijuana use, characterized by monthly use for a year, is the primary independent variable. Control variables include demographic factors, alcohol use, cigarette smoking, drug use, moderate physical activity, hormone use, contraceptive use, and treatment for pelvic inflammation. Results: In this study, compared to their counterparts, we find that the adjusted odds ratio for marijuana use was 3.91 (95% CI: 0.59 – 25.96, p = 0.158), suggesting an increased likelihood of menstrual irregularities among individuals who reported marijuana use, although the association did not reach statistical significance. We also find a positive association, and inconsistent relationships between marijuana use and other factors of reproductive health (ever being pregnant, diabetes in pregnancy, and ever having a cesarean section), though not statistically significant. Marijuana use could have a complex relationship with reproductive health factors including menstrual health that cannot be explained by cross-sectional studies alone. Conclusion: The findings of the logistic regression model, involving 913 females, indicate that we do not have sufficient evidence to reject the null hypothesis, suggesting that, in this specific model, marijuana use may not be statistically significantly related to menstrual irregularities among the 913 females in the study. This non-significant association raises the possibility of a more intricate relationship between marijuana use and reproductive health factors, particularly menstrual health, which may extend beyond the scope of cross-sectional studies. The complexity of these associations underscores the need for comprehensive and longitudinal investigations to better elucidate the potential impact of marijuana use on menstrual patterns and other reproductive health outcomes. In summary, our study underscores the intricacies involved in understanding the relationship between marijuana use and menstrual irregularities, emphasizing the limitations of cross-sectional approaches in capturing the multifaceted nature of this connection.


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