January 18, 2023
Can Cannabis Help Menopause-Related Symptoms?
More menopausal women are trying marijuana for relief. Here’s what science says.
By Selene Yeager
I got my medical marijuana card because I was curious. Could a cannabis product help take the edge off the occasional bout of postmenopausal anxiety or when I’m stuck in the stress-loop at the end of a particularly hard day when I might otherwise reach for a glass or two of wine?
For me, the answer was yes. My tincture — Hope 1, which is a mild 1:1 THC/CBD extract — has become another tool in my toolbox, along with exercise, nutrition, adaptogens, and mindfulness that can help me relax, recover, and get a sound, healing night’s sleep no matter what my circumstances.
I’ve long used CBD (which I’ll say upfront needs more research), and after working on a whole book on the topic, I also recognized it works best with its sister molecule THC. Hence taking the next step and giving medical marijuana a whirl. (I should note that I’m not completely new to cannabis. It’s very common in the mountain bike community, and though it’s traditionally not been my thing, I’ve used it a handful of times over the years.)
Research shows I’m far from alone in wading into weed for menopause-related relief. One Canadian survey of nearly 1,500 women (median age, 49.0 years) reported at last year’s North American Menopause Society (NAMS) Annual Meeting found that roughly a third (33%) reported using cannabis within the past 30 days.
Of the 499 current cannabis users in that study, 75% reported using it for medical purposes. The most common reasons for current use included: sleep issues (65%), anxiety (45%), muscle/joint achiness (33%), irritability (29%), and depression (25%). Three-quarters of these users found cannabis helpful with their symptoms.
In another study of 258 peri and postmenopausal women with an interest in and/or history of cannabis use published in Menopause this past September, 86% said they currently used cannabis, and 79% of them did so at least in part to manage menopause-related symptoms. The top three menopause-related symptoms participants reported using cannabis to treat were sleep disturbances (67.4%), mood/anxiety (46.1%), and libido (30.4%).
Previous Hit Play Not Pause guest, Lauren Streicher, MD, presented an abstract on a study she did on The Use of Cannabis for Relief of Menopause Symptoms at this year’s NAMS Annual Meeting. In it, she surveyed 310 peri – or postmenopausal women who currently or had recently used cannabis for relief of menopause symptoms, such as hot flashes, low libido, orgasm problems, and sleep disturbances. The types and forms of cannabis they used for symptoms were all over the map, but the perception of their relief from their symptoms was consistently high.
Obviously, you can’t rule out the placebo effect there. But there’s scientifically based reasoning for how cannabis could help alleviate menopause-related symptoms at their root.
How Cannabis Works
The cannabis plant contains numerous components, including molecules called cannabinoids. The human body also makes cannabinoids as part of the endocannabinoid system (ECS), which is involved in nearly every biological process including digestion, metabolism, hormone regulation, appetite, immunity, thermoregulation, pain, memory, mood, stress, sleep, and more. We naturally make our own cannabinoids — known as endocannabinoids — to keep this system humming along.
The endocannabinoid system also interacts with our sex hormones, and research shows that the change in production of estrogens and progesterone during menopause is strongly related to changes in ECS activity, which in turn may partly explain the myriad symptoms we experience in and beyond the menopause transition, such as depression, anxiety, mood swings, lower libido, and difficulty sleeping, according to endocrineweb.com.
So, hypothetically, supplementing cannabinoids back into the system could help smooth things out. The two cannabinoids that are extracted from the flower of the marijuana plant that get the most attention in menopause are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the psychoactive component of cannabis, aka the part that gets you high. CBD does not have psychoactive properties (i.e., it won’t get you high). It does, however, have anti-inflammatory and antioxidant properties, which may help with pain and promote health. Some studies have found that CBD can also reduce anxiety, which is common in menopausal women.
It’s important to note here that cannabis also has a biphasic effect, meaning low and high doses have opposite effects, which can lead people to get into trouble with using it to unwind, but ending up wound up, anxious, and paranoid instead. That’s why cannabis dispensaries all caution that users “start low and go slow.”
But Does it Really Work for Menopause?
As the surveys indicate, a lot of women believe cannabis helps relieve burdensome menopause-related symptoms. But if you want to see cold, hard data, it just isn’t there. And we’re not likely to see large, gold-standard randomized, double-blind, placebo-controlled studies on how cannabis impacts menopausal symptoms anytime soon, because that kind of research is extraordinarily difficult to do with cannabis.
There are well over 100 cannabinoids, which have different effects. For instance, though much of the existing research has been done on THC and CBD, scientists say there are other cannabinoids, such as cannabinol (CBN), cannabigerol (CBG), and cannabichromene (CBC) that should be investigated as well. There are also different types of cannabis, such as Sativa, Indica, and hybrids, which have very different psychological effects. The form you take cannabis in (such as tinctures or edibles or vaping) influence how it affects you.
Even though cannabis is legal, either medically or recreationally or both, in various states, it remains a Schedule 1 substance, meaning in the eyes of the federal government it has “no currently accepted medical use and a high potential for abuse,” and marijuana remains illegal at the federal level. That scheduling and prohibition make it onerous for researchers who want to study it, setting up a Catch-22 of sorts, as critics want to see research as proof of its benefits before changing its scheduling and legal status.
Assuming it can provide some relief, there are more than a few pitfalls for the cannabis curious to navigate. First, there’s the obvious “being high” part. Sure, it’s possible to use marijuana without getting stoned. But there’s a trial-and-error period that some women may find problematic. There are also a lot of very high-THC products on the market today, so it’s important to be an educated consumer. You obviously have to be vigilant about not driving under any influence. Cannabis can also interact with certain medications, so it’s important to consult with your doctor if you’re going to try it.
It may also have other yet to be uncovered unwanted effects. A study out last month in the World Journal of Urology reported that compared with no cannabis use, recent cannabis use was associated with higher odds of women reporting stress, urge, and mixed urinary incontinence. The connection got stronger with heavier use. As always, correlation doesn’t prove causation, but there’s still much to learn.
The bottom line: cannabis and medical marijuana have promise as therapeutics for menopause symptoms, but we have a long way to go before we have hard scientific evidence. If you’re cannabis curious (and in a state where it’s legal), work with a practitioner who can help guide you to the product, form, and dosage that is best for you.