December 2022 by Sandy Yanez
A recent study suggests that it is becoming more common for women to use cannabis for menopause-related symptoms over traditional hormone therapy (HT).
What is menopause?
Menopause is a natural process that occurs as a woman’s ovaries stop producing eggs and the production of female hormones (estrogen and progesterone) declines. Whether menopause is natural or brought on by surgical removal, damage, or disease to the ovaries, the dramatic shift in hormones during menopausal years can cause an array of symptoms that include but are not limited to anxiety, irritability, brain fog, fatigue, depression, weight gain, joint stiffness, insomnia, hair loss, and hot flashes. Though some women opt for hormone replacement therapy, this treatment has fallen out of favor in recent years, prompting many women to seek alternative non-hormonal treatments.
It was the ancient Greek philosopher Aristotle who made the first reference to menopause when he wrote the observance of women that stopped having menstrual discharge and subsequently lost the ability to bear children between the ages of 40 to 50 years old.
Menopause was first coined in 1821 by a French physician who linked women’s symptoms of depression, hot flashes, and irregular periods to problems of the uterus. Doctors were quick to label women with “hysteria,” which is derived from the Greek word “hysterus,” which means “womb.” That is, physicians believed that mild mental illness not caused by disease in women was caused by the uterus or womb.
By the Victorian era, women’s reproductive health in general, and menopause, in particular, were the focus of deep distrust. Physicians believed that there was a link between the womb and the brain, making all women susceptible to insanity. This was thought to be especially true of women in menopause who were believed to suffer from a condition called “climacteric insanity.” As a result, they believed the only logical treatment was to lock up these women in asylums.
The Victorians thought that a woman’s ovaries “were the seat of feminine essence and all that was virtuous in women sprang from them.” It follows then that if the ovaries were diseased or stopped functioning (as they do in menopause), then a woman was not of sound mind. The solution they created was to remove the offending organs. This, they assumed, would make women more compliant, docile, and harder working.
What followed was the surgical removal of the ovaries from hundreds of women, an operation deemed necessary to cure mental disorders, including nymphomania and hysteria.
However, it wasn’t until the late 1920’s that doctors began recognizing the connection between hormones and menopause. Then, in 1942, the first modern commercial hormone prescription Premarin (made from extraction from pregnant horses’ urine) came to market. Things changed drastically in 1963 when gynecologist Robert Wilson and his wife published a scientific article highlighting the medical symptoms and consequences of menopause and demanding better treatment for the condition.
Why are women using cannabis over traditional treatments?
Treating the symptoms of menopause is generally limited to hormone replacement therapy or non-hormone-containing prescription medications. But these options can have health risks and may not be appropriate for everyone.
There are a few reasons why women are turning to cannabis for help with menopausal symptoms. One is that cannabis has some effects that can alleviate menopause symptoms. THC can mimic some aspects of anandamide (bliss molecule), a cannabinoid made by our body that helps regulate body temperature, which helps with hot flashes and can uplift your mood as well as improve sleep. Another reason is both THC and CBD influence the endocannabinoid system in areas of pain, memory, mood, hunger, stress, sleep, metabolism, immune responses, and the reproductive system. And CBD alone has been shown to help clear away “brain fog”, pain, mood swings, stress, depression, sleep, and much more.
Estrogen is important to the endocannabinoid system because it regulates fatty acid amide hydrolase (FAAH, which aids in the breakdown of our bliss molecule anandamide). So, if there are lower (or fluctuating) levels of estrogen in your body, this can affect your endocannabinoid system, which in turn may partly explain some of the effects of perimenopause such as depression, anxiety, mood swings, lower libido, and difficulty sleeping. So, it would make sense that doses of cannabinoids would help out with those symptoms. If only it were that simple.
Although cannabis research is advancing, conducting clinical research is challenging due to the fact cannabis remains illegal in many states. So far there have been very few studies of cannabis with menopausal humans.
A 2022 study featured over 250 women, 131 pre-menopausal women, and 127 post-menopausal women, who were recruited through advertising, targeting women interested in women’s health and cannabis. The study looked at cannabis consumption, modes of use, and usage trends.
According to the findings, 86% of the women surveyed use cannabis as an additional therapy for a variety of menopausal symptoms. Smoking was the most popular way of consumption, accounting for 84.3%, with edibles accounting for 78.3%. Anxiety and sleep difficulties were the most commonly reported symptoms for which medical cannabis was used.
A 2021 study from Canada analyzed responses from close to 1,500 women – 18% were premenopausal, 33% were perimenopausal, and 35% were postmenopausal. Of the 499 participants that were currently using cannabis, 75% reported its use for medicinal purposes with the most common reason being sleep 65%, anxiety 45%, muscle & joint aches 33%, irritability 29%, and depression 25%. It was reported that 3/4th of the women found cannabis helpful with their symptoms.
“Our study confirmed that a large percentage of midlife women are using cannabis for symptoms that overlap with menopause, especially those women who reported more symptoms. In addition, many of these women are claiming to get relief for their symptoms through the use of cannabis,“ says Katherine Babyn, First Author and Master of Science Student, University of Alberta.
Babyn goes on to say that while more women are using cannabis to help manage their menopause symptoms, further research is still needed.
There is emerging research that suggests CBD may regulate certain hormones, such as estrogen and progesterone, but more research is still needed.
A study using CBD on estrogen-deficient mice found that CBD improved several menopause-related symptoms and conditions. The mice were divided into two groups, given the same diet with the exception of one group receiving CBD isolate with their food. After several weeks of CBD treatment, the mice showed significant improvements in blood sugar, improved energy (metabolism), a reduction in intestinal inflammation, improved bone density, and an increase of Lactobacillus, a probiotic that helps protect against bone loss and decreases inflammation in the gut and our bones.
CBD has been shown through studies to help with pain and inflammation, works with the serotonin receptors in the brain producing antidepressant and anti-anxiety effects, and also helps with cognitive impairment allowing mental clarity.
My personal story
The day was busy and was approaching supper time. I was stressing over what to make when out of nowhere I had to catch my breath as an intense wave of heat consumed my upper body while sweat poured down my face. I knew immediately what was going on but knew there was no way it could be happening to me at age 37. Yes, at age 37 I was diagnosed with perimenopause.
Shortly after being diagnosed with perimenopause, I started using CBD and THC to help with pain and inflammation from a back injury. The cannabis helped greatly with my pain, but what I was not expecting was the relief I received for my perimenopause symptoms. Over time the symptoms just fell away. Mood swings, depression, insomnia, and brain fog were gone or down to almost nonexistent. After consuming cannabis, specifically CBD, for one year the hot flashes were hardly noticeable.
Flash forward a few years, and now age – well a bit older, I am continuing to use CBD and THC for any menopausal-related symptoms without the use of hormonal replacement therapy.
My story may be common for many, but other women unfortunately do not reap the same benefits from cannabis. For example, cannabis may help with the brain fog and insomnia that are associated with menopause and do nothing for your hot flashes or may not be strong enough for the intense mood swings. This is when hormone replacement therapy may be needed in partnership with cannabis.
Currently, it is difficult to say if cannabis will be a successful treatment for menopause due to the lack of clinical trials on humans. In addition, there isn’t enough evidence to provide physicians with recommendations on how to prescribe it. Yet another compelling indication of the therapeutic value of this controversial plant is the rising number of women choosing to use it to alleviate menopausal symptoms.
The increased involvement of women in politics, public debate, and the workforce, as well as the growing population of baby boomers going through menopause, have been driving forces in shattering the silence and stigma of menopause. For many, menopause is still an unpleasant issue, full of outdated misconceptions and misunderstandings regarding treatments and symptoms. And, while modern medicine is a relatively new breakthrough in the history of menopause, it’s vital to appreciate how much women have had to go through in the past, as well as the trailblazers in medical and ordinary culture who have contributed to making a difference for all women.
Babyn, K., et. al. (2021) More women using cannabis for menopause symptoms. Menopause 2021. Analyzed response. https://www.menopause.org/docs/default-source/press-release/cannabis-use-for-menopause-symptoms.pdf
Bianchi, E. (2014) Sexual differences in potentiality and actuality. The Feminine Symptom: Aleatory Matter in the Aristotelian Cosmos (New York. NY, 2014; online edn, Fordham Scholarship Online,21 May 2015), https://doi.org/10.5422/fordham/9780823262182.003.0007
Crippa, J. A., Guimarães, F. S., Campos, A. C., & Zuardi, A. W. (2018). Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Frontiers in immunology, 9, 2009. https://doi.org/10.3389/fimmu.2018.02009
Dahlgren, K., El-Abboud, C., Lambros, A., Sagar, K., et. al. (2022) A survey of medical cannabis use during perimenopause and postmenopause. Menopause 2022; 29(9)1028-1036 doi:10.1097/GME.0000000000002018
Hill, M. N., Karacabeyli, E. S., & Gorzalka, B. B. (2007). Estrogen recruits the endocannabinoid system to modulate emotionality. Psychoneuroendocrinology, 32(4), 350–357. https://doi.org/10.1016/j.psyneuen.2007.02.003
Houck J. A. (2002). How to treat a menopausal woman: a history, 1900 to 2000. Current women’s health reports, 2(5), 349–355. https://pubmed.ncbi.nlm.nih.gov/12215307/
Sui, K., Tveter, K., Bawagan, F., Buckendahl, P., et. al. (2022) Cannabidiol-Treated ovariectomized mice show improved glucose, energy, and bone metabolism with a bloom in Lactobacillus. Front. Pharmacol. 13:900667 https://doi.org/10.3389/fphar.2022.900667