An original study recently published in The Journal of North American Menopause Society titled “A Survey of Medical Cannabis Use During Perimenopause and Postmenopause” compares Cannabis use among women experiencing the transition to menopause with women after menopause.
Perimenopause is defined as the time when ovaries gradually reduce the production of estrogen, which can include irregular menstrual flow, hot flashes, and night sweats. Postmenopause is the period after perimenopause and defined as no menstrual flow for 12 consecutive months.
The study is a cross-sectional, observational study designed to collect information at a single time point identifying menopause related symptoms associated with medical Cannabis use. The study did not try to show how well Cannabis worked for menopausal symptoms, which is difficult in an observational study design.
To better understand medical Cannabis use among menopausal women, researchers conducted surveys on 131 perimenopausal and 127 postmenopausal individuals. They found that individuals experiencing perimenopause were more likely to have a diagnosis of depression and anxiety and more likely to use medical Cannabis than postmenopausal women. In other words, the transition period to menopause was associated with more Cannabis use.
92% of the women had tried Cannabis at least once in their lifetime. 84% were regular Cannabis users, using at least once per month. Smoking flower (84%) and using edibles (78%) were the most common methods of using Cannabis. It’s interesting to note that a broad range of products were used by at least 25% of the participants including vape pens, tinctures, vaporizing the flower and topicals. The top three reasons for using Cannabis were poor sleep, anxiety, and to improve sex drive. The top reasons why women were not interested in using Cannabis were because they had a lack of knowledge of Cannabis, or their menopausal symptoms were already well managed. Other reasons were no access to Cannabis products, fear of getting high, and cost.
Hormone replacement therapy (HRT) is the medically recommended treatment for menopause. However, HRT is associated with negative symptoms such as mood swings and fatigue. There is also an increased risk of developing cancer with HRT.
It’s known that Human ovaries produce the endocannabinoid anandamide with peak blood levels occurring at ovulation and correlating with estrogen levels. Giving estrogen to animals that have their ovaries removed (a model for menopause), increases the expression of cannabinoid receptors and levels of anandamide. This indicates that the endocannabinoid system is very likely linked to functioning ovaries. This is molecular evidence why Cannabis may benefit menopause.
The study authors do note some concerns with current Cannabis use for menopause. Smoking tobacco is associated with an increased risk of early menopause. Although smoking Cannabis is different than smoking tobacco (unless you are smoking a spliff or a blunt), it’s uncertain whether it may also affect the onset of menopause. Another concern is that dosage is uncertain with broad spectrum or full spectrum Cannabis products and needs to be studied in prospective clinical trials. And finally, the effect of cannabinoids on liver metabolism is important to consider when prescribed medicines are also being used.
All in all, this study highlights that medical Cannabis has great potential as treatment for the adverse symptoms related to menopause.
Jean Talleyrand, M.D.,