In 2023, a survey of 1485 women over the age of 35 (35% were postmenopausal and 33% perimenopausal), 34% reported they were currently taking cannabis – with 75% of those saying they were doing so for medical purposes, most commonly for sleep, anxiety and muscle/joint achiness. 74% of those currently taking cannabis believed the plant helped manage menopause symptoms.
Beyond self-reported benefits, there are many studies supporting this experience, albeit not in studies specifically about menopause but in research exploring symptoms such as insomnia, anxiety, mood fluctuations, hot flushes, burning mouth syndrome and nervous system dysregulation. However, prominent groups such as The Menopause Society and The Society of Obstetricians and Gynaecologists of Canada (SOGC) have yet to officially recommend cannabis for treating menopause.
Concurrent with much global women’s health data, there remains a paucity in research into cannabis for menopause.
Perimenopause, menopause and post-menopause: what the terms mean
Perimenopause
Perimenopause generally starts in a woman’s mid-40s as the ovaries begin to make less estrogen and progesterone in the run-up to menopause. During this time, periods can become irregular and heavy, then gradually lighten until they stop completely. Several symptoms commonly occur due to hormonal changes, often including sleep problems, mood changes, vaginal and bladder changes (such as dryness, discomfort or an urgent need to urinate) and hot flashes. This is the transition to menopause.
Menopause
Menopause begins 12 months after a woman’s final menstrual period, marking a new biological phase in life where natural pregnancy is no longer possible. Ovarian follicles deplete, and eggs are no longer released. For some women, the new normal of having very low estrogen and progesterone (which gradually declined during perimenopause) can bring about similar but sometimes stronger symptoms that occurred during perimenopause. These might include insomnia, brain fog, mood shifts, discomfort during sex, night sweats, weight gain and bone density loss.
Post-menopause
Post-menopause is considered to start 12 months after a woman’s periods stopped completely. This marks a new, permanent phase in life. At this time, menopause symptoms settle as the body regulates and adjusts to its new way of being. However, low estrogen can continue to increase the risk of osteoporosis and heart disease over time.
Which menopause symptoms might medical cannabis help with?
Hot flushes and night sweats
Anecdotally, some women report that medical cannabis helps with hot flushes and night sweats, but clinical evidence is very limited. There is, however, a small-scale study looking at synthetic THC for the treatment of night sweats in cancer patients, in which all five patients found it to be effective. The study concluded that medical cannabis might be a promising therapy for the management of night sweats.
Sleep
Sleep issues and cannabinoids are well studied, and overall research suggests cannabis may help with insomnia and other sleep disturbances if used appropriately at the right dose. Studies also show that chronic use of high-dose cannabis can cause sleep issues and decrease REM sleep.
THC and CBN are the two cannabinoids best known for treating sleep problems such as insomnia. CBD has also been found to be supportive, but studies on the isolated effects of CBD on sleep architecture are limited and mostly have mixed results.
A 2020 a clinical review titled ‘Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies’reported that there is ‘promising preliminary evidence’ that provides ‘the rationale for future randomised controlled trials of cannabinoid therapies in individuals with sleep apnea, insomnia, post-traumatic stress disorder-related nightmares, restless legs syndrome, rapid eye movement sleep behaviour disorder, and narcolepsy’. However, further investigation is needed.
Anxiety and mood
As exacerbation or triggering of anxiety, depression and mental health conditions is widely discussed as one of the main risks of taking cannabis, yet some studies have also shown it can help with these issues, it may come as no surprise that results in this area are mixed. The most positive results for anxiety and mood tend to be self-reported by patients.
Joint and muscle pain
People who take cannabis for menopause sometimes do so to address joint and muscle pain. Cannabinoids for chronic pain disorders such as fibromyalgia, cancer-related pain and neuropathic pain are a well-researched area, and THC in particular has been found to possess analgesic and muscle relaxing effects through modulation of the central nervous system.
One study explored the relationship between THC and CBD for pain, testing various inhaled doses and a placebo without THC or CBD. The combination of high THC and high CBD was found to significantly decrease pain, while other variants showed little difference from the placebo.
CBD or THC for menopause symptoms, what is the difference?
Both CBD and THC may be supportive for people experiencing symptoms of menopause, but in different ways.
CBD has no psychoactive effects and inhibits the enzyme that ordinarily degrades naturally produced endocannabinoids, resulting in higher levels in the bloodstream. CBD is best known for anti-inflammatory and antioxidant properties.
THC is psychoactive and primarily acts on endocannabinoid receptors in the central nervous system (brain and spinal cord) and is often used to treat chronic pain and nausea.
Medical cannabis and HRT
Medical cannabis is not a hormone replacement therapy and does not replace one. It can be taken alongside HRT under clinical supervision, and some people find the combination to be very helpful, but anyone taking HRT should have their full medication list reviewed by the prescribing clinician.
Where this sits alongside the other options a GP can offer
HRT is the most common first-line treatment for menopause symptoms. There are also some non-hormonal medications available such as fezolinetant (Veoza) and clonidine. In addition, some people find lifestyle and dietary changes can help, as well as cognitive behavioural therapy. Medical cannabis can be used alongside these treatments under clinical supervision.
Risks and side effects
Medical cannabis can interact with certain medications, so it’s important to follow the guidance provided by your Releaf clinician. Cannabis is also not suitable for everyone, particularly individuals with a history of bipolar disorder or schizophrenia. A full assessment will be conducted during the approval process to mitigate risks.
How to get assessed for medical cannabis for menopause in the UK
If you have already tried two or more frontline therapies to manage the symptoms of menopause, cannabis may be an option for you. Take a look at how Releaf works, then begin the approval process by filling in our medical cannabis eligibility checker online.
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