Why are Women Using Cannabis For Menopause?

Women are commonly using cannabis to help manage symptoms of menopause. Does it help?

Menopause can be a difficult transition for women. The average age of menopause onset is fifty-one years old, but it can present as early as a woman’s thirties. These symptoms could include hot flashes, chills, sleep problems, mood changes, and weight gain. There are a wide range of menopause treatment options available, but according to the Mayo Clinic, the most effective treatment option is hormone therapy. Hormone therapy, prescribed in pill, skin patch, gel-cream, or spray form, is designed to replace hormones that are no longer made after menopause. Disturbingly, hormone therapy can markedly increase the risk of endometrial^[1]Brinton, L. A., & Felix, A. S. (2014). Menopausal hormone therapy and risk of endometrial cancer. The Journal of Steroid Biochemistry and Molecular Biology, 142, 83-89. and breast cancers, depending on age and other factors. Although many experts contend that menopause doesn’t normally require treatment, many women are now using cannabis to treat menopause.

Menopause and the Endocannabinoid System

Estrogen, a hormone that declines with menopause, plays a role in the functioning of the endocannabinoid system. When women begin menopause, they stop producing high levels of estrogen, and there is a reduction in endocannabinoid signaling. Specifically, researchers have demonstrated that estrogen regulates the activity of anandamide through the inhibition of fatty acid amide hydrolase (FAAH). Further, as estrogen decreases, FAAH increases, resulting in lower anandamide activity. Anandamide influences several physiological responses related to mood, appetite, pain, and fertility. Theoretically, menopausal cannabis treatment would involve the input of exogenous cannabinoids to bring the endocannabinoid system back to homeostasis. Based on the results of a 2017 survey, cannabis treatment is already working for an increasing number of menopausal women.^[2]Berg, J. A., Larson, C. A., & Pasvogel, A. E. (2008). Menopausal symptom perception and severity: results from a screening questionnaire. Journal of Clinical Nursing, 17(7), 940-948.

Survey: Women Regularly Choose Cannabis to Treat Menopause

In 2017, BDS Analytics released the results of its Women’s Health Consumer Insights Survey, detailing how American women are incorporating cannabis into their self-care routines. The survey consisted of 1,281 women across the four states (California, Colorado, Oregon, and Washington) in which cannabis sales were legal at the time.

The survey found that menopause was one of the top three reasons that women choose cannabis for self-care, and that older women may choose cannabis to complement or replace hormone therapy. Forty percent of women surveyed chose cannabis as a natural alternative to cope with mood swings, thirty-two percent for relieving symptoms, and twenty-five percent of women reported reducing prescription medications. Additionally, thirty-five percent of those surveyed chose cannabis to improve sleep.

This fits, considering how research shows that sleep difficulty is the symptom of menopause that women struggle with most.

Menopausal Women Rank Lack of Sleep as the Worst Symptom

In a study published in the Journal of Clinical Nursing (2008), the researchers aimed to assess menopausal symptom perception and severity. The study results consisted of one hundred and ten women with a mean age of just over forty-nine years old. The assessment was a menopause symptom and severity questionnaire.

The results showed that of one hundred and ten women, almost ninety-five percent reported sleep difficulties as a perceived symptom. Additionally, sleep difficulties carried the highest severity score of any identified symptom. This research suggests that improving the sleep of menopausal women could have a significant impact on their well-being. Evidently, cannabis could be the answer.

Is Cannabis Inducing Sleep?

The influence of the endocannabinoid system on circadian rhythm suggests a logical relationship between cannabis and sleep. Moreover, a literature review published in Current Psychiatry Reports (2017), concluded that the effect of cannabis on improving sleep could depend on the cannabinoid in question.^[3]Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, cannabinoids, and sleep: a review of the literature. Current Psychiatry Reports, 19(4), 23.

Although THC might have short-term sleep benefits, long-term THC administration associates with habituation to the sleep-enhancing qualities, meaning patients might need higher doses of THC to achieve the same effect. Furthermore, the review states that the researchers found a link between THC, daytime sleepiness, and delayed sleep onset.

However, the same review found that medium to high doses of CBD improved sleep in a pilot study of humans. Subsequently, the authors note that small sample sizes, short-term follow-up, and a lack of controls limit sleep and cannabis research.

Women Using Cannabis to Treat Menopause Expect it to Work

Nevertheless, in a study published in Addiction Research & Theory (2016), the researchers found that women expect cannabis to relieve their menopausal symptoms. Particularly, they expected cannabis to improve hot flashes, joint and muscle discomfort, irritability, sleep problems, depression, and anxiety.^[4]Slavin, M. N., Farmer, S., & Earleywine, M. (2016). Expectancy mediated effects of marijuana on menopause symptoms. Addiction Research & Theory, 24(4), 322-329.

The authors note that many of these symptoms are not the target of hormone replacement therapy. Certainly, it suggests that cannabis may provide benefit as an adjunct therapy. Furthermore, their symptoms predicted the frequency of use, without additional cannabis-related problems. Basically then, this research suggests that women can consume cannabis to alleviate menopause symptoms without increasing negative outcomes. However, this research also highlights the need for better-designed research studies.

The Need for Randomized Controlled Trials

The increasing awareness and popularity surrounding cannabis increase the likelihood of an expectancy effect. Basically, those trying cannabis may be more likely to believe that it will work.

However, there is evidence of therapeutic relief from symptoms associated with menopause. The symptoms it can aid include sleep difficulties and arousal. However, more research on using cannabis to treat menopause will be a welcome addition to the medical canon on the subject.

Menopausal women finding success with cannabis should feel comfortable continuing their physician-directed or self-prescribed treatment plan, as the benefits seem to outweigh the risks. Further research will shed better light on the problem and for many women, perhaps offer a much-needed solution.