Ease the Transition: How medical cannabis can help during the menopause

Every year, May hosts both National Women’s Health Month and National Women’s Health Week in the US. These events are dedicated to raising awareness around the mental and physical health concerns experienced by women and people assigned female at birth. Women and people with a uterus face unique health issues, from periods and pregnancy to endometriosis and menopause; yet, stigma alongside a lack of education often means awareness of them and their impact can be underestimated, underdiagnosed, and generally misunderstood.

There are approximately 13 million peri or postmenopausal women in the UK alone. As a natural biological event, it will eventually impact around half of the population; yet, evidence shows that many women are still not receiving a satisfactory level of relief from their symptoms, either due to a general lack of access or a lack of efficacy of existing treatments. In the face of this, evidence suggests that a growing number of women are turning to alternative therapies, including medical cannabis.

What is menopause?

The term ‘menopause’ refers to a stage in a person’s life when they have not had a period for 12 months. It usually occurs in women (and anyone who has periods) between the ages of 40 and 60.

Menopause is a natural biological characterised by the loss of ovarian follicular function - or in simpler terms, when the ovaries stop producing eggs. This leads to a reduction in hormones, namely oestrogen and progesterone. These changes are associated with a wide range of symptoms. While all women and people with periods will eventually undergo menopause as a natural process, it can also be caused by surgery (the removal of the ovaries or uterus), cancer treatments, or genetics. 

What are the symptoms of menopause?

Over 30 symptoms are associated with menopause which can vary significantly in severity from person to person. According to a 2022 survey by Fawcett Society, 77% of women experience one or more menopausal symptoms they describe as ‘very difficult’.

Some common menopausal symptoms include:

• Hot flashes (also called hot flushes): It is estimated that around 80% of people who go through menopause will experience hot flashes. This refers to the sudden onset of hot or cold in the face, neck and chest which can make you feel dizzy.
• Sleep disturbance: A reported 84% of women experience changes to their sleep during the menopause. This may be associated with other symptoms such as night sweats.
• Brain fog: Almost three-quarters (73%) of menopausal women experience brain fog, which is often described as problems with memory or concentration. 
• Anxiety and depression: Many people going through menopause experience changes in their mood with 69% of people reporting difficulties with anxiety or depression. 

Fawcett Society’s survey also sheds light on the prevalence of other menopausal symptoms, including joint pain or stiffness (experienced by 67% of respondents), low or no interest in sex (54%), heavy periods (44%), heart palpitations (41%) and vaginal dryness or urinary tract infections (39%). Almost half of respondents described three or more of their symptoms as very difficult.

How long do menopausal symptoms last?

Women may begin to experience these symptoms in the years before their last period (typically lasting between four and eight years). This is known as perimenopause. The 12 months following a woman’s final period are known as menopause, while postmenopause refers to the years after. 

The menopausal transition usually lasts about seven years, but it can be as long as 14 years. Symptoms can last for months or years and some will change over time. Some may improve while others may worsen and some symptoms may persist after the menopause phase into postmenopause.

Conventional treatments for menopause

Treatments for menopause symptoms may include medical interventions in combination with lifestyle changes. For example, eating a healthy diet and exercising regularly, as well as avoiding smoking and drinking excessive alcohol may help to relieve some physical and mental symptoms. 

The main medicinal treatment for menopause and perimenopause symptoms is horomone replacement therapy (HRT). This treatment replaces the hormones that are reduced as a result of menopause. Official guidance states that HRT should be offered to women who are experiencing difficult menopause symptoms; however, recent figures indicate that only around four in ten women are immediately offered the treatment by their GP, and only 14% of menopausal women said that they are taking HRT. 

Furthermore, in recent years, there have been shortages of HRT products in the UK, leaving many people without treatment or using different products to usual - an issue that can be worrying as finding the right product and dose can take a long process of trial and error. However, some people may choose not to use HRT, either because they simply don’t want to use hormones, due to potential risks (which can include a slightly heightened risk of breast cancer, blood clots, and stroke) or because it has proven ineffective at managing their symptoms. 

Medical cannabis and menopause

In recent years, the stigma around cannabis - particularly for medicinal use - has slowly begun to dissipate. With a growing number of countries around the world now acknowledging the therapeutic value of cannabis and its derivatives, and many now prescribing cannabis-based medicines for a wide range of conditions, people are inevitably becoming more interested in how this diverse plant could help them manage their symptoms. This is a trend that can also be seen among people going through menopause. 

Some compounds found in cannabis - called cannabinoids - interact readily with the body’s Endocannabinoid System (ECS), a receptor system that plays a vital role in regulating a number of physiological processes. These interactions are thought to be responsible for many of the effects of cannabis, including its potential pain relief, anti-anxiety, and anti-inflammatory properties.

Does cannabis help with menopause symptoms?

Several studies have aimed to better understand the use of cannabis among menopausal women. For example, in a 2023 survey of 1,485 women aged over 35 and over in Canada, 68% (1,010) of whom were peri or postmenopausal, and 34% (499) were currently using cannabis. Of these, over 75% reported using cannabis for medicinal purposes, including to manage symptoms associated with menopause: sleep (65%), anxiety (45%) and muscle/joint achiness (33%). Almost three-quarters of medicinal users reported that medical cannabis was helpful for symptoms. 

A 2022 study also aimed to assess patterns of medical cannabis use among perimenopausal (131) and postmenopausal (127) women in the US. Most of the participants (86.1%) reported current cannabis use, with over three-quarters endorsing its use for menopause-related symptoms, including sleep disturbance (67.4%) and mood/anxiety (46.1%). 

Fewer studies have explored the potential of cannabis for night sweats and the therapeutic use of cannabis for hot flashes. Nonetheless, current evidence indicates that many people are already experiencing the benefits of medical cannabis for menopause-related symptoms.

So, what’s a better option? THC or CBD for menopause? 

Does THC help menopausal symptoms?

While no studies have focused specifically on the potential of THC in easing menopausal symptoms, existing clinical evidence may support its benefits in managing individual symptoms. For example, a 2015 review indicated that THC-based therapies increased the odds of improvement of pain among chronic pain patients - including those with rheumatoid arthritis. This may indicate the potential benefits of THC in managing joint pain. 

Furthermore, THC may also have a role to play in relieving hot flashes through its interactions with cannabinoid receptors in the hypothalamus - the part of the brain that regulates body temperature. These interactions may help to restore homeostasis, reducing spikes in body temperature; however, more clinical evidence is required to better understand this potential.

Does CBD help menopausal symptoms?

If you are interested in medical cannabis for menopause but are concerned about the side effects of THC, you may wonder: Can CBD treat menopause symptoms?

Given the boom in the popularity of CBD products in recent years, it’s no surprise that many people may wonder about the potential of CBD for menopause. After all, current evidence indicates that this non-psychoactive cannabis compound may have anti-anxiety and anti-inflammatory properties, as well as potentially helping improve sleep. 

A survey of 387 CBD users in the UK in 2021 (the majority of whom were female) found that the most common reasons people in the UK used CBD products were self-perceived anxiety (42.6%), sleep problems (42.5%), stress (37%), general health and well-being (37%), and arthritis/joint pain (~20%). There is growing clinical evidence to support the potential benefits of CBD in these settings; however, there is currently little research on the use of CBD for hot flashes.

Nonetheless, these results indicate that women in the UK may be interested in the potential of CBD - particularly CBD oil, for menopause symptoms. Of course, clinical evidence focuses on medical-grade CBD products, so the true potential of over-the-counter CBD oil and other CBD products remains unclear.

Final thoughts

Figures indicate that women and older adults are the fastest-growing demographic of cannabis users. Furthermore, the average age of medical cannabis patients in the UK is 52 years, according to recent data. Yet, despite the growing acceptance of medical cannabis among older adults in the UK, many people remain unaware that medical cannabis is legal and the many conditions and symptoms it could be beneficial for. 

Medical cannabis may be useful for managing many symptoms of menopause, including hot flashes, anxiety, and joint pain. If you’re struggling to find a treatment that works for your symptoms, or are interested in trying medical cannabis, we recommend you speak with a healthcare professional who will be able to provide additional information and guidance.