An edible for hot flashes? Some women use cannabis to manage menopause.
To relieve hot flashes, sleep problems and low libido, some menopausal women are choosing to seek relief with cannabis, usually in the form of a joint or an edible, new research shows.
The study, a survey of women either in perimenopause or postmenopause, sought to gather data about how women are using cannabis to treat the symptoms of menopause. The analysis, published by Menopause: The Journal of the North American Menopause Society in August, included responses from 258 participants, more than 80 percent of whom had a history of regular cannabis use. While the survey was not a representative sample, it does offer insights into how some women use cannabis to relieve the symptoms of menopause.
The top three symptoms the participants said were alleviated by cannabis were sleep problems, mood disturbances or anxiety, and low libido. Respondents also used the drug to relieve hot flashes, night sweats, body pain, vaginal dryness and pain and to increase pleasure during sex. Some women took medical cannabis while others used recreational forms. They reported both smoking and using edibles as the most common forms of use to self-medicate for menopausal symptoms.
"These are salient targets for future clinical trials," said study author Staci Gruber, director of the Marijuana Investigations for Neuroscientific Discovery program at McLean Hospital and associate professor of psychiatry at Harvard Medical School. "How can the data inform our next steps to optimize treatment options for individuals suffering with these symptoms?"
The study did not look at frequency of use, dose, or whether the women had tried other treatments. Another limitation is that most participants already had a history of using the drug, so the results may not apply to women who haven't used cannabis before.
One reason cannabis may work for these women is that substances in cannabis could mimic a chemical compound, anandamide, produced by the ovaries whose production drops during menopause, Gruber said.
Anandamide is an endocannabinoid, which are molecules produced by the body that are structurally similar to cannabinoids, the substances found in the cannabis plant. Endocannabinoids are part of the body's endocannabinoid system, which regulates functions such as emotional processing, sleep and temperature control. It is also known to influence the female reproductive system. For example, anandamide levels have been shown to correlate with estrogen levels, which decrease during perimenopause and trigger the onslaught of symptoms.
Javier Mejia-Gomez, a gynecological oncologist at the Mature Women's Health and Menopause Clinic at Mount Sinai Hospital in Toronto, noticed an uptick in patients using cannabis to manage their symptoms in recent years. The trend prompted him to search for published research on the topic, but he found very little. Out of 564 studies mentioning menopause and cannabis that he initially reviewed, only three ended up making the cut for his systematic review. The rest were either animal studies, of poor quality, or did not directly investigate the impact of cannabis on menopause symptoms.
"Due to the lack of research and evidence-based medicine on this subject, it is hard for us to accurately counsel our patients on the use of cannabis for the management of their menopausal symptoms," Mejia-Gomez said.
Vanessa Fleeton, 53, said she found solace for a wave of debilitating perimenopause and menopause symptoms such as problems sleeping, body pain, anxiety and brain fog through an unexpected - and scientifically unproven - remedy. "Medical marijuana is much better than anything else that I've tried for menopause," she said.
The most effective treatment to reduce or eliminate menopausal symptoms is hormone therapy. But the treatment, which can include estrogen alone or estrogen combined with progestin, comes with a heightened risk of blood clots, stroke and breast cancer. An antidepressant, paroxetine, also has been approved by the Food and Drug Administration to treat hot flashes.
But many women don't want to use hormones or take an antidepressant. Some try unproven treatments such as over-the-counter supplements and herbal remedies, chiropractic interventions and acupuncture.
Nola Blackburn, 49, said she doesn't want to use hormones, so she takes cannabis in pill form daily for her menopausal symptoms. "I find I sleep better and have less nightmares due to the anxiety caused by hormonal fluctuations," said Blackburn, of West Kelowna, British Columbia.
Ilse Blommers, 53, who lives in Bangkok, eats half a cannabis brownie before going to bed. Her perimenopause started four years ago and brought on night sweats that would wake her up at 3 a.m. She decided to try cannabis. "I sleep like a baby," Blommers said. "My back pain and mood swings are so much better."
Experts warn that women interested in cannabis for their menopause-related symptoms should proceed with caution. Rigorous clinical trials to demonstrate its efficacy and safety are needed, said Stephanie Faubion, director for Mayo Clinic's Center for Women's Health.
"Everybody is jumping on the cannabis bandwagon, and I think we need to step back a bit," said Faubion, who was not involved in the study. "There's no proof that it works or is safe, so caution should be exercised."
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