Hot flashes and changes in sleep or mood are well-known, bothersome symptoms that can occur during perimenopause and menopause. Now, a survey shows that almost 80% of middle-aged women use cannabis to relieve certain symptoms, such as mood problems and sleep problems.
More and more US states have legalized marijuana for medical or recreational use in recent years. This wave of acceptance comes with skepticism in some quarters about FDA-approved menopause treatment options, including hormone therapy. But a lack of long-term research data on cannabis use has led a Harvard expert to question how safe it can be, even as she acknowledges its potential effectiveness for some menopausal ailments.
"More and more patients tell me every year that they've tried cannabis or CBD (cannabidiol, an active ingredient in cannabis), particularly for sleep or anxiety," says Dr. Heather Hirsch, head of the Menopause and Midlife Clinic at Harvard. affiliated Brigham and Women's Hospital. “What adds to its appeal is that cannabis is now legal in so many places and works high for a few hours. You don't need a prescription. Socially, it can be easier to justify than using a drug. But why is there a movement to say OK to something that has unknown long-term effects, more than something that has been studied and proven safe?'' he wonders.
Research reports on who uses cannabis, why and how
The new Harvard study, published in the journal Menopause, looked at the cannabis use patterns of 131 women in perimenopause – the often long period before a period ends – along with 127 women who had gone through menopause. Participants were recruited through online postings on social networking sites and an online recruitment platform. Almost all survey respondents were white, and most were middle-class, according to income reports.
The vast majority (86%) were current cannabis users. Participants were divided into whether they used cannabis for medical reasons, recreational purposes, or both. Almost 79% approved it for relieving symptoms related to menopause. Of those, 67% said cannabis helps with sleep disturbance, while 46% said it helps improve mood and anxiety.
Perimenopausal women reported worse menopausal symptoms than their postmenopausal peers, as well as greater use of cannabis to manage their symptoms. More than 84% of participants reported smoking cannabis, while 78% consumed edibles and nearly 53% used vape oils.
An obvious limitation of the analysis is the self-selected group of participants, which lacked diversity and may have skewed the results. But Dr. Hirsch was not surprised by the high percentage who reported regular cannabis use. "I wouldn't be surprised if these numbers are reflective of the wider population," he said.
How Can Cannabis Help Menopause Symptoms?
It makes sense that middle-aged women reported that cannabis improved anxiety, mood and sleep, says Dr. Hirsch. The drug likely helps all these symptoms by "shrinking the prefrontal cortex, the decision-making part of our brain."
For many women, stress increases during menopause, she notes. Common stressors during this time, such as aging parents or an empty nest, add to the effects of hormones. "It's that feeling of 'I can't turn my brain off.' It's really worrying because they fall into bed and can't fall asleep, so they're more tired, moody and irritable the next day,” she explains. Reducing the blurring of the prefrontal cortex allows people to calm down.
Hot flashes, often cited as the most common symptom of menopause, were not as improved by cannabis use, according to survey respondents. That makes sense, too, says Dr. Hirsch, because the hypothalamus – the area of the brain considered the body's thermostat – is not thought to be significantly affected by the drug.
There is no research yet on the long-term effects
Given the lack of clinical trials objectively testing the efficacy and safety of cannabis for the management of menopausal symptoms, more research is clearly needed.
“If people find relief from cannabis, that's great. But is it safe? We think so, but we don't know," he says. “There are no studies of middle-aged women using cannabis for 10 years, as long as menopausal symptoms often last. Will there be long term effects on memory? In lung function? We do not know".
Source Harvard Medical Blog