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cbd oil for menopause symptoms

CBD oil and menopause

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Contents

  1. Research overview
  2. Patient perspective

A normal and inevitable part of aging, menopause is a transitional period when menstruation ceases. Menopause can cause a wide range of symptoms, many of which vary from one woman to the next. Most often occurring between the ages of 45 and 55, this transition typically lasts around seven years.

During menopause, estrogen levels significantly drop, causing numerous symptoms. However, research is beginning to suggest that cannabis and the body’s endocannabinoid system (ECS) may be able to help counteract some of these effects without the possible dangers of hormone replacement therapy (HRT). Notably, combination HRT and estrogen-only therapy have shown to increase the risk of breast and ovarian cancers, according to Breastcancer.org. Even short-term combination HRT may increase the risk of breast cancer at an alarming rate of 75 percent.

CBD, as well as THC, have become key areas of interest, offering potential low-risk treatment options for menopause symptoms. Photo by: Gina Coleman/Weedmaps

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Cannabidiol (CBD) and THC have become key areas of interest, offering potential low-risk treatment options for menopause symptoms. Women of all ages have experienced CBD-related relief in relation to other female-specific hormone-related conditions and symptoms, including premenstrual syndrome (PMS), as reported in an article published in 2017 in the journal Addiction Research & Theory.

Research overview

While studies on CBD and menopause are limited, there is evidence that high-quality CBD products may help combat associated symptoms. This is particularly true when CBD is combined with other treatment options.

According to a literature review published in 2019 in the Journal of Ovarian Research, the ECS impacts female reproductive tissues and processes, playing a vital role in temperature regulation, sleep, pain, mood, memory, and immune function.

Several studies have reported the positive effects of CBD and CBD-rich cannabis oil on mood changes, joint pain, and sleep problems, all commonly associated with hormonal changes during menopause. Though the studies didn’t look specifically at menopause, the results indicate that CBD could provide relief for these symptoms regardless of their cause.

In addition, numerous studies have identified the potential impact of CBD on mood, including its inherent anti-anxiety and antidepressant effects. A 2018 study published in the Journal of Affective Disorders found that cannabis significantly reduced perceptions of depression, anxiety, and stress in both women and men. Researchers also reported that women experienced greater reductions in anxiety compared to men and that low-THC/high-CBD strains were best for reducing symptoms of depression.

Aches and joint pain frequently occur post-menopause, as reduced estrogen levels tend to produce higher levels of inflammation. Luckily, CBD has been shown to offer relief from pain and inflammation, as reported in a 2015 literature review published in the journal Bioorganic & Medicinal Chemistry

Aches and joint pain are also often reported post-menopause, as reduced estrogen levels tend to produce higher levels of inflammation. Photo by: Gina Coleman/Weedmaps

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In addition, a 2016 study published in the European Journal of Pain examined the efficiency of transdermal CBD for pain and inflammation in rats. Researchers found that topical CBD can help reduce swelling as well as other signs of inflammation. The study concluded that CBD provides potential therapeutic relief when aiming to treat arthritis pain, as well as inflammation, without any apparent side effects.

Sleep disturbances are also an area of concern among menopausal and postmenopausal women, with 61% reporting insomnia symptoms. In a 2019 study published in the Permanente Journal, researchers were interested in whether CBD would improve sleep and anxiety among a clinical population. After providing CBD treatment to 72 adults, the researchers found that anxiety scores decreased in 79% of patients within the first month and sleep scores improved in 67% of patients within the first month.

Patient perspective

Dr. Melanie Bone, a board-certified OB-GYN and cannabis specialist, shared the stories of two of her patients who are going through menopause and using CBD as a treatment option. Names have been redacted in accordance with patient privacy laws.

J.A. is a 52-year-old woman who has had one period in the last six months. She has trouble sleeping because she is awakened with hot flashes and sweats. This makes her tired during the day and she feels depressed because she can’t get a good night’s sleep. J.A.’s sister had breast cancer at age 54 and she is worried about being diagnosed herself. She is scared to use hormones due to the history of breast cancer in her family.

Dr. Bone said, “The patient wanted a consult because she is having so much trouble concentrating at work that she is afraid she will lose her job. After I explained to her that she could opt to try hormones, she decided to try cannabinoids first, with hormones as a fallback. Currently, she is doing exceedingly well with excellent management of most of her complaints. Just a few daytime hot flashes remain as a reminder of her menopause.”

cbd and menopause

Using both cannabis and bioidentical hormones may be helpful to some menopausal patients. Photo by: Gina Coleman/Weedmaps

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cbd and menopause

C.T. is a postmenopausal patient who uses both cannabis and bioidentical hormones. She told Weedmaps, “I was using bioidentical hormones to help with hot flashes, mood changes, and dryness. After discussing my situation with Dr. Bone, we agreed that I might benefit from the addition of cannabis.

“Now that I have been using both, I feel great. I have no more symptoms of menopause and my husband is delighted to have me back to my old self.”

It is important to note that these are individual testimonials and results will vary among patients. Be sure to consult with your physician before beginning a CBD regimen to address the symptoms of menopause.

What the experts say

Researchers are only just beginning to understand how the ECS works in relation to menopause and other health-related conditions. However, for those looking for an alternative therapy option, CBD may show great promise, according to some physicians.

“There are more issues at stake in menopause: sexual dysfunction, dryness, urinary complaints, and weight changes,” Dr. Bone said. “While some of these complaints are best managed with hormones, in women who have contraindications to using estrogen, such as a history of breast cancer, there is a definite role for cannabinoids to help as well.”

Bone continued, “There is a wealth of history and tradition pointing to the efficacy of cannabis for a variety of women’s conditions, from menstrual cramps to postpartum hemorrhage. The THC of cannabis helps with aches and pains associated with arthritis that sets in with menopause. It also helps with some of the mood swings that can herald the onset of menopause. CBD is important to manage anxiety that is almost universal during menopause. The combination of CBD and THC is essential to help with sleep problems, which are all too common in menopausal women. The ratio that works depends on which complaints are most prominent, but I find that a 1:1 is the sweet spot for a lot of women. In addition, local cannabinoids can be added for vulvovaginal-vaginal complaints and painful sex.”

Dr. Adie Rae, a neuroscientist and scientific adviser to Weedmaps, added, “Although cannabis does not address vaginal dryness, it has been shown to increase libido, decrease pain, and enhance orgasm.”

In fact, certain cannabis strains and products have been designed with women’s sexual pleasure in mind. CBD topicals like Night Moves, Happy Clam Oil, and Smooth Operator are all touted to enhance women’s sexual wellness.

Bottom line

CBD oil and CBD-rich cannabis oil may combat some of the most problematic symptoms associated with menopause, including sleep disturbances, mood changes, and aches. Anecdotal evidence and animal model studies suggest that combined cannabinoids, rather than the more readily available CBD isolate, may be better at alleviating some of the more severe symptoms associated with menopause. When high-quality CBD oil is combined with positive lifestyle changes, there may be a greater synergistic effect, though further research is necessary.

While studies on CBD and menopause are limited, there is evidence that high-quality CBD products may help combat associated symptoms. This is particularly true when CBD is combined with other treatment options.

Everything You Always Wanted to Know About Cannabis and Menopause

How it works, what to avoid, and where to legally acquire it

With Melanie Bone MD

Seeing a menopause and cannabis savvy healthcare practitioner is one way to make sure your foray into this alternative treatment is both safe and effective.

Just about every one of us going through the stages of menopause or perimenopause knows someone who swears cannabinoids, whether CBD or THC, have made her feel so much better. Maybe you’ve even been experimenting yourself. But does cannabis really help? Or is it all just wishful thinking and clever marketing? The short answer is, it’s complicated.

How cannabinoids work

We all have an endocannabinoid system composed of cell receptors throughout the body that help maintain homeostasis. These respond to endocannabinoids, the cannabinoids your body produces, as well as to external cannabinoids.

There are 113 cannabinoids found in marijuana and hemp flowers. Non-psychoactive compound CBD (cannabidiol) is most often extracted from hemp flowers, which also contain trace amounts of (0.3 percent) THC (tetrahydrocannabinol). Marijuana flowers contain much higher concentrations of THC. We are still learning more about other compounds such as CBG, CBN, and CBC.

Estrogen is important to the endocannabinoid system because it regulates fatty acid amide hydrolase (FAAH), which breaks down certain endocannabinoids. So, if there are lower (or fluctuating) levels of estrogen in your body, this can affect your endocannabinoid system, which in turn may partly explain some of the effects of perimenopause such as depression, anxiety, mood swings, lower libido, and difficulty sleeping. So, it would make sense that doses of cannabinoids would help out with those symptoms. If only it were that simple.

The thing is, we’re still learning about how cannabis works in the human body. Conducting clinical research is challenging, especially because marijuana is still illegal in many states. Thus far there have been no peer-reviewed clinical studies of cannabis with menopausal humans. Research into CBD is still in early stages as well (for example, CBD has been found to address depressive symptoms, but so far only in mice).

That said, preliminary research looks promising for a number of issues associated with perimenopause and the post-menopause years.

Sleep disorders and cannabis

Ob-Gyn and medical marijuana provider Dr. Melanie Bone says sleep disorders, whether falling asleep, staying asleep, or both, are very common among women during the menopause years. When treating patients, she first rules out any other possible medical reasons (such as sleep apnea), then she tailors her treatment according to the type of insomnia her patients are struggling with.

“I think women have trouble turning off their thoughts at night and this causes insomnia,” says Dr. Bone. Sound familiar? “Either they ruminate and can’t fall asleep, or they wake to use the bathroom, and they immediately start thinking about the next day’s to-do list and can’t fall back asleep.” She says cannabis can be very helpful treating these issues. “I usually recommend a higher THC product to fall asleep, but a lower THC product to stay asleep (for if they wake up in the middle of the night).”

Preliminary research backs this up. Certain combinations of CBD and THC may provide relief for conditions such as pain and sleep disorders. One study showed that people with PTSD who smoked 5mg of THC twice a day improved their sleep. And a new 2019 study on CBD and sleep/anxiety concluded that it could be helpful, but that more research was needed.

Cannabis for hot flashes?

THC can mimic some aspects of anandamide, an endocannabinoid that helps regulate body temperature. Can it quell hot flashes?

Dr. Bone says that while hot flashes are best treated with HT (Hormone Therapy), their most common triggers can be treated with cannabinoids. Take one of the biggest triggers, anxiety. “When a woman finds herself in a high-stress moment, she may start to sweat and flash,” says Dr. Bone. “This is often ameliorated with cannabis. I find that higher-CBD products are best to reduce anxiety, but years of practicing have taught me that every patient is unique and there are women who respond best to higher doses of THC to help mitigate anxiety.”

The link between cannabis and sexual function

A meta-analysis of 12 human studies and 8 animal studies concluded that cannabinoids may have an effect on female sexual function, but it’s unclear whether that’s positive or negative, and more studies are needed. As for vaginal/vulvar dryness, that can be partly managed with topical cannabis, Dr. Bone concedes, “but I get better results using a combination of local (vaginally applied) hormones and cannabis.”

The entourage effect

Doctors and researchers are finding that when we use all parts of the cannabis plant, the cannabinoids, terpenes, and flavonoids seem to work together synergistically for maximum effect; and this is called the entourage effect. (Leaving those trace amounts of THC in a CBD product makes it more effective than without.)

That also goes for the complex issues of the menopausal transition, according to Bone. While she doesn’t usually recommend replacing HT with cannabinoids, she says they can be used in conjunction with hormones for best results. “I do see a dose reduction in hormones in a lot of women who use cannabinoids,” she says.

“There is no one-size-fits-all approach,” Dr. Bone cautions. It depends on what you’re treating. “If you have a day-in and day-out set of symptoms such as hot flashes, it is helpful to recommend a form of cannabis that treats for longer duration without impairment.” This could be sublinguals, suppositories, lube, edibles, or infused drinks. It can take a little experimenting to find the right dosage. Vaping and smoking work quickly, but Dr. Bone finds them less than ideal because they would necessitate multiple doses during the day and carry their own cardiovascular risks that many menopausal women are wise to want to avoid.

What cannabis products are best for menopause?

Doctors generally don’t recommend smoking or vaping cannabis because that can damage your respiratory system. Infused food and drinks (edibles), tinctures (liquids in a dropper), or sublinguals (tabs you dissolve under your tongue), and lube are generally considered safer delivery systems.

Sublinguals

Sublinguals are growing in popularity because they are almost as quickly absorbed in your body as smoking/vaping, but without the deleterious health effects. You can take most tinctures sublingually unless otherwise specified.

Your body distributes cannabinoids from sublinguals, smoking, and vaping differently than from edibles, which go through your digestive system. Paradoxically, while we absorb more THC from smoke/vape/sublinguals, edibles are more likely to create a stronger body high, often referred to as the “couch lock.” This is not so bad if you just want to go to sleep, but not too helpful if you want to remain awake and social.

Topicals

Topical CBD in the form of suppositories, lubes, oils or creams can reduce inflammation where applied, and, because your skin has cannabinoid receptors, can temporarily relieve pain from conditions such as arthritis, vaginal irritation during sex, or cramping during perimenopause. But cannabis applied topically will not reach your bloodstream, so it will not address other issues such as anxiety or insomnia, and you will not get high from any amount of THC in the product when it is applied topically, if that is a concern.

Dosing

Effective dosing varies widely by individual and condition. For CBD, most experts recommend starting with 20mg and waiting 90 minutes (especially for edibles) to gage the effects of that dose before taking more. Start low and slow. As for THC products, microdosing (2.5-5mg) is gaining in popularity because it can be highly effective without the psychotropic effects, and a good way to try out cannabis without risking feeling too altered. Remember, you can always add more, but you can’t lower the dose once you have taken it, so start small, particularly if you are just beginning experimenting with these therapies.

If you’re using either or both as a sleeping aid, for best results use in concert with other sleep-supportive strategies such as having a regular routine, avoiding stimulants in the afternoon, and limiting electronics before bedtime. Think of cannabinoids as supporting or enhancing your other health-promoting practices, not replacing them.

How to read cannabis product labels

Familiarize yourself with these terms:

Full spectrum CBD

This means the product includes all the cannabinoids in the hemp flower, giving you the entourage effect.

Broad spectrum CBD

This means nearly the same thing, but with the trace amounts of THC removed.

THC products come in full spectrum as well. Some people prefer isolates, in which specific cannabinoids are extracted for intended results.

Flower not seed

The active ingredient of a CBD product should be listed as hemp extract, CBD cannabidiol, hemp oil, full spectrum hemp, or PCR (phytocannabinoid rich) hemp extract. This tells you it comes from the flower. Do not buy “hemp seed oil” as this is simply oil extracted from the seed, not the flower, and contains no CBD.

Third-party testing

This means a lab independent from the cannabis company analyzed the product and vouched for its ingredients. This is how you know it’s safe and reliable. There should be a CoA (Certificate of Analysis) either in the packaging or online, which you can access via a QR code on the label.

Origin

Products made from cannabis grown in the USA tend to be safer and more trustworthy.

Method of extraction

CO2-based extraction is a very clean kind of extraction because no solvents are used. Also, look for cannabis-infused products. Some edibles are simply sprayed with a solution, which makes them less reliable and effective.

What to be wary of:

Specific health claims

Take any claims about intended effects (sleep aid, reducing anxiety, etc.) in the marketing or packaging with a grain of salt. As cannabis and CBD supplements are not regulated, none of those claims can be substantiated.

Where to buy legal cannabis

If you live in a state where THC is legal, your best bet is a dispensary. As CBD is legal in more states, it’s more widely available in places from yoga studios to boutiques, but just because it’s legal doesn’t mean it’s legal in all forms. According to the FDA, it’s not legal to sell food or beverages containing CBD (you will find them everywhere anyway). For CBD products, it’s especially important to read the labels and buy from trusted sources, e.g. not from a multi-level marketing company.

Two reputable companies that sell legal, high-quality CBD products online and only offer THC if it is legal in your state (so you don’t have to worry about it if it is not) are Lord Jones and Foria.

Cannabis website Weedmaps updates their searchable maps of local dispensaries.

Online magazine Leafly tracks cannabis laws by state (see also their CBD laws by state).

Project CBD is a nonprofit created by journalists who compile the latest research.

Cannabis education platform Nice Paper has a comprehensive guide to dosing CBD.

Information on marijuana and menopause, according to doctors of the medical marijuana network.

How it works, what to avoid, and where to legally acquire it.