Past and Present: Cannabis for the Treatment of Menopause

Women’s health, a topic traditionally excluded from scientific research, is slowly getting more recognition. Menopause is one such condition getting renewed attention, including through the lens of medical cannabis.

 

Menopause, characterized by the end of menstruation, with symptoms ranging from hot flashes, chills, night sweats, sleep problems, mood changes, and slowed metabolism, is a condition that can seriously impact quality of life. According to the results of a 2013 study reported in the Journal of Women’s Health, “Women experiencing menopausal symptoms reported significantly lower levels of HRQoL and significantly higher work impairment, and healthcare utilization than women without menopausal symptoms.”

 

A new survey presented at the 2020 Virtual Annual Meeting of The North American Menopause Society reported that 27 percent of respondents relied on cannabis (past or present) to relieve “bothersome” symptoms of menopause. A further 10 percent reported curiosity about trying medical cannabis in the future. What’s more intriguing? Less than 20 percent of the women indicated more conventional menopause management. This survey suggests cannabis may provide more satisfactory relief than pharmaceutical options and is the preferred choice for many.

 

Could medical cannabis finally offer relief where other medications and treatments have failed?

 

History of Cannabis Use for the Symptoms of Menopause

 

The new interest in medical cannabis for treating the symptoms of menopause is technically a renewed one. Although rarely discussed, there is a long medical history of cannabis for women’s health, from dysmenorrhea (pain related to menstruation) to menopause.

 

As summarized by Ethan B. Russo in “Cannabis Treatments in Obstetrics and Gynecology: A Historical Review in 2008,” there are several historical mentions of cannabis preparations for menopause dating back to 19th-century medical literature.

 

The first instance highlighted in Russo’s piece is from a physician named John W. Farlow, M.D. In Farlow’s 1889 publication “On the use of belladonna and Cannabis indica by the rectum in gynecological practice,” he discussed using rectal suppositories of cannabis for soothing the most common menopausal symptoms.

 

Farlow wrote, “At the menopause the well-known symptoms, the various reflexes, the excitement, the irritability, and pain in the neck of the bladder, flashes of heat, and cold, according to my experience, can frequently be much mitigated, by the suppositories.” Rectal preparations reduced the risk of intoxication. In his words, “I do not think there is anything to be gained by pushing the drugs to their physiological action.” It is an opinion Farlow shares with many modern-day physicians.

 

Charles Sajous highlighted cannabis once again for use during menopause in his Analytic Encyclopedia of Practical Medicine, published in 1927. Sajous advised on its application for several gynecological conditions, including as an “analgesic for menopause, uterine disturbances, dysmenorrhea, menorrhagia and impending abortion, and postpartum hemorrhage.”

 

Of course, western medicine represents only a small window into how cannabis may have alleviated the symptoms of this condition worldwide. A brief historical summary detailed in “Cannabis and symptoms of PMS and PMDD” highlighted evidence from ancient China, in 4000 BC under Emperor Chen Nungs’s reign. Cannabis was a standard medicine, recommended for a variety of illnesses including ‘female disorders.”

 

Return to Medical Cannabis for the Symptoms of Menopause

 

The majority of modern studies into cannabis for the symptoms of menopause have largely failed to move beyond patient surveys exploring patterns of use and reported relief of symptoms. At the time of writing, there were no clinical trials in any phase of recruitment or completion working with cannabis to treat menopause.

 

Yet, increasingly patient surveys tell us that women are finding relief with medical cannabis for symptoms ranging from painful inflammation to depression to insomnia, including within RYAH’s extensive data ecosystem.

 

Between January 1, 2018, and December 1, 2020, a total of 9,270 women between the ages of 40 to 60 reported medical cannabis consumption in the RYAH Data ecosystem. Within this age demographic, women make up slightly more of the dataset at just over 51.7 percent of the total reporting. Why is this interesting? As soon as the age filter is removed, men become the majority, representing 55.5 percent of RYAH Data’s population. This suggests women find more relief for more conditions or symptoms during this age range.

 

What’s even more fascinating is the subtle shift in conditions treated by the female demographic between ages 40 and 60. RYAH Data tells us that anxiety, stress, depression, pain, and insomnia are the top five conditions that women treat, no matter how the data is sorted, typically with the mood disorders as the top three. But as soon as we filter for women between the ages of 40 to 60, something shifts.

 

According to RYAH Data, women within the menopausal demographic treat anxiety (8.89 percent), pain (8.79 percent), depression (7.73 percent) stress (7.36 percent), and inflammation (6.13 percent). Two other common symptoms of menopause are the sixth and seventh most reported: insomnia (5.89 percent) and fatigue (5.89 percent). This demographic clearly relies on medical cannabis for different conditions than younger women — conditions directly associated with menopause.

 

Although RYAH Data does not explicitly include menopause as a condition treated, many menopausal and perimenopausal symptoms are covered (ex. anxiety, inflammation, fatigue, insomnia, etc.). The 2013 paper from the Journal of Women’s Health mentioned above tells us that “depression, anxiety, and joint stiffness were symptoms with the strongest associations with health outcomes.” Women in RYAH within the menopause demographic list these conditions as the third, first, and fifth most commonly treated symptoms (presuming that inflammation and joint stiffness are one and the same).

 

What’s Next for the Evolution of Cannabis for Menopause?

 

With definite historical indication that women relied on cannabis for menopause and other gynecological conditions, and substantial evidence for its current use as well, what’s next?

 

While there is a growing number of patient surveys reporting that women rely on cannabis to reduce many of the most challenging systems of menopause, there is little (if any) research exploring how it works.

 

Considering the endocannabinoid system regulates hormone production and the female reproductive system, this will inevitably be the first area to explore. But with no clinical trials in the pipeline, this novel area of menopause treatment is years away from clarity. Unfortunately, women’s health continues to receive less attention than conditions that also affect men.

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