What doctors want women to know about cannabis and menopause
When it comes to perimenopause and menopause, many experience symptoms that make them feel uncomfortable and even downright miserable at times. Yet more and more people are finding a new way to cope: Some have found that marijuana can help with hot flushes, sleep disturbance, mood changes and vaginal dryness and pain. While more feel comfortable turning to cannabis to help, there’s little research showing whether it works or how to use it.
“The research we have about using cannabis, whether it’s marijuana or CBD, to help with menopausal symptoms is really lacking,” Dr. Jennifer Lincoln, author of the book, “Let’s Talk About Down There: An OB-GYN Answers all Your Burning Questions … Without Making You Feel Embarrassed for Asking,” told TODAY. “Truly, we do need more research on cannabis and CBD.”
She said because the U.S. Food and Drug Administration considers cannabis a schedule one drug (meaning it has no accepted medical use) “it really ties our hands and makes research very difficult.” There are FDA-approved treatments, such as hormone replacement therapy, that work well for many of the symptoms.
“Historically, women’s health, things that affect women’s health, tend to be under-researched and underfunded, but we do know there are good treatments to deal with the symptoms of menopause, whether it’s vaginal dryness or hot flushes or mood disturbances,” Lincoln said. “They are well studied. We know the doses and formulations.”
Still, many might feel like their symptoms are simply part of aging and don’t seek help for them. Or, they might try to discuss it but feel as if they’re being dismissed. That could contribute to people seeking cannabis to help.
Why people in menopause are turning to cannabis
A study from 2020 found that nearly 27% of people in menopause used marijuana to ease symptoms. Another 10% indicated they wanted to use marijuana to cope with the symptoms while only 19% used traditional treatments.
“People going through menopause are left thinking, ‘Well, I don’t know where else to turn,’ so they try (cannabis),” Lincoln explained. “I feel for them because they feel like nobody’s listening to them.”
Dr. Lauren Streicher, medical director of Northwestern Medicine Center for Sexual Medicine and Menopause, has been writing a series of books about menopause symptoms. In her latest, “Hot Flash Hell,” she explains how to use marijuana as a treatment for hot flashes in one chapter.
“What we know is there are a lot of women who are using cannabis to alleviate menopause symptoms and they really have no direction at all,” Streicher told TODAY. “There’s not been a lot of research done.”
She looked at what experts do know about cannabis and applied it to how some might want to use it for menopause.
“Any information that I give is based on the science behind cannabis as opposed to (a study where) we took 1,000 menopausal women with hot flashes and we gave half of them cannabis,” she said. “We don’t have those studies.”
Streicher also started surveying people to understand what symptoms cause them to take cannabis. While she’s still collecting data, early results provide some insight into what signs encourages cannabis use.
“Overall the two things that people are using cannabis for are hot flashes and sleep and, of course, they go together,” she said. “It’s the hot flashes that in the majority of cases are keeping women awake at night.”
She said she’s also hoping to understand if a doctor, pharmacist or dispensary employee tells them how to take it and what types of products they might use.
“When I say, ‘Who directed you as to what to take?’ over 50% say, ‘Nobody. I was just trying to figure it out on my own,’” she said. “Therein lies the problem.”
For example, people sometimes take edibles, which can take up to several hours to work. When they don’t feel the effects fast enough, they might pop a few more. That might mean they’re taking too high of a dose. In other cases, they’re not taking enough because they do not realize how their bodies process cannabis.
“No one is directing them that they metabolize it far more slowly, which is going to impact not only what they should be taking, but how they take it and how much they take,” she said. “That’s the direction I was trying to give in my chapter as best as I could to say, ‘OK if you’re going to do this, I don’t want you to get in trouble.’”
Talk with your doctor first
The experts both agree that if people take cannabis for any reason they should tell their doctors. It can interact with certain medications and it impacts the amount of anesthesia one might need, for example.
“Please tell us,” Lincoln said. “We’re here to help you and we’re not judging you when you tell us that you’re using this or that. It’s just like it is with any other supplement. It’s super important that we know what you’re on.”
She adds that there is one menopause symptom that people should definitely talk to their doctors about and not try to treat themselves.
“Any bleeding after you’ve officially gone through menopause we need to know about because you’re at high risk for cancer of the uterus,” Lincoln said. “It doesn’t mean that’s what it is. I don’t want to scare you away from getting treatment. But we need to check you out.”
Streicher hopes more people talk about menopause so they understand what it is and what treatments are available.
“Their doctors don’t bring it up. They don’t bring it up. And in the event that they do bring it up, more often than not women have a doctor who is not an expert,” she said. “You’re never done with menopause. You enter menopause and you’re in menopause until you die.”