If you’re a woman managing menopause symptoms, you may be no stranger to experimenting with purported remedies and complementary treatments. Research cites survey results that note about half of women turn to supplements and yoga during this transition.
Now a study presented this week at the 2023 annual meeting of the Menopause Society suggests another approach — cannabis, or marijuana — may be increasingly popular for mitigating symptoms such as sleep difficulties and mood issues, despite a lack of research on the efficacy of marijuana for these purposes.
The current study has not been published in a peer-reviewed medical journal.
“We know that cannabis use is becoming more common with normalization and with legalization in adults over the age of 50, and women are the fastest-growing populations for those who use cannabis,” says the lead author, Carolyn Gibson, PhD, an assistant professor of psychiatry and a health services researcher at the University of California in San Francisco.
Marijuana is now legal for recreational use in adults 21 and older in 23 states, along with Washington, DC, and two U.S. territories, and medical-use marijuana is legal in 38 states, three territories, and Washington, DC, according to the National Conference of State Legislatures. It contains the psychoactive compound tetrahydrocannabinol (THC), which causes a “high” or mind-altered state. On the other hand, cannabidiol (CBD), another active component of cannabis, is not impairing, according to the Centers for Disease Control and Prevention (CDC). CBD is legal in the United States, with restrictions varying by state, Harvard Health Publishing notes.
Increased access and acceptance has driven cannabis use to an all-time high. According to a Gallup poll released in August 2023, 50 percent of U.S. adults reported experimenting with marijuana.
Although women are using cannabis at a higher rate than ever, “most studies have focused on men and younger adults — not many have looked closely at women in midlife, so there’s a gap in what we know,” says Dr. Gibson.
Many Middle-Aged Women Use Cannabis Daily
To further explore how and why middle-aged women are using cannabis, researchers used data from 5,174 women ages 45 to 64 with an average age of 55. The majority of the women had already gone through menopause, 63 percent were white, and two-thirds were working full- or part-time.
Highlights from the survey included:
- 42 percent of the women reported lifetime cannabis use in any form, most commonly smoking marijuana or using edible products.
- Of the women who said they had smoked, 30 percent reported smoking daily or near daily for a year or longer.
- Of the women who used cannabis, 62 percent used it recreationally, 25 percent reported both recreational and medical use, and 13 percent solely used it to medically manage symptoms and chronic health conditions.
- More than 10 percent of participants had used cannabis in the previous 30 days; most reported smoking or consuming edibles.
- Among the women who had used cannabis in the prior 30 days, about 3 in 10 reported smoking cannabis on a daily or near-daily basis, while close to 2 in 10 reported daily or near-daily use of edible cannabis products.
In those women who used marijuana medically, the most common reasons were for chronic pain (28 percent), anxiety (24 percent), and sleep and stress (both 22 percent).
An estimated 6 percent of women used cannabis to manage menopause symptoms, primarily to target menopause-related mood and sleep difficulties.
Findings also show that middle-aged women appear to be using cannabis for many of the same reasons as adults in general: anxiety, sleep, and stress, but also menopause symptoms, says Gibson. “But we still do not know if use is actually helping for those symptoms, or if it may be contributing to other challenges,” she says.
Anecdotally, Cannabis May Help With Menopause-Related Sleep Issues
Karen Adams, MD, a clinical professor of obstetrics and gynecology and the director of the menopause and healthy aging program at Stanford Health Care in California, says that her patients report turning to CBD or THC-containing marijuana to help them sleep.
“My menopausal patients tell me they are incredibly bothered by their sleep difficulties. They used to be good sleepers, and if they got up at 2 a.m. to go to the bathroom, they could still fall back to sleep pretty quickly. But after menopause, once they were up, they were up for hours — so much so that the next day they experienced brain fog and fuzziness,” says Dr. Adams, who was not involved with this study.
Adams has observed that taking these products before bed has been a game changer for her patients, helping them get to sleep and stay asleep. “Anecdotally it seems to work. However, we need more science investigating the risks, side effects, and long-term outcomes in women using cannabis for sleep issues in menopause,” says Adams.
Using Cannabis for Menopause Symptoms? Talk With Your Provider
“It’s unclear why women are turning to cannabis, a product not thoroughly evaluated as it relates to efficacy and safety, and if they are also talking to their healthcare practitioners about these symptoms,” says Juliana (Jewel) Kling, MD, MPH, a professor of medicine and the chair of women’s health internal medicine and dean of the Mayo Clinic Alix School of Medicine in Scottsdale, Arizona, and who was not involved in this study.
These findings highlight that middle-aged women are having significant quality-of-life symptoms and are looking for options to treat these symptoms, says Dr. Kling. “There are many products available to treat menopause symptoms, but it may be that women aren’t aware of them, aren’t offered them, or are not associating their symptoms with menopause,” she says.
In addition to discussing menopause symptom treatment options, practitioners should ask patients about cannabis given that it is likely widely used, says Kling.
Gibson agrees, saying, “We need to normalize talking about cannabis in the healthcare setting.”
What Are the Health Risks of Smoking or Consuming Edible Cannabis?
The results indicate that smoked and edible forms of cannabis are the most popular ways of using marijuana, and each may be concerning in their own way, says Gibson.
“Obviously, when we think about smoking anything, it brings up concern for cardiovascular health and respiratory health, especially if people are smoking on a daily basis,” she says.
Smoking marijuana “clearly damages the human lung,” has been linked to chronic bronchitis, and may negatively impact the body’s immune system, according to the American Lung Association.
Consuming cannabis via edibles may be safer, but there are concerns about products that have a really high potency, or aren’t labeled (typically in states where marijuana may not be legal and thus regulated), and the potency isn’t known at all, says Gibson.
“Higher potency brings risks for increased tolerance, which brings risks for dependence, and also acute risks such as acute anxiety, fall risk, maybe psychosis, the things that send people to the emergency room,” she says.
THC levels of cannabis have increased, with today’s THC levels about 10 times higher than in the 1970s and ’80s, says Bonnie Halpern-Felsher, PhD, a professor of pediatrics and psychiatry and behavioral sciences at Stanford Medicine in California, who was not involved with this study.
More Research Is Needed to Explore the Benefits and Risks of Cannabis
Gibson and her team concluded that given the “relatively common use” of marijuana, more research is needed to evaluate how cannabis may benefit or harm women during the menopause transition and beyond.
Historically, that’s been difficult given that cannabis is illegal at the federal level, but there’s been some recent progress. In December 2022, President Biden signed into law a bill that streamlines access to marijuana for clinical trials and expedites applications for universities and producers to grow and distribute cannabis for research.
There’s also a move to reclassify cannabis from the highly regulated Schedule 1 class to Schedule 3, which would also make it easier for researchers to conduct studies, according to PBS News Hour.
If you’re thinking about using cannabis for menopause symptoms, talk to your doctor first, says Gibson. “Your provider can give you information on how using it may not be affecting other medications you’re taking. They may also offer other menopause treatment approaches that may have some more evidence,” she says.