Menopause marks a natural and significant transition in a biological woman’s life, which signals the end of their reproductive years. This stage is frequently accompanied by a challenging collection of symptoms, which can dramatically impact daily comfort and quality of life. These symptoms often include intense hot flashes, chronic sleep problems, and difficult mood swings like anxiety, depression, and irritability.
Hormone therapy (HRT) is often the most effective and commonly recommended conventional treatment option, but a growing number of women now actively seek non-hormonal alternatives. This pursuit has led to a significant increase in the clinical exploration of medical cannabis as a potential treatment.
The way cannabis may help manage these symptoms involves its interaction with the body’s endocannabinoid system (ECS). The ECS functions as a primary regulatory system, governing homeostasis in key physiological processes such as sleep, mood, pain sensitivity, muscle function and tension, and thermoregulation.
The natural decline in the primary female hormone, estrogen, during menopause can cause the ECS to become unbalanced.
However, CBD (cannabidiol) and THC (tetrahydrocannabinol), the active compounds in the cannabis plant, help stabilize the ECS, acting as supports that restore the body’s internal balance when estrogen levels drop.
Patient surveys and studies show that most women using cannabis for menopause often find relief for their symptoms, particularly problems with sleep, intense anxiety and mood swings, and general muscle and joint pain. People often prefer CBD for reducing anxiety, while they use THC, even in small amounts, to treat more serious issues such as severe pain or insomnia. Scientists also think THC might help with bothersome hot flashes and night sweats by gently alleviating the part of the brain that manages body temperature.
Recent studies indicate that a substantial number of women are already turning to cannabis as an add-on (adjunctive) treatment for menopause-related symptoms, with many reporting it as helpful. The most common symptoms women are self-medicating for include sleep disturbances, anxiety, mood issues, and muscle or joint aches.
For example, a 2023 cross-sectional study in Alberta, Canada, found that of almost 1,500 women currently using cannabis, 65% used it for sleep, 45% for anxiety, and 33% for muscle or joint aches, with 74% reporting it was helpful for their symptoms.
Similarly, a 2022 survey of perimenopausal and postmenopausal women reported that 67.4% used medical cannabis for sleep disturbances and 46.1% for mood and anxiety symptoms. Women actively drive most of this use as they seek non-hormonal options, often due to concerns about menopausal systemic hormone therapy (HRT).
However, major medical organizations, such as the North American Menopause Society (NAMS), emphasize that researchers have not yet produced enough high-quality, randomized controlled trial data to confirm the safety, efficacy, and proper dosing of medical cannabis for menopause. As of their most recent position statement in 2023, their view on cannabinoids in menopause is still not supportive because of these limitations.
Therefore, while the reported benefits are promising, healthcare professionals currently do not routinely recommend this treatment until comprehensive clinical research is complete. While states do not formally recognize this diagnosis alone for medical cards, a few states allow prescribers freedom to initiate cannabis therapy where their experience says it could help debilitating conditions.
Researchers have not yet clinically proven it to be an effective treatment in randomized controlled studies, even though its therapeutic potential is promising from self-reported studies.
However, we know cannabis is generally low-risk when used under appropriate medical supervision, and the potential benefits likely outweigh these risks, though it is not yet formally proven to all healthcare professionals.
Women are increasingly turning to cannabis as a potential alternative to traditional treatments. And the potential for its relief is rooted in the way cannabis compounds interact with the body’s ECS, which is closely tied to vasomotor and hormonal regulation.
Specifically, CBD possesses anxiety-calming and sedative properties, which can significantly improve insomnia and sleep disturbances, a top concern for women in menopause. THC and CBD may both reduce inflammation, spasticity, and pain, which can relieve muscle and joint aches while easing mood swings and irritability linked to hormonal changes. Researchers also suggest that THC may help regulate body temperature and reduce hot flashes and night sweats by mimicking the endocannabinoid anandamide, which controls thermoregulation.
However, while women turn to cannabis because it may pose as a natural and less risky alternative to hormone therapy, experts stress that “natural” does not equal “100% safe,” especially when considering natural aging and polypharmacy. This is because one of the primary safety concerns is the high risk of drug-drug Interactions (DDI) in midlife women, who often manage chronic conditions with more than one prescription. Because the liver enzymes responsible for breaking down cannabinoids —THC and CBD, are the same ones that metabolize many common medications, including blood thinners and virtually all antidepressants, combining them could alter the effectiveness or increase the toxicity of these other drugs.
Concerns also exist about the psychoactive effects of THC, causing side effects like lightheadedness, dizziness, and cognitive impairment that may increase risk of vertigo, falls, or the need for caretaking. High THC specifically may potentially exacerbate anxiety and pre-existing mood disorders in older individuals.
There is also an unknown long-term impact of chronic cannabis use on cardiovascular health in a population already at risk for these issues due to age and menopausal changes. However, there are still many protective benefits left to be elucidated in the gut-brain-bone axes, stemming from positive influence in the endocannabinoidome and gut microbiome.
Although cannabinoids like CBD and THC show promising benefits, medical experts agree that until randomized controlled trials (RCTs) confirm safe, specific dosing, using cannabis for menopause remains an experimental form of adjunctive treatment that patients should carefully discuss with their healthcare provider.
The safest ways to take medical cannabis are employing methods that avoid respiratory harm, provide consistent dosing, and minimize the psychoactive effects of THC. Healthcare providers generally recommend smoke-free, non-inhalable methods that allow for careful control over the amount of cannabinoids consumed.
Regardless of the delivery method, safety can be maintained by beginning with a minimal amount and gradually increasing the dose only while monitoring for both benefit and side effects.
The best cannabis products for managing menopause are generally those that maximize therapeutic CBD or CBG content while carefully controlling the amount of THC, and they are delivered through non-inhalable methods to ensure safety and consistent dosing.
In summary, the best products move away from high-THC recreational strains toward pharmaceutical-grade formulations, such as CBD or CBG-dominant oils and low-dose balanced (1:1) capsules, which prioritize consistency, controlled effects, and long-lasting relief.
Traditional treatments for menopause fall into three main categories: Hormone Therapy, Non-Hormonal Prescription Medications, and Lifestyle/Behavioral Modifications.
HRT remains the most effective and “gold standard” treatment for severe hot flashes and night sweats (vasomotor symptoms) and urogenital symptoms.
This involves:
For women who cannot use or choose to avoid hormonal treatment, several effective non-hormonal prescription options are available. They include:
Certain antidepressants, specifically SSRIs and SNRIs, are proven to reduce the frequency and severity of hot flashes by influencing the brain’s temperature regulation. They include:
This is a fundamental element in menopausal management.
READ: Medical Marijuana for Menopause, Endometriosis, and Women’s Health
Yes, cannabis may help to manage symptoms like hot flashes, night sweats, insomnia, sleep disturbance, anxiety, and muscle or joint pain during menopause. However, medical experts stress that consulting with a doctor is absolutely necessary due to a lack of definitive safety with common medications, in older populations, and with limited efficacy data available.
The main categories of drugs used are hormone therapy to replace hormones and non-hormonal medications, such as certain antidepressants and anti-seizure drugs.
Marijuana does not reliably regulate hormones; rather, it may influence them. Its compounds interact with the body’s systems that control hormones, which could potentially lead to an imbalance of reproductive hormones or, conversely, help reduce stress hormones like cortisol. In reality, the most relevant functions here are vasomotor, mood, and sleep regulation.
Long-term and frequent use of marijuana may lead to dependence or addiction (cannabis use disorder), an increased risk of triggering underlying or pre-existing psychosis or schizophrenia, and temporary impairments in motor skills, memory, and learning.
Physical side effects from heavy or long-term use include chronic bronchitis if smoked (a persistent irritation and inflammation of the airways), severe cyclic nausea (cannabinoid hyperemesis syndrome – a condition causing repeated, intense bouts of vomiting), and an increased risk of heart attack.
There is conflicting evidence that marijuana directly increases estrogen. However, its main compound, THC, may influence the body’s key hormonal signals (the HPG axis) in a way that could actually contribute to decreased estrogen levels.
Hormone therapy (HRT) is the most effective treatment for the most common menopause symptoms. However, non-hormonal drugs like fezolinetant, gabapentin, or certain antidepressants may be better for individuals who cannot use HRT. A doctor must evaluate your personal health history to determine the safest and most effective option for you.
The newest menopause drug approved by the FDA is fezolinetant (Veozah®), authorized in May 2023.
It is a non-hormonal treatment that helps to reduce the frequency and severity of moderate to severe hot flashes. Fezolinetant is an alternative for women who cannot use hormone therapy.
Written by Chiagozie Ekemezie
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