Women are turning to cannabis to manage menopause symptoms. Does it help?

Menopause is having a moment. Gone are the days of suffering in silence — today’s menopausal women can choose from wellness retreats, celebrity-backed supplements and hot flash pajamas that all promise to ease the hormonal transition.

But if recent studies are any indication, the buzziest trend in menopausal wellness is weed.

The latest and largest cross-sectional survey to date, which involved more than 5,100 American women between the ages of 45 and 64, found that 42% reported using cannabis. Of those users, 13% solely used the plant — in edible and vape form — to manage age-related symptoms like chronic pain, while 6% specifically turned to weed to treat symptoms of menopause, such as anxiety and sleep disorders. The study, led by Carolyn Gibson, health services researcher at the University of California, San Francisco, and presented at the Menopause Society’s Annual Meeting in September, offered a glimpse into the new normal for midlife women in the age of cannabis legalization.

“We know that cannabis products are being marketed to women to manage menopause symptoms, and these findings suggest that midlife women are turning to cannabis for menopause symptoms and other common issues in the menopause transition,” Gibson stated in a release.

A handful of other surveys in the U.S. and Canada back that up, with participants using medical cannabis to help everything from hot flashes and lowered libido to mood issues and insomnia.

As of October, 38 states have some form of legalized cannabis measures, and women over 50 are one [of] the fastest-growing groups of users. But according to Gibson, “we still do not know if use is actually helping for those symptoms or if it may be contributing to other challenges.”

Hormone therapy remains the safest, most effective treatment for menopausal symptoms but it’s gotten a bad rep over the years, mostly due to a debunked cancer link that made doctors and patients wary.

Another issue is a lack of understanding around menopause in general. On average, women reach menopause — defined as 12 months without a period — between the ages of 46 and 52. But hormonal symptoms such as trouble sleeping and heightened anxiety can kick in up to 10 years earlier, leading women to treat their symptoms rather than the root cause.

And while many midlife women surveyed find cannabis products helped with sleep and mood issues, there’s a lack of scientific research to back those claims.

What we know so far about menopause and cannabis

In the years leading up to menopause, hormones produced by the ovaries begin to fluctuate and eventually decrease. Lower estrogen, in particular, is linked to symptoms like hot flashes, mood changes, lowered libido, joint aches and a host of debilitating issues.

But in recent years, researchers have homed in on the endocannabinoid system, a complex network of transmitters that regulate hormones, such as estrogen.

Endocannabinoids act as an internal air traffic control, regulating everything from body temperature to sleep-wake cycles, memory, bone health and sexual function. But a shift in hormones can throw the system’s whole homeostatic balance out of whack.

Here’s where it gets interesting: Cannabinoids found in the cannabis plant mimic certain endocannabinoids inside your body.

“So theoretically, since THC might mimic anandamide [the temperature-regulating endocannabinoid], it should help with hot flashes,” Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine and the author of Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat, tells Yahoo Life. “Does it actually help hot flashes? We don’t know. That’s the research we need.”

In theory, fewer hot flashes means better sleep, and better sleep can reduce anxiety and a whole host of other menopausal symptoms. For women suffering from sleep disorders, there is some early evidence that cannabis might help regulate sleep-wake cycles and reduce anxiety linked to menopause, but there are a lot of unknowns in regards to long-term risks and interactions with other medications.

More is known about CBD, the non-psychoactive cannabinoid found in pot. It has anti-inflammatory properties and promotes blood flow, which may help ease joint aches and vaginal dryness caused by decreased hormone levels. On its own, it’s legal across the country and sold as cream or oil-based products you can apply directly to pain points. But like all cannabis-based treatments, it still has a lot of unknowns.

That hasn’t stopped a host of new menopause-centric cannabis products from hitting the market — from vaginal suppositories for hot flashes to menopause-branded gummies and oils for anxiety and sleep support.

What we don’t know about cannabis and menopause

Apart from anecdotal evidence, not much is known about the effects of cannabis on menopause symptoms. To date, there are zero clinical trials exploring the risks and efficacy for this cohort. Scientific research on cannabis has long focused on male participants and, to a lesser degree, younger women — two groups that metabolize cannabis faster than menopausal-aged women.

“The first thing we need to do is a randomized controlled trial on women who are using cannabis to treat these symptoms — and a control group not on cannabis — in order to see which symptoms improve and which don’t,” Dr. Stephanie Faubion, director of the Mayo Clinic Center for Women’s Health and medical director of the Menopause Society, tells Yahoo Life.

But that’s easier said than done. While legalization varies by state, cannabis remains a federally classified Schedule 1 drug. That means it’s much harder to obtain for scientific research. It’s also unlikely to receive the kind of funding for rigorous clinical trials that pharmaceutical companies back in order to get FDA approval because cannabis is already on the market.

“What’s the incentive to fund a study if the product is already out there?” notes Streicher. Moreover, what happens if they find their product doesn’t work?

For now, it’s up to women to be savvy consumers. But in the ever-evolving world of legal cannabis, it’s hard to know where to start. A lot of articles suggest “talking to your doctor” about treating your symptoms with cannabis, but what doctor and for which symptoms? Even if you have a provider you trust, there’s still a knowledge gap between clinicians and newfangled cannabis treatments.

Asking your local budtender isn’t any easier, as Streicher has learned. In her own “unscientific experiment,” she’s found that most dispensary clerks don’t know the first thing about menopausal symptoms or how to treat them.

That’s left women like Ellen Scanlon to conduct their own “word of mouth” research. Scanlon was working in health care 10 years ago when she began experimenting with cannabis products to treat her painful endometriosis symptoms. Now she hosts How To Do the Pot, a podcast that brings medical experts together with everyday cannabis users to close the information gap. This month, she’s launching a four-part series on menopause and cannabis for those wanting to wade into weed.

Curious about cannabis? Here’s where to start.

It’s crucial to start “slow and low,” according to Streicher, who suggests taking half of the lowest recommended dose of any edible. (Smoking has a whole host of health risks and is best to avoid, particularly for women over 40.) Streicher also tells new users to keep a diary of symptoms, products, doses and their responses to each.

“The thing that I think is the most important is that you do not have to get high to get the benefits of cannabis,” says Scanlon. “Understanding how cannabis is dosed is also really important, especially if you're buying it in an edible or topical form.”

She says to look for products with a higher ratio of CBD to THC. Think, a ratio of 3 to 1 or even 20 to 1. She also suggests starting with no more than 2 to 3 milligrams.

While cannabis gummies are popular for sleep, they also take longer to kick in and can last up to six hours. For faster, shorter-acting effect, Scanlon suggests oil tinctures for short-term pain and anxiety relief because they’re metabolized quicker.

If you do find yourself feeling too high, Scanlon suggests a drop of CBD oil under your tongue will “bring you back down and help you feel more like yourself.”

Overall, it’s a process of trial and error. “Everyone's endocannabinoid system is different,” says Scanlon, “so you're going to have to experiment to find the amount that makes you feel your best.”

But should you experiment at all?

Other experts suggest first trying more mainstream options to manage menopause symptoms before experimenting with cannabis. “I think women need to back up a little bit here,” says Faubion. “Why are you going to use an unproven therapy when we have plenty of safe and effective therapies, including hormone therapy, available for treatment of menopause symptoms? Why are we not using that?”

Streicher agrees that hormone therapy remains the “gold standard” for symptom treatment. But that doesn’t change the fact that women are turning to cannabis in droves for relief. “Women with menopause symptoms that negatively impact their ability to function are desperate for answers,” says Streicher, who’s conducting her own online survey of menopausal cannabis users here. “For some, this feels like their answer.”

That’s not to say it’s the answer, especially with how little is known about the safety and efficacy in symptom treatment. “Is it better to eat a cannabis gummy for sleep than a sleeping pill? I can’t answer that,” admits Streicher, “but I do know it should be in the toolbox.”