There are estimated to be around 13 million peri- or menopausal women in the UK; yet, according to recent findings, only a fraction of these are finding adequate symptom relief with conventional treatments. Furthermore, in a society where women’s health is often overlooked, menopause continues to be treated with stigma. As a result, many feel uneducated and unheard when it comes to this natural life phase.
But in this context of stigma and poor symptom management, a growing number of peri- and post-menopausal people are embracing the potential benefits of cannabis. But is there any evidence that cannabis and/or its derivatives could be useful in the management of menopause symptoms?
What is menopause?
As mentioned above, menopause is a completely natural life phase in which women and people with uteruses cease to have periods. This change tends to begin between the ages of 45 and 55; however, in less common cases, it can occur much earlier. Menopause is caused by hormone changes – namely, when the production of oestrogen and progesterone begins to decrease.
Menopause symptoms can begin before a person’s periods have stopped – this is known as peri-menopause. This phase ends, and a person reaches menopause when they have not had a period for 12 months. Menopause is associated with a wide range of symptoms which can vary significantly in severity. Some common symptoms include:
- Hot flushes
- Brain fog
- Sleep disturbance
- Anxiety
- Depression
- Reduced sex drive
- Muscle and joint pain
Conventional treatments for menopause symptoms
The main treatment for menopause is hormone replacement therapy (HRT), which replaces the hormones that are in decline. But while HRT is considered a safe and effective treatment, it is currently estimated that only 10-13% of menopausal women in the UK are using it. Furthermore, according to a recent report, only around four in 10 women are immediately offered HRT by their GP.
The reasons behind the low utilisation of HRT are varied. In the past, there have been several supply shortages; however, some people may also choose not to take HRT due to ineffectiveness or personal preference.
Other non-hormonal approaches may include:
- Medications: Clonidine and gabapentin for hot flushes and night sweats
- Antidepressants: To relieve mood symptoms
- Cognitive behavioural therapy (CBT): Psychological support
- Lifestyle changes: Healthy diet and regular exercise
Nonetheless, over three-quarters still report experiencing one or more menopause symptoms that they find “very difficult” to manage.
Cannabis and menopause: what the research shows
It’s no secret that cannabis is being increasingly utilised for a huge range of symptoms and conditions. This is partly thanks to the growing acceptance of the medicinal potential of the plant among both patients and lawmakers around the world. But could cannabis and its derivatives help to ease the symptoms of menopause? Well, a growing number of people seem to think so – and clinical evidence is slowly catching up.
Canadian study reveals widespread cannabis use among menopausal women
In 2023, a study of women in Alberta, Canada, where cannabis has been legal for medicinal uses since 1999 and for recreational purposes since 2018, surveyed 1,485 women aged 35 and over. The findings, published in BMJ Open, revealed striking usage patterns:
- 33% were current cannabis users (median age 49)
- 66% had used cannabis at some point in their lifetime
- 75% of current users employed it for medical purposes
- 35% of respondents were post-menopausal
- 33% were perimenopausal
Over a third of respondents (35%) were post-menopausal, and a third (33%) were perimenopausal. Significantly, 75% of respondents who reported medicinal use of cannabis said that it was helpful for menopausal symptoms, with the most commonly reported uses being:
- Sleep disturbance (most common)
- Anxiety
- Muscle and joint pain
- Mood swings
- Irritability
- Hot flushes
Importantly, the study found that women using cannabis reported more severe menopause symptoms overall, including sleep issues, mood swings and depression. However, most users sourced their information online rather than from healthcare providers, highlighting a significant gap in medical guidance.
US findings mirror Canadian trends
A smaller study conducted in 2022 specifically assessed medical cannabis use among 258 perimenopausal and postmenopausal women in the United States. The results were striking: The vast majority of participants (86.1%; n = 222/258) reported current cannabis use. Furthermore, over three-quarters endorsed the use of medical cannabis for menopause symptoms.
Primary symptoms treated with cannabis:
- 67.4% used it for sleep disturbance
- 46.1% for mood and anxiety
- 30.4% for libido issues
The study noted that perimenopausal women in particular reported higher severity of mood and anxiety symptoms and were more likely to use cannabis for these issues.
CBD and menopause symptoms
In recent years, cannabidiol (CBD) has become immensely popular among people of all ages and backgrounds. This non-intoxicating common cannabinoid has been used for everything from stress and anxiety to sleep disturbance and pain. With such a range of potential uses, it should come as no surprise that CBD products have become especially popular among women. But is there any evidence to support the use of CBD for these symptoms?
Various studies have been conducted in recent years to understand the therapeutic potential of CBD. Some findings, including a 2019 study into the use of CBD for sleep and anxiety, indicate that the cannabinoid may be beneficial for improving sleep and anxiety.
2019 CBD study results (72 participants):
- 66.7% showed improved sleep scores
- 79.2% showed improved anxiety scores
- Improvements observed within the first month of treatment
To learn more about the potential of CBD in the management of menopause symptoms, take a look at our article, “Can CBD help with the symptoms of menopause?“
THC and CBD: getting the balance right
When it comes to medical cannabis for menopause symptoms, the ratio of tetrahydrocannabinol (THC) to cannabidiol (CBD) matters significantly. Research and clinical experience suggest that balanced formulations containing both THC and CBD may be particularly effective for managing mood swings, emotional well-being and anxiety.
However, it’s crucial to note that THC-heavy cannabis products can sometimes worsen certain symptoms, particularly anxiety and mood disturbances. This is why a tailored approach – where prescriptions are adjusted to individual symptom profiles – is essential.
Key considerations for cannabinoid balance:
- Balanced THC/CBD formulations may support emotional regulation and mood stability
- CBD-dominant products may help with anxiety without intoxicating effects
- THC-heavy products should be approached cautiously, as they may exacerbate anxiety or paranoia in some individuals
- Individual responses vary, requiring personalised treatment plans
Key limitations and research gaps
While these surveys provide valuable insights into real-world usage patterns, it’s important to note significant limitations:
- No randomised controlled trials: All current evidence comes from observational surveys and self-reported data
- Selection bias: Respondents may be more likely to be cannabis users, skewing the results
- Lack of causality: We can’t determine whether cannabis actually improves symptoms or whether users simply perceive benefits
- No dosing guidance: Studies don’t provide information on optimal doses, strains or cannabinoid profiles
- Long-term effects unknown: Safety and efficacy over extended periods remain unstudied
Researchers emphasise the need for rigorous clinical trials to validate these self-reported benefits and establish evidence-based treatment protocols.
Medical cannabis for menopause in the UK
Despite limited public awareness, medical cannabis has been legal to prescribe in the UK since November 2018. This means that eligible patients experiencing menopause-related symptoms may be able to access medical cannabis through specialist clinics within a regulated framework.
How UK prescribing works
Unlike over-the-counter CBD products, prescription medical cannabis in the UK operates under strict clinical governance:
- Specialist assessment: Patients undergo consultation with registered specialist doctors
- Individualised prescriptions: Treatment plans are tailored to specific symptom profiles
- Balanced formulations: Prescriptions typically emphasise balanced THC and CBD ratios rather than high-THC products
- Ongoing monitoring: Regular follow-ups ensure treatment efficacy and safety
- Quality assurance: Products are pharmaceutical-grade and tested for consistency
Which menopause symptoms may qualify?
Medical cannabis prescriptions in the UK may be considered for menopause-related symptoms, including:
- Chronic sleep disturbance unresponsive to other treatments
- Anxiety and mood disorders
- Chronic pain (including joint and muscle pain)
- Depression that has not responded adequately to conventional treatments
It’s important to note that medical cannabis is typically considered when first-line treatments have been insufficient or unsuitable. Patients should have tried conventional approaches before exploring medical cannabis options.
Can you use medical cannabis alongside HRT?
One of the most common questions among women exploring medical cannabis for menopause is whether it can be used safely alongside HRT. While research in this area remains limited, the current consensus is that there aren’t any significant interactions between the two, but the emerging evidence and clinical experience provide some important insights.
Cannabis as a complement, not a replacement
It’s crucial to understand that medical cannabis cannot replace HRT. HRT works by directly addressing the hormonal decline that causes menopause – specifically, the reduction in oestrogen and progesterone production. Cannabis, on the other hand, works indirectly through the endocannabinoid system (ECS), which plays a role in regulating mood, sleep, pain and other physiological processes.
Interestingly, oestrogen influences the endocannabinoid system. As oestrogen levels decline during menopause, ECS function may be altered, which some researchers believe could make cannabinoids potentially supportive for symptom balance. However, this does not mean cannabis can perform the same hormonal function as HRT.
Using both treatments together
Some women use medical cannabis complementarily with HRT to manage symptoms that persist despite hormonal treatment. Early clinical observations suggest that:
- CBD may enhance certain HRT benefits, particularly for anxiety, pain, sleep disturbance and potentially bone health
- Some healthcare providers have noted that patients using both therapies may require lower HRT doses, though this requires further study
- The combination may be particularly useful for managing symptoms like chronic pain or anxiety that don’t fully respond to HRT alone.
The relationship between medical cannabis and HRT in managing menopause symptoms remains an evolving area. While some women report benefits from using both, the lack of rigorous research means each case must be individually assessed by prescribers.
So, what’s the verdict?
While research dedicated specifically to the potential of cannabis for menopause remains relatively scarce, there is a growing body of evidence to support its potential in the management of a number of menopause-associated symptoms, including sleep disturbance, joint pain, anxiety and depression, and low libido.
Current evidence snapshot:
- ✓ Widespread real-world use by menopausal women (33% in some regions)
- ✓ Self-reported benefits for sleep, anxiety and pain
- ✓ High user satisfaction rates (75-86%)
- ✗ No randomised controlled trials
- ✗ No standardised dosing protocols
- ✗ Limited healthcare provider involvement
With a growing number of jurisdictions opening up access to medical cannabis, more people could discover the potential of the plant and its derivatives for managing their menopause symptoms. Despite an ongoing lack of awareness in the UK, medical cannabis can, in fact, be prescribed for a wide range of conditions and symptoms – including many which commonly affect those going through menopause.
For more information on accessing a medical cannabis prescription in the UK, take a look at the leafie guide.