Cannabis and Cannabinoids -THIS ARTICLE IS FROM THE TREATMENT PORTION OF THE NATIONAL CANCER INSTITUTE!!!!!
Cannabis, also known as marijuana, is a plant grown in many parts of the world. It makes a resin (thick substance) that contains compounds called cannabinoids (see Question 1). By federal law, possessing Cannabis is illegal in the United States outside of approved research settings. However, a growing number of states, territories, and the District of Columbia have passed laws to legalize medical marijuana (see Question 1). Cannabinoids are chemicals in Cannabis that cause drug-like effects throughout the body, including the central nervous system and the immune system (see Question 2). The main psychoactive cannabinoid in Cannabis is delta-9-THC. Another active cannabinoid is cannabidiol (CBD), which may relieve pain, lower inflammation, and decrease anxiety without causing the "high" of delta-9-THC (see Question 2). Cannabinoids can be taken by mouth, inhaled, or sprayed under the tongue (see Question 4). Cannabis and cannabinoids have been studied for relief of pain, nausea and vomiting, anxiety, and loss of appetite caused by cancer or the side effects of cancer therapies (see Question 6). Two cannabinoid drugs (dronabinol and nabilone) are approved by the U.S. Food and Drug Administration (FDA) for the prevention or treatment of nausea and vomiting caused by chemotherapy (see Question 6 and Question 8). The FDA has not approved Cannabis or cannabinoids for use as a cancer treatment (see Question 8). Questions and Answers About Cannabis 1. What is Cannabis? Cannabis, also known as marijuana, is a plant first grown in Central Asia that is now grown in many parts of the world. The Cannabis plant makes a resin (thick substance) that contains compounds called cannabinoids. Some cannabinoids are psychoactive (affecting your mind or mood). In the United States, Cannabis is a controlled substance and has been classified as a Schedule I agent (a drug with a high potential for abuse and no accepted medical use). Clinical trials that study Cannabis for cancer treatment are limited. By federal law, possessing Cannabis (marijuana) is illegal in the United States unless it is used in approved research settings. However, a growing number of states, territories, and the District of Columbia have passed laws to legalize medical marijuana. (See Question 3). 2. What are cannabinoids? • • • • • • • • Cannabinoids, also known as phytocannabinoids, are chemicals in Cannabis that cause drug-like effects in the body, including the central nervous system and the immune system. The main psychoactive cannabinoid in Cannabis is delta-9-THC. Another active cannabinoid is cannabidiol (CBD), which may relieve pain and lower inflammation without causing the high of delta-9-THC. Cannabinoids may help treat the side effects of cancer and cancer treatment. 3. If Cannabis is illegal, how do some cancer patients in the United States use it? Although federal law prohibits the use of Cannabis, the map below shows the states and territories that have legalized Cannabis for medical purposes. Some other states have legalized only one ingredient in Cannabis, such as cannabidiol (CBD), and these states are not included in the map. Medical marijuana laws vary from state to state. 4. How is Cannabis given or taken? Cannabis may be taken by mouth (in baked products or as an herbal tea) or may be inhaled. When taken by mouth, the main psychoactive ingredient in Cannabis (delta-9-THC) is processed by the liver and changed into a different psychoactive chemical (11-OH-THC). When Cannabis is smoked and inhaled, cannabinoids quickly enter the bloodstream. The psychoactive chemical (11-OH-THC) is made in smaller amounts than when taken by mouth. A map showing the U.S. states and territories that have approved the medical use of Cannabis. A growing number of clinical trials are studying a medicine made from an extract of Cannabis that contains specific amounts of cannabinoids. This medicine is sprayed under the tongue. 5. Have any laboratory or animal studies been done using Cannabis or cannabinoids? In laboratory studies, tumor cells are used to test a substance to find out if it is likely to have any anticancer effects. In animal studies, tests are done to see if a drug, procedure, or treatment is safe and effective in animals. Laboratory and animal studies are done before a substance is tested in people. Laboratory and animal studies have tested the effects of cannabinoids in laboratory experiments. See the Laboratory/Animal/Preclinical Studies section of the health professional version of Cannabis and Cannabinoids for information on laboratory and animal studies done using cannabinoids. 6. Have any studies of Cannabis or cannabinoids been done in people? No ongoing studies of Cannabis as a treatment for cancer in people have been found in the CAM on PubMed database maintained by the National Institutes of Health. Small studies have been done, but the results have not been reported or suggest a need for larger studies. Cannabidiol (CBD) taken by mouth to treat solid tumors that have recurred (come back). An oral spray combining 2 cannabinoids (delta-9-THC and CBD) given with temozolomide to treat recurrent glioblastoma multiforme. CBD taken by mouth to treat acute graft-versus-host disease in patients who have undergone allogeneic hematopoietic stem cell transplantation. Cannabis and cannabinoids have been studied as ways to manage side effects of cancer and cancer therapies. Nausea and vomiting Cannabis and cannabinoids have been studied in the treatment of nausea and vomiting caused by cancer or cancer treatment: Delta-9-THC taken by mouth: Two cannabinoid drugs, dronabinol and nabilone, approved by the U.S. Food and Drug Administration (FDA), are given to treat nausea and vomiting caused by chemotherapy in patients who have not responded to standard antiemetic therapy. Clinical trials have shown that both dronabinol and nabilone work as well as or better than other drugs to relieve nausea and vomiting. Oral spray with delta-9-THC and CBD: Nabiximols, a Cannabis extract given as a mouth spray, was shown in a small randomized, placebo-controlled, double-blinded clinical trial in Spain to treat nausea and vomiting caused by chemotherapy. Inhaled Cannabis: Ten small trials have studied inhaled Cannabis for the treatment of nausea and vomiting caused by chemotherapy. Newer drugs given for nausea caused by chemotherapy have not been directly compared with Cannabis or cannabinoids in cancer patients. There is growing interest in treating children for symptoms such as nausea with Cannabis and cannabinoids, but studies are limited. The American Academy of Pediatrics has not endorsed Cannabis and cannabinoid use because of concerns about its effect on brain development. • • • • • • Stimulating appetite The ability of cannabinoids to increase appetite has been studied: Delta-9-THC taken by mouth: A clinical trial compared delta-9-THC (dronabinol) and a standard drug (megestrol, an appetite stimulant) in patients with advanced cancer and loss of appetite. Results showed that delta-9-THC did not help increase appetite or weight gain in advanced cancer patients compared with megestrol. However, a clinical trial of patients with HIV/AIDS and weight loss found that those who took delta-9-THC had better appetite and stopped losing weight compared with patients who took a placebo. Inhaled Cannabis: There are no published studies of the effect of inhaled Cannabis on cancer patients with loss of appetite. Pain relief Cannabis and cannabinoids have been studied in the treatment of pain: Vaporized Cannabis with opioids: In a study of 21 patients with chronic pain, vaporized Cannabis given with morphine relieved pain better than morphine alone, while vaporized Cannabis given with oxycodone did not give greater pain relief. Further studies are needed. Inhaled Cannabis: Randomized controlled trials of inhaled Cannabis in patients with peripheral neuropathy or other nerve pain found pain was reduced in patients who received inhaled Cannabis compared with those who received placebo. Cannabis plant extract: A study of Cannabis extract that was sprayed under the tongue found it helped patients with advanced cancer whose pain was not relieved by strong opioids alone. In another study, patients who were given lower doses of cannabinoid spray showed better pain control and less sleep loss than patients who received a placebo. Control of cancer-related pain in some patients was better without the need for higher doses of Cannabis extract spray or higher doses of their other pain medicines. Adverse events were related to high doses of cannabinoid spray. Delta-9-THC taken by mouth: Two small clinical trials of oral delta-9-THC showed that it relieved cancer pain. In the first study, patients had good pain relief, less nausea and vomiting, and better appetite. A second study showed that delta-9-THC could relieve pain as well as codeine. An observational study of nabilone also showed that it relieved cancer pain along with nausea, anxiety, and distress when compared with no treatment. Neither dronabinol nor nabilone is approved by the FDA for pain relief. Anxiety Cannabis and cannabinoids have been studied in the treatment of anxiety. Inhaled Cannabis: A small case series found that patients who inhaled Cannabis had improved mood, improved sense of well-being, and less anxiety. In another study, 74 patients newly diagnosed with head and neck cancer who were Cannabis users were matched to 74 nonusers. The Cannabis users had markedly lower anxiety or depression and less pain or discomfort than the nonusers. The Cannabis users were also less tired, had more appetite, and reported greater feelings of well-being. 7. Have any side effects or risks been reported from Cannabis and cannabinoids? Side effects of cannabinoids can include: Fast heartbeat. • • • • • • • • Low blood pressure. Muscle relaxation. Bloodshot eyes. Slowed digestion. Dizziness. Drowsiness. Depression. Hallucinations. Paranoia. Both Cannabis and cannabinoids may be addictive. Symptoms of withdrawal from cannabinoids include: Being easily annoyed or angered. Trouble sleeping. Unable to stay still. Hot flashes. Nausea and cramping (rare). These symptoms are mild compared with symptoms of withdrawal from opiates and usually go away after a few days. Studies on risks from Cannabis use Studies on the risk of various cancers linked to Cannabis smoking have shown the following: Lung cancer: Because Cannabis smoke contains many of the same substances as tobacco smoke, there are concerns about how inhaled Cannabis affects the lungs. A cohort study of men in Africa found that there was an increased risk of lung cancer in tobacco smokers who also inhaled Cannabis. A population study of lung cancer patients found that low Cannabis use was not linked to an increased risk of lung cancer or other aerodigestive tract cancers. Testicular cancer: A 1970 study interviewed over 49,000 Swedish men aged 19 to 21 years about their personal history of using Cannabis at the time they enlisted in the military and then followed them for up to 42 years. The study did not find a link between those who had "ever" used Cannabis and testicular cancer, but did find that "heavy" use of Cannabis (more than 50 times in a lifetime) was linked to more than twice the risk of testicular cancer. The study was limited by the way data was gathered and did not note whether the testicular cancers were seminoma or nonseminoma types or whether Cannabis use also occurred after enlistment. Bladder cancer: A review of bladder cancer rates in Cannabis users and non-users was done in over 84,000 men who took part in the California Men's Health Study. After more than 16 years of follow-up and adjusting for age, race, ethnic group, and body mass index, rates of bladder cancer were found to be 45% lower in Cannabis users than in men who did not report Cannabis use. Larger studies that follow patients over time are needed to find if there is a link between Cannabis use and a higher risk of testicular germ cell tumors. • • • • • • • • • • • • • • • • • 8. Are Cannabis or cannabinoids approved by the U.S. Food and Drug Administration for use as a cancer treatment or treatment for cancer-related symptoms or side effects of cancer therapy? The U.S. Food and Drug Administration (FDA) has not approved Cannabis or cannabinoids for use as a cancer treatment. Cannabis is not approved by the FDA for the treatment of any cancer-related symptom or side effect of cancer therapy. Two cannabinoids (dronabinol and nabilone) are approved by the FDA for the treatment of nausea and vomiting caused by chemotherapy in patients who have not responded to antiemetic therapy. Current Clinical Trials Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. About This PDQ Summary About PDQ Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish. PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH. Purpose of This Summary This PDQ cancer information summary has current information about the use of Cannabis and cannabinoids in the treatment of people with cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care. Reviewers and Updates Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board. Clinical Trial Information A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237). Permission to Use This Summary PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].” The best way to cite this PDQ summary is: PDQ® Integrative, Alternative, and Complementary Therapies Editorial Board. PDQ Cannabis and Cannabinoids. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/aboutcancer/treatment/cam/patient/cannabis-pdq. Accessed . [PMID: 26389314] Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images. Disclaimer The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page. Contact Us More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us. General CAM Information Complementary and alternative medicine (CAM)—also called integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease. Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies. Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any type of treatment. Some complementary and alternative therapies may affect their standard treatment or may be harmful when used with conventional treatment. Evaluation of CAM Therapies It is important that the same scientific methods used to test conventional therapies are used to test CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health (NCCIH) are sponsoring a number of clinical trials (research studies) at medical centers to test CAM therapies for use in cancer. Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have been tested using demanding scientific methods. A small number of CAM therapies that were thought to be purely alternative approaches are now being used in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) meeting in November 1997, acupuncture has been found to help control nausea and vomiting caused by chemotherapy and pain related to surgery. However, some approaches, such as the use of laetrile, have been studied and found not to work and to possibly cause harm. The NCI Best Case Series Program which was started in 1991, is one way CAM approaches that are being used in practice are being studied. The program is overseen by the NCI’s Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients’ medical records and related materials to OCCAM. OCCAM carefully reviews these materials to see if any seem worth further research. Questions to Ask Your Health Care Provider About CAM When considering complementary and alternative therapies, patients should ask their health care provider the following questions: What side effects can be expected? What are the risks related to this therapy? What benefits can be expected from this therapy? Do the known benefits outweigh the risks? • • • • Will the therapy affect conventional treatment? Is this therapy part of a clinical trial? If so, who is the sponsor of the trial? Will the therapy be covered by health insurance? To Learn More About CAM National Center for Complementary and Integrative Health (NCCIH) The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public. NCCIH Clearinghouse Post Office Box 7923 Gaithersburg, MD 20898–7923 Telephone: 1-888-644-6226 (toll free) TTY (for deaf and hard of hearing callers): 1-866-464-3615 E-mail: firstname.lastname@example.org Website: https://nccih.nih.gov CAM on PubMed NCCIH and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the websites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.) Office of Cancer Complementary and Alternative Medicine The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI website. National Cancer Institute (NCI) Cancer Information Service U.S. residents may call the Cancer Information Service (CIS), NCI's contact center, toll free at 1-800-4-CANCER (1-800- 422-6237) Monday through Friday from 9:00 am to 9:00 pm. A trained Cancer Information Specialist is available to answer your questions. Food and Drug Administration The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective. • • • • Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 Telephone: 1-888-463-6332 (toll free) Website: http://www.fda.gov Federal Trade Commission The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include: Who Cares: Sources of Information About Health Care Products and Services Fraudulent Health Claims: Don’t Be Fooled Consumer Response Center Federal Trade Commission 600 Pennsylvania Avenue, NW Washington, DC 20580 Telephone: 1-877-FTC-HELP (1-877-382-4357) (toll free) TTY (for deaf and hard of hearing callers): 202-326-2502 Website: http://www.ftc.gov Updated: June 27, 2019 If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Cannabis and Cannabinoids (PDQ®)–Patient Version was originally published by the National Cancer Institute.” • •
Menopause is something that nearly all women experience. A woman’s reproductive years typically begin when she is between 10 and 18 when she starts having a menstrual period. In most cases, these reproductive years last for several decades, characterized by mostly regular periods, unless the woman is pregnant. If you are experiencing “the change,” it means your body is beginning to transition away from these reproductive years to the next stage of your life.
Though this transition is entirely natural, as you go through it, you may experience some symptoms that could range from uncomfortable to unbearable. As we will see, medical marijuana can be an excellent way to experience natural relief from the symptoms associated with menopause.
What Is Menopause?
Though most women are generally aware of what menopause is, it’s easy to become confused about different terms associated with menopause, including premenopause, perimenopause and postmenopause in addition to the term menopause itself. Additionally, there are two classifications for menopause — natural and induced. Let’s look at each of these terms to clarify what menopause is along with its related terms.
1. PremenopausePremenopause is a generic term that can refer to any time in a woman’s reproductive life before menopause. Some people may use it to refer to a short amount of time before menopause, but it can also be used to refer to the entirety of a woman’s reproductive period.
2. PerimenopauseWhen women’s bodies begin to change, primarily marked by decreased estrogen production, this time is called perimenopause. Many people refer to this transition period leading up to menopause as menopause itself, but this is technically incorrect. It is actually perimenopause that causes the symptoms that are often referred to as menopausal symptoms.
3. Natural MenopauseMenopause technically refers to a woman’s final menstrual period, though many people use the term to refer to the whole transition to this point. A woman can know with certainty that she has reached menopause when it has been one full calendar year since her last period or the last time she experienced any degree of spotting. Not having a period is known as amenorrhea. This year-long duration of amenorrhea signifies that a woman’s periods have permanently ceased and that she can no longer get pregnant.
4. Induced MenopauseIn most cases, menopause occurs naturally. However, it can be brought on by medical interventions that affect a woman’s ovaries, including surgical removal of the ovaries, damage from chemotherapy or radiation or from pharmaceuticals intended to force the onset of menopause. Women whose menopause is induced will experience the same symptoms but will not have the benefit of a more gradual transition period.
5. PostmenopauseThe term postmenopause is used to label the time after a woman has gone through menopause, meaning it has been one year since her last period. At this time, menopausal symptoms may go away, but a woman’s body has entered a new normal. The lower estrogen level puts postmenopausal women at a higher risk of specific health issues, including heart disease and osteoporosis.
Menopause does not affect all women the same way. However, the hormonal changes menopause brings often cause some or all of these symptoms:
Let’s look at several statistics that can help build our understanding of menopause in the world today.
Common Treatment Options and Their Side Effects
Some women may not experience symptoms that are severe enough to motivate them to find treatment. In many cases, however, women may seek relief to keep their symptoms from interfering with their daily lives. They may try one or several different treatment options to help alleviate their symptoms. Since menopause is a natural process and not a disorder, treatment options are not meant to “cure” or resolve menopause but simply to lessen the impact of menopausal symptoms. Let’s look at several common methods of treating these symptoms:
1. Hormone Replacement TherapyOne of the most common means of treating menopause is through hormone replacement therapy (HRT). Since the symptoms associated with perimenopause stem from the drop in hormone levels your body experiences, replacing some of these hormones can lessen the severity of symptoms. Combination HRT involves taking both estrogen and progesterone. Women who have undergone a hysterectomy will only be prescribed estrogen. Hormones can be administered via a pill, patch, cream or vaginal ring among other means.
The possible side effects of HRT include:
2. Prescription Drugs for Hot FlashesIf hormone replacement therapy isn’t an option, some women are prescribed other types of pills, typically to help them with hot flashes. Most of these drugs have other uses beyond treating menopausal symptoms. For example, the drug Gabapentin, which is primarily used for nerve pain and to treat seizures, can also help with hot flashes. This medication often causes dizziness, drowsiness and lack of coordination. The blood pressure medication Clonidine is also useful for providing relief from hot flashes. It can cause side effects similar to Gabapentin along with possible dry mouth and constipation.
Non-hormonal prescription medications designed explicitly for menopause are rare, but one example is Conjugated Estrogens-Bazedoxifene, which treats hot flashes and is meant to help preserve bone mass. Its side effects include:
With the many negative side effects you can expect from prescription drugs, it’s no wonder some women are desperate for an alternative. The natural remedies and lifestyle changes discussed above can help, but unfortunately, there are relatively few studies to support their efficacy. There is another natural remedy that is worth considering, however — one that shows great promise for relieving symptoms related to menopause.
Because marijuana is not legal nationwide, clinical research on marijuana is limited. Therefore, there are no studies that directly look at marijuana as a method of treatment for menopause. However, there is a solid base of research to support the idea that marijuana can help with many symptoms of menopause, including hot flashes, insomnia, changes in mood, depression, anxiety, and low libido.
Why does marijuana help ease symptoms that are the result of a drop in hormones, especially estrogen? The answer is found in the relationship between estrogen and the body’s endocannabinoid system. Estrogen regulates the fatty acid amide hydrolase (FAAH) which breaks down some endocannabinoids. When estrogen levels are up, so are endocannabinoid levels. When estrogen levels drop, so do endocannabinoid levels since FAAH is allowed to break down more endocannabinoids. The idea is that it is not just estrogen helping to regulate the body but the endocannabinoid system, too.
Where does marijuana fit into this?
Marijuana has cannabinoids that directly interact with your endocannabinoid system, supplementing the lower endocannabinoid levels. These endocannabinoid levels are thought to have a strong influence on a person’s mood as well as other physiological factors, so supplementing low cannabinoid levels caused by a drop in estrogen can make a significant difference.
There is still room for scientists to learn more about the endocannabinoid system and the effects of cannabis, but it is already clear that it plays an important role. Since hot flashes are a major symptom of menopause, it’s especially interesting to note that tetrahydrocannabinol (THC), a compound in cannabis, mimics many aspects of anandamide, an endocannabinoid in the body, including the fact that they have both been found to help to regulate body temperature.
Another study of interest demonstrated that cannabidiol (CBD), another compound in cannabis, had antidepressant-like effects in mice, suggesting that it could effectively combat depression in humans, as well. Yet another study demonstrated that regulating a woman’s cannabinoid levels could help boost bone density, which is extremely important for menopausal and postmenopausal women.
Best Methods of Marijuana Treatment
Medical cannabis can be administered in a variety of ways, including:
Side Effects of Medical Marijuana
Being a natural substance, marijuana doesn’t involve a mile-long list of side effects like many pharmaceuticals do. However, it does cause some side effects. The good news is that, with so many strains to choose from, if you don’t like the reaction you experience from one strain, you can always try another.
Here are a few side effects to be aware of that cannabis could cause:
Updated on April 1, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
Unfortunately, you may have discovered that the medical system is often woefully unprepared to deal with the symptoms of menopause. Previous generations of women were so quiet about “the change” that the medical system is only just now waking up to the needs of peri- and post-menopausal women. So, like many others, you may be turning to traditional herbal medicines – like CBD oil – for support, because our great- great-grandmothers were probably on to something.
Most of us never seriously consider menopause until we find ourselves on its doorstep — woefully unprepared to deal with its many symptoms. Some of us might not even recognize these symptoms during the early stages of perimenopause. But the sooner we notice and proactively respond to the changes happening within our bodies, the better our future health.
Cannabis & Hemp for Menopause
Menopause is one of the top three reasons women use therapeutic cannabis products — menstruation and sex are the other two. The good reputation that hemp and cannabis-derived CBD oils are gaining for treating peri- and post-menopausal symptoms isn’t based just on testimonials — scientific research also indicates how cannabidiol (CBD) could be useful for:
More than Estrogen: A Sea of Changes
You’re probably familiar with the estrogen story by now: women are born with millions of immature eggs in their ovaries. Starting at puberty, our bodies are pumped full of estrogen every time an egg matures — approximately once a month. However, over the years, our supply of eggs dwindles. And once all our eggs are gone, our periods stop and the estrogen bursts go away, triggering menopause.
But in reality, menopause is not so clear-cut. For years before the menopause (a period called the perimenopause), our estrogen levels swing unpredictably high or low before the final plunge. And it’s not just estrogen that goes on a roller-coaster ride — a full supporting cast of hormones that (more-or-less) kept our bodies operating smoothly over the years also begin rebelling.
Controlled by these hormones, countless molecules in our bodies also increase or decrease. Our brain neurochemistry changes. Our bodies ramp up production of inflammatory molecules. From brain function to fat accumulation to bone reabsorption — menopause changes the inner workings of our bodies. And each woman’s experience of menopause will be unique.
Menopausal Symptoms: Causes & Support
If menopause has left you feeling like the medical system doesn’t understand your needs, you’re probably right. Scientists are still uncovering why and how our bodies change during menopause.
Much of the information in this article is at the cutting edge of menopause research, and may have never been explained to you by your doctor — but we believe that the more you understand about your symptoms, the easier it will be for you to find support.
Here are some of the most widespread issues women face during menopause:
Aches & Joint Pain
What’s going on: Does your body hurt more than it used to? Don’t be so quick to blame it on age – without estrogen, our bodies produce higher levels of inflammatory molecules (specifically, tumor necrosis factor, or TNFα). This means arthritis symptoms could skyrocket during menopause. More than 60% of women aged 40 to 64 suffer from pain in their muscles and joints.
How CBD could help: It is more important than ever to reduce inflammation in your body during menopause. Cannabidiol has proven anti-inflammatory properties. In mice, CBD is anti-arthritic, protects joints against inflammatory damage, and lowers levels of inflammatory TNFα. Low-impact exercise and dietary changes are also excellent resources in a fight against inflammation.
Mood Swings & Depression
What’s going on: It’s not unusual for women to experience anxiety or depression during menopause. Estrogen and progesterone influence the activity of serotonin and other neurotransmitters in the brain — which directly affect mood. As levels of these hormones become erratic and eventually plummet, your neurochemistry will change.
How CBD could help: If you’re emotionally distressed, you should seek the support of a medical professional. They might suggest therapeutic or pharmaceutical solutions. If you supplement your treatment with CBD oil, it turns out that CBD activates serotonin receptors, similar to the anti-anxiety drug buspirone. (For more on this topic, read our articles about the different ways that CBD could help anxiety or depression.)
Hot Flashes & Night Sweats
What’s going on: Hot flashes and night sweats are frequently joked about, but in reality they’re no laughing matter. They disrupt our sleep and daily routines, which can reduce the quality of our lives. These “vasomotor” symptoms are caused by altered neurochemistry in the hypothalamus — your body’s thermostat control. In other words, your body’s cooling system — blood vessel dilation & sweat response — gets switched on way too easily. When tested in the lab, women who suffer from hot flashes are triggered when their body temperatures increase by only 1.5 degrees, whereas other women’s bodies don’t switch on the cooling system unless their temperatures increase almost 3 degrees.
How CBD could help: Because hot flashes have a neurochemical basis, some SSRIs and antidepressants can help relieve hot flashes. Although there aren’t studies that have specifically tested CBD for hot flashes, its influence on the body’s serotonin system could be one reason why some women swear by CBD for this symptom. Other treatments like therapy, hypnosis and relaxation techniques that calm the nervous system can also influence your neurochemistry and help reduce hot flashes.
Weight Gain & Diabetes
What’s going on: Hormones shape our bodies on so many levels, including controlling our metabolism. Without estrogen, our bodies burn fewer calories — even while sleeping — and we also burn less fat during exercise. Even if you cut calories and maintain a stable weight throughout menopause, the ongoing hormonal shift tells your body to trade in lean muscle mass for abdominal fat. And this pattern of fat storage unfortunately raises your predisposition to insulin resistance, diabetes and cardiovascular disease.
How CBD could help: Population studies have found that adults who use cannabis products have lower insulin levels and smaller waist circumferences. Cannabidiol could contribute by switching on genes for healthy metabolism (through the PPAR-γ receptor). CBD also helps buffer the activity of natural endocannabinoids, including 2-AG, which is linked to insulin resistance and ramped up during menopause.
Genitourinal Syndrome (Vaginal Dryness, Atrophy & Bladder Control)
What’s going on: Sexual health and bladder control after menopause might seem like two separate subjects, but they are so intimately related that they are now lumped into a single medical condition. Estrogen helps keep blood flowing to the pelvic region, delivering fresh oxygen to the tissues of the urinary tract and sexual organs — keeping things elastic and healthy. Once menopause arrives, women should give their pelvis some extra love and attention to keep up the blood flow. (For more on this topic, read our article on sexual health after menopause.)
How CBD could help: Along with regular sexual activity, a topical lubricant that contains cannabinoids like CBD or THC — which are both potent vasodilators — can increase blood flow to the pelvic region. This keeps tissues healthy while also moisturizing the vaginal canal. Topical CBD can also fight inflammation, relax muscles and calm pain-perceiving nerves in the vulva and vagina, making CBD-infused lube and suppositories one of women’s best companions through menopause.
What’s going on: Our bodies constantly move calcium and other minerals into — and out of — bones. As we enter perimenopause, the net result is often bone resorption (where more bone is taken away than is added), lowering bone density and increasing our risk for fractures. We’ve all heard about the importance of dietary calcium and exercise for preventing osteoporosis, but new research suggests that inflammation from arthritis or other conditions might be one of the biggest causes of bone resorption. Inflammatory TNFα is particularly adept at telling your body to increase bone resorption.
How CBD could help: The same anti-inflammatory features that make CBD oil a popular remedy for arthritic symptoms might also prove useful for bone health. In rats with periodontitis, CBD lowers TNFα levels and prevents oral bone loss. However, human evidence for this application is lacking, and we encourage you to use every medical resource available if you’ve been diagnosed with low bone density. Resistance exercise also decreases TNFα levels, which may explain why exercise can help prevent bone loss.
What’s going on: Many peri- and post-menopausal women have trouble getting a good night’s sleep. And sleep deprivation can really wear a person down — triggering fatigue and a full spectrum of other health issues. Menopause might disrupt your sleep a number of different ways, including through night sweats and increased anxiety or depression. You’ll need to identify the biggest hurdles between you and a good night’s sleep before you can troubleshoot the best solutions. Track your sleep or ask your doctor about a sleep study if you need help.
How CBD could help: People of all genders and ages report that CBD formulations help them get restorative sleep. Whether or not CBD could help you get a better night’s sleep depends on the source of your disruptions. CBD’s influence on neurochemistry and anxiety could help improve sleep for women experiencing insomnia or disruptive night sweats.
What’s going on: It’s tempting to blame memory loss on age, but even younger women who go through surgical menopause can experience rapid memory loss. The brain region responsible for memory, learning and emotion, the hippocampus, is a hotbed of synaptic plasticity. Hormones like estrogen and progesterone encourage neurons in the hippocampus to form new connections, and our memories might suffer without these hormones.
How CBD could help: Scientists are actively investigating CBD for encouraging synaptic plasticity and neuroprotection, particularly in the hippocampus. However, there is not yet solid evidence for its recommendation, and there are many other ways you can protect this important brain region. If you want to improve your memory, check out 9 ways to naturally rewire your hippocampus.
Self-Directed Care for Menopause
Now, more than ever, is an important time to observe the changes happening within your body and life. Be honest with yourself and others about how much support you need.
Estrogen and progesterone shouldered a lot of responsibilities within your body, and CBD should only be one of many resources that help you through (and beyond) menopause.
CBD: Are You Doing It Right?
For those who are new to the world of CBD, in addition to purchasing a high-quality product, it’s important to optimize your dosage and delivery for the desired effect.
For instance, vape pens deliver immediate benefits that dwindle within an hour or two, whereas oral CBD oil takes longer to kick in — but its effects can last 8-12 hours.
For help choosing the best products and optimizing your CBD dosage, check out this article.
Genevieve R. Moore PhD