By Peter Vermeul - Plant Extraction Specialist, Researcher pioneer

The transition (menopause) is a challenging period for many women, characterized by hormonal changes and a wide range of symptoms. Cannabis extracts, such as CBDa (cannabidiolic acid, the acidic form of CBD), and other cannabinoids (for example CBD, THC, THCa, CBG), are gaining interest as possible agents to relieve menopausal complaints. In this extensive overview, we discuss menopause and its symptoms, the role of the Endocannabinoid System, the properties of different cannabinoids (including CBDa) and terpenes/flavonoids, as well as scientific findings and anecdotal experiences about the use of Cannabis for menopausal symptoms.

Background - Menopause and Common Symptoms

Menopause marks the end of a woman’s fertile life phase. Around an age of approximately 45–55 years, egg reserves run out and the production of female hormones, mainly estrogen, declines. These hormonal fluctuations lead to the cessation of menstruation and are often accompanied by various complaints. About 25-30% of women experience so many symptoms that daily life is disrupted.

Common menopausal complaints include:

• Hot flashes and night sweats: sudden heat attacks with flushing, sweating, and sometimes palpitations.

• Sleep problems: difficulty falling asleep or staying asleep, often due to night sweats or hormonal restlessness.

• Mood swings and irritability: rapid emotional changes, anxiety, or low mood. Joint and muscle pain: stiff joints, muscle pain, and sometimes headaches due to inflammatory processes with declining estrogen.

• Reduced libido and vaginal dryness: less interest in sex, vaginal atrophy (dryness, discomfort during intercourse) due to declining estrogen levels.

• Weight gain and metabolic changes: a slowed metabolism can lead to extra pounds.

• Bone loss (osteoporosis): declining estrogen accelerates bone breakdown, reducing bone density.

Traditional treatments such as hormone therapy (HT) can relieve symptoms but many women look for more natural alternatives. This is where Cannabis comes into the picture, which, thanks to its diverse active substances, can potentially provide relief without the severe side effects of HT.

The Endocannabinoid System and Hormones

An important reason Cannabis may have an effect on menopausal symptoms interaction with the Endocannabinoid system (ECS). This internal regulatory system plays a role in maintaining balance (homeostasis) in many bodily processes, including mood, sleep, pain perception, and temperature regulation. The ECS consists of cannabinoid receptors (mainly CB1 and CB2), endocannabinoids (endogenous cannabinoids such as anandamide and 2-AG), and enzymes that produce or break down these substances.

Estrogen significantly influences the ECS. For example, it appears that estrogen inhibits the breakdown of anandamide by regulating the enzyme FAAH. During the menstrual cycle, anandamide levels are highest around ovulation, in parallel with peaking estrogen levels.

When estrogen production plummets during the transition, the level of endocannabinoids generally also decreases. This can contribute to various complaints because the body is less able to maintain balance.

Existing research suggests that changes in the ECS during menopause may contribute to health risks. For example, a link has been found between post-menopause, bone loss, and the ECS. A study showed that overactivity of CB2 receptors in bone-resorbing cells was associated with faster bone resorption in osteoporosis patients. In addition, low endocannabinoid levels after menopause have been linked to an increased risk of overweight and insulin resistance. All of this indicates that the decline of estrogen and endocannabinoids can have a double impact on women’s health after menopause.

Cannabis cannabinoids may possibly play a role here by helping the ECS maintain balance. Dr. Genester Wilson-King, a gynecologist, notes that the ECS is very active in the female reproductive system and that Cannabis can be useful for her patients when hormone therapy is not suitable or does not help enough. The idea is that cannabinoids from the Cannabis plant can supplement the body’s own endocannabinoids or mimic their action. In this way, certain symptoms of estrogen deficiency might be mitigated.

Cannabis and Its Active Substances: Cannabinoids, Terpenes, and Flavonoids

Cannabis Sativa (hemp or weed) contains dozens of active substances. The main groups are cannabinoids, terpenes, and flavonoids. These often work together (the entourage effect), meaning that the combination of substances can be more effective than a single isolated substance.

Cannabinoids

These are compounds that act on the ECS. The best known is THC (Δ⁹tetrahydrocannabinol), responsible for the intoxicating “high.” THC binds mainly to CB1 receptors in the brain and can relieve pain, promote sleep, and influence mood.

CBD (cannabidiol) is another major component; it is non-intoxicating and is known for relaxing, anti-inflammatory, and anxiolytic (anxiety-reducing) effects. CBDa (cannabidiolic acid) is the acidic precursor of CBD, present in the raw plant. When heated (decarboxylation), CBDa is converted into CBD.

CBDa itself also has unique properties, for example, it has been shown to be a powerful anti-inflammatory via inhibition of the COX-2 enzyme. Furthermore, CBDa appears to have a strong anti-nausea effect (more effective than CBD in some preclinical tests) and possibly a hormone-balance-supporting effect.

THCa (THC acid) is the raw form of THC and has no intoxicating effects until it is heated. There is some evidence that THCa can be anti-inflammatory and neuroprotective, which may be relevant for, for example, joint complaints, without the intoxicating side effects of THC.

CBG (cannabigerol) is a minor cannabinoid (present in smaller amounts) but is called the “mother of all cannabinoids” because CBG in the plant is the precursor of many other cannabinoids. CBG is not intoxicating and acts directly on both CB1 and CB2 receptors.

It has potential antidepressant, analgesic, and antibacterial properties, and there are indications that CBG can support the Endocannabinoid System in restoring balance in, for example, mood and inflammation. CBN (cannabinol) (although not mentioned in the question, this is the degradation product of THC) is known for a sedative effect and is sometimes used as a sleep aid.

Terpenes

These are aromatic oils in Cannabis (and other plants) that create the characteristic smell and taste. Terpenes also have medicinal properties. For example, linalool (also found in lavender) has a calming effect and can promote sleep - useful for menopause-related insomnia. Myrcene is calming and mildly sedating and can contribute to pain relief. β-caryophyllene is a terpene that also functions as a cannabinoid by binding to CB2 receptors; it has strong anti-inflammatory and analgesic effects. Pinene can promote alertness and inhibit inflammation (useful for brain fog or joint pain), and humulene suppresses appetite (possibly relevant for weight gain). By choosing specific terpene profiles (for example, a variety rich in myrcene and linalool for sleep, or rich in pinene for energy), women can somewhat steer the Cannabis experience toward their needs.

Flavonoids

These are color- and flavor-compounds in plants, and unique flavonoids have been found in Cannabis (cannflavin). Flavonoids have strong antioxidant and anti-inflammatory properties. Research shows that certain Cannabis flavonoids, such as cannflavin A and B, are extraordinarily potent anti-inflammatories (cannflavin A would, in vitro, inhibit COX-2 up to 30 times more effectively than aspirin). Although specific research on flavonoids in menopausal complaints is scarce, these substances in full-spectrum Cannabis extracts may contribute to overall effects, for example, by reducing inflammation (relevant for joint pain or hot flashes) and protecting cellular health (anti-aging effect on skin, cardiovascular system).

Full-spectrum Cannabis oil contains a broad range of the above components (cannabinoids plus terpenes and flavonoids) and is preferred by many experts and users over a single isolated agent, precisely because of the entourage effect and the longer duration of relief. For example, anecdotal sources reported that vaporizing Cannabis flowers gave immediate relief (but shorter, a few hours), while full-spectrum CBD oil could provide 4–6 hours of relief from symptoms.

Cannabinoids, Terpenes, and Flavonoids

Cannabis Sativa (hemp or weed) contains dozens of active substances. The main groups are cannabinoids, terpenes, and flavonoids. These often work together (the entourage effect), meaning that the combination of substances can be more effective than a single isolated substance.

Cannabinoids

These are compounds that act on the ECS. The best known is THC (Δ⁹ tetrahydrocannabinol), responsible for the intoxicating “high.” THC binds mainly to CB1 receptors in the brain and can relieve pain, promote sleep, and influence mood. CBD (cannabidiol) is another major component; it is non-intoxicating and is known for relaxing, anti-inflammatory, and anxiolytic (anxiety-reducing) effects.

CBDa (cannabidiolic acid) is the acidic precursor of CBD, present in the raw plant. When heated (decarboxylation), CBDa is converted into CBD. CBDa itself also has unique properties; for example, it has been shown to be a powerful anti-inflammatory via inhibition of the COX-2 enzyme. Furthermore, CBDa appears to have a strong anti-nausea effect (more effective than CBD in some preclinical tests) and possibly a hormone-balance-supporting effect.

THCa (tetrahydrocannabinol acid) is the raw form of THC and has no intoxicating effects until it is heated. There is some evidence that THCa can be anti-inflammatory and neuroprotective, which may be relevant for, for example, joint complaints, without the intoxicating side effects of THC.

CBG (cannabigerol) is a minor cannabinoid (present in smaller amounts) but is called the “mother of all cannabinoids” because CBG in the plant is the precursor of many other cannabinoids. CBG is not intoxicating and acts directly on both CB1 and CB2 receptors. It has potential antidepressant, analgesic, and antibacterial properties, and there are indications that CBG can support the Endocannabinoid System in restoring balance in, for example, mood and inflammation.

CBN (cannabinol) (although not mentioned in the question, this is the degradation product of THC) is known for a sedative effect and is sometimes used as a sleep aid.

Terpenes

These are compounds that act on the ECS. The best known is THC (Δ⁹ tetrahydrocannabinol), responsible for the intoxicating “high.” THC binds mainly to CB1 receptors in the brain and can relieve pain, promote sleep, and influence mood.

CBD (cannabidiol) is another major component; it is non-intoxicating and is known for relaxing, anti-inflammatory, and anxiolytic (anxiety-reducing) effects. CBDa (cannabidiolic acid) is the acidic precursor of CBD, present in the raw plant. When heated (decarboxylation), CBDa is converted into CBD.

CBDa versus CBD: Special Properties of “Raw” Cannabinoids

Specifically, CBDa (cannabidiolic acid) deserves attention because it is often overlooked in favor of CBD, while it may have unique advantages. CBDa is abundant in raw hemp/Cannabis plants and is largely lost with heating (converted into CBD). Preclinical research has revealed interesting properties of CBDa.

Anti-inflammation

CBDa appears to be a selective COX-2 inhibitor. COX-2 is an enzyme that plays a role in inflammatory responses and pain. By inhibiting this enzyme (similar to NSAID painkillers, but in a natural way), CBDa can help with inflammation-related pain, such as arthritis-like complaints that worsen due to declining estrogen. For women in the transition with joint pain or muscle pain, this is potentially valuable.

Anti-anxiety and mood

There are indications that CBDa can reduce anxiety already at very low doses, possibly even more powerfully than CBD, via influence on serotonin receptors (5-HT_1A).

Many women report anxiety or mood swings during menopause; CBDa could, because of its interaction with both the ECS and the serotonin system, be beneficial here.

A blog article states that preliminary research shows CBDa can interact positively with the ECS to relieve these symptoms, although we should note that hard clinical data are still lacking.

Anti-nausea

Although nausea does not typically belong to the core symptoms of menopause, it is worth mentioning that CBDa has proven exceptionally effective in suppressing nausea and vomiting, for example in hemotherapy patients. This is relevant because a subset of women in the transition can experience migraine or dizziness accompanied by nausea.

Moreover, these findings suggest that CBDa is a powerful modulator of the vomiting center in the brain via serotonin and CB receptors, underscoring the versatility of this compound.

Hormone regulation

Interestingly, CBDa may be able to support hormonal balance. In an animal study, stimulation of the ECS increased the release of luteinizing hormone (LH) - a hormone involved in ovulation and gonadal function. Although this is more relevant to fertility than to post-menopause, it shows that cannabinoids such as CBDa can exert influence on hormonal axes. This could mean that CBDa indirectly dampens some hormonal imbalances of perimenopause, but more research is needed here.

CBDa is generally available via raw hemp juice, tinctures or capsules that have specifically not been heated. Some CBD oil producers offer “CBDa oil” or full-spectrum oil with a high CBDa content (at low extraction temperatures). Consumers who want to try CBDa should keep in mind that CBDa is less stable (can break down at room temperature over time) and that most standard CBD oils mainly contain CBD. Still, interest in CBDa as a supplement is growing, precisely because it can produce different effects than CBD.

Many users describe a “fresher” or “more energetic” feeling from raw cannabinoids such as CBDa and THCa, as opposed to the more calming effects of their decarboxylated forms.

Scientific Research: What Do We Know So Far?

Research into Cannabis and menopause is still in its infancy, but both scientific studies and user surveys are beginning to shed some light on the potential benefits and points of attention.

Women use Cannabis for menopausal complaints - surveys

Several surveys show that a substantial proportion of women are already using Cannabis themselves to address menopausal symptoms. For example, researchers from the University of California, San Francisco, in 2020 presented a survey among 232 women (average age 56, mostly veterans) who indicated they had menopausal complaints.

This showed that 27% of these women had used or were using Cannabis for symptoms such as hot flashes, insomnia, or mood complaints. Another 10% were open to future Cannabis use. By comparison, only 19% used traditional treatments such as hormone therapy. The researchers concluded that “the use of Cannabis to treat menopausal symptoms was common in this sample... these findings suggest that Cannabis use to manage symptoms is relatively frequent”. This result was striking, although the authors noted that this concerned a specific population (California veterans) and generalizability to other regions depends on legal and cultural attitudes.

A larger online survey (2022) among 285 women by Harvard Medical School found similar results: 79% of the participants used Cannabis specifically to treat menopause related symptoms. The most used routes of administration were smoking (84%) and edibles (78%). This suggests that many women used THC-rich Cannabis, and the top symptoms they tried to relieve were sleep disturbances (67%) and mood/anxiety symptoms (46%).

That insomnia and anxiety were at the top is not surprising, given these complaints are very often mentioned in the transition. The high percentage of current Cannabis users (86% were using Cannabis at that time) may be because the survey was partly conducted among existing Cannabis users or those interested. Still, these figures confirm that a large group of women is seeking relief outside mainstream medicine.

Importantly, medical experts have divided opinions on this. On the one hand, they point to the lack of extensive clinical data: an article by Massachusetts General Hospital (MGH) from 2020 notes that women apparently prefer to try “natural” remedies, but warns that “we actually have no data on the safety and effectiveness of daily Cannabis use in older individuals”.

In the same blog post, concern is expressed about possible effects on cognitive functioning and psychiatric symptoms in older people with long-term Cannabis use. On the other hand, some healthcare providers acknowledge that current treatments do not work for everyone or are acceptable, and that Cannabis could become a legitimate option if there is more evidence.

As early as 2020, researchers posed the question of whether we should embrace this growing Cannabis use or view it with suspicion. Are we dealing with women who have discovered an effective remedy, or with a trend that is running ahead of the science?

Preclinical Research: Indications of Effectiveness

Although no large-scale clinical trials have yet been completed, there are animal studies exploring the biology behind Cannabis and menopause. A notable study was carried out at Rutgers University (published 2022), where researchers looked at the effects of CBD in a mouse model of post-menopause. They took female mice whose ovaries had been removed (so estrogen falls away, just like in menopause) and gave a group of them CBD via food. The results were promising: estrogen-deficient mice that received CBD showed improved glucose metabolism, they burned more energy (less weight gain) and their bone density increased compared to untreated menopausal mice. In addition, the researchers saw fewer inflammatory markers in gut and bone tissue and a healthier composition of gut bacteria in the CBD group.

This study was the first to confirm in a controlled preclinical model what had previously been suggested anecdotally, CBD could possibly counteract the metabolic and bone-related consequences of estrogen deficiency. The senior author, Dr. Diana Roopchand, emphasized that this preclinical evidence supports the many stories of women who already use CBD for menopausal complaints. The implication is that CBD (and perhaps other cannabinoids) could serve as a safer treatment to address weight gain, osteoporosis, inflammation and possibly gut issues in post-menopause. Of course, follow-up research remains necessary, but it provides a scientific basis that underpins the anecdotal use.

Other preclinical findings focus on individual complaints, for example research into pain relief shows that activation of CB1 and CB2 receptors (such as by THC or certain synthetic agonists) has an analgesic effect, while blocking these receptors does the opposite. This confirms that cannabinoids can play a role in chronic pain control. Since lower estrogen levels are associated with more inflammation and pain during menopause, it is logical to investigate whether Cannabis reduces that pain. Likewise, it has been discovered that the ECS is involved in thermoregulation (the hypothalamus regulates body temperature and contains endocannabinoids) and that disruption of it may contribute to hot flashes - although this area is complex and not yet well understood.

Clinical and Ongoing Research

Direct clinical studies in humans are scarce, but there are some interesting developments:

Current medical practice

Some doctors already integrate cannabinoids into care for menopausal patients. The Spanish gynecologist Dr. Gudrun Lorenz-Eberhardt published her experiences, in which she applies CBD in peri- and postmenopausal women.

Her findings are predominantly positive, CBD oil (oral or topical) helped many of her patients with complaints such as palpitations, mood problems, joint pain, osteoporosis-related pain and even vaginal dryness (via CBD suppositories or creams).

For example, she notes that full-spectrum CBDa under the tongue was very effective in lowering a rapid heart rate and high blood pressure in menopausal women with palpitations. She also reports success with local CBD treatment of vaginal atrophy; in observations, the results were comparable to local estrogen hormone. This clinical experience, although not in a randomized trial, indicates that CBD can be used as a natural alternative for various complaints, something her patients appreciate.

It is striking, however, that she mentions that CBD alone usually does not significantly reduce hot flashes for that she rather advises herbs (phytoestrogens) or hormone therapy. This suggests that for vasomotor symptoms Full-spectrum-CBD might be more effective than a CBD isolate (we will return to experiences here).

Ongoing studies

Scientific interest is increasing. In the US, for example, a clinical study has been set up (by Washington State University) to investigate to what extent “hemp-derived minor cannabinoids” can alleviate menopausal symptoms. With “minor cannabinoids,” this probably refers to compounds such as CBG, CBC, or CBDa that can legally be obtained from hemp.

This study (phase 2, as online trial) looks at the effectiveness and tolerability of a cannabinoid-containing product for menopausal complaints. Smaller studies and surveys are also underway in Canada and Europe. This means that in the coming years, we may expect more evidence-based answers to questions such as, does Cannabis really work against hot flashes? What is the best composition (THC vs CBD) for sleep or anxiety? etc.

Menopause and ECS Theory

A group of Italian scientists published a paper in 2021 in which they discussed the role of the Endocannabinoid System in menopause-related disorders. They suggest that the estrogen decline and the accompanying endocannabinoid decline may explain why postmenopausal women have a higher risk of certain diseases (e.g. osteoporosis, dementia, heart disease, even some cancers). Anandamide has antitumor properties, so less anandamide could contribute to a higher cancer risk. Such theoretical frameworks motivate further research and provide a biologically plausible basis for using agents that modulate the ECS (such as Cannabis) to improve the health of postmenopausal women.

In summary, science cautiously supports the idea that Cannabis components can be beneficial in menopausal complaints, especially with regard to mood, sleep, pain, weight metabolism and bone health. However, rigorous clinical data are still largely lacking, especially for specific symptoms such as hot flashes. Therefore, we also have to look at the bigger picture, the experiences of women themselves, and smaller case descriptions.

Experience Stories and Anecdotal Evidence

Alongside laboratory and clinical data, there is a wealth of anecdotal experience from women who use Cannabis during their menopause. These stories range from very positive to mixed, but together they provide insight into how cannabinoids play out in practice.

A striking example is the story of Mary Jane Rose, a Spanish-Flemish woman who openly shared her menopause experience with Cannabis. In a personal column, she describes how Cannabis became her “best friend” in this phase of life. Initially, she used cannabinoids (via Cannabis oil) to stimulate her sharply decreased libido again, successfully.

To her surprise, she later also noticed that she had far fewer to no hot flashes when she used Cannabis oil internally (she is probably referring here to vaginal Cannabis oil use). After a period of daily use, her hot flashes clearly decreased in frequency. The proof of the pudding came when she stopped for two weeks on holiday (out of fear of taking oil through customs) her hot flashes returned in full force in the hot southern Spanish summer, causing a lot of discomfort. Desperate, she made new Cannabis oil on the spot, and “after just a few hours” she noticed fewer hot flashes and milder symptoms.

For her, this was convincing proof that Cannabis helped with all symptoms, physical and mental of her menopause. She concludes, “all women should discover Cannabis as they approach menopause, it is like having your best friend with you in the fun but also in the dark moments”.

This is, of course, one individual experience, but not unique. Internet forums and social media contain countless stories from women trying Cannabis products. Some often-heard experiences:

Sleep and relaxation

Cannabis (especially THCa-rich varieties or combinations with CBD) is often mentioned as a savior for insomnia. Women report that a few puffs of vaporized Cannabis (or a small edible) before bedtime helps them sleep through the night and manage night sweats.

CBD oil alone can also contribute, although CBD does not directly make you sleepy, it gives many people a sense of calm, making it easier to fall asleep and improving sleep quality. In a survey, 67% of women indicated using Cannabis for sleep disorders in menopause.

Three women from different countries described that Cannabis greatly improved their sleep, anxiety, and even migraines during perimenopause. THCa suppositories in particular proved to be a solution for one woman with vulvodynia (pain of the vulva), which benefited her sleep and sexual comfort.

Mood and anxiety

The mood swings, irritability, and anxiety that arise from hormonal peaks and troughs appear to be sensitive to Cannabis. Many women report that micro-dosing THC or regular CBD doses help you feel “more balanced”. CBD is known for its anxiolytic effect, and women indicate that a few drops of CBD oil daily make them less likely to be overwhelmed by panic or low moods.

At the same time, experienced users warn that dosage is crucial, low doses of THC usually have an anxiety-reducing effect, but doses that are too high can actually trigger anxiety.

This matches scientific findings: a low dose of Cannabis relaxes, a high dose can cause palpitations and paranoia, something especially sensitive people in menopause can suffer from. One Reddit user, for example, shared that Cannabis helped her anxiety disorder for years, but that around perimenopause, panic attacks suddenly occurred after use.

This illustrates that hormonal changes can influence the way Cannabis is tolerated. Nevertheless, the general tenor in anecdotes is that careful titration (slowly increasing the dose to the desired effect) can help a lot with emotional fluctuations. Some call Cannabis “their salvation” to avoid immediately having to resort to antidepressants or tranquilizers.

Pain and stiffness

Menopause is sometimes accompanied by new or worsening aches and pains, whether headache, joint pain, or muscle pain. From personal experience and small patient case reports, Cannabis can play a valuable role here. Dr. Lorenz reported that many of her patients with diffuse bone and joint pain benefited from CBD.

In particular, a CBD roller (a roll-on bottle to apply to temples or painful points) was popular and effective for dizziness and headaches. For arthritis-like complaints during menopause (stiff joints in the morning, creaky knees), a combination of oral and topical cannabinoids is often used. Topical CBD creams or balms on painful joints reduce local inflammation and pain, while a THC/CBD-rich extract orally (or via inhalation) provides systemic relief. One of the most frequently mentioned benefits of Cannabis in menopause forums is that women became less dependent on NSAIDs or painkillers, because Cannabis made their chronic pain complaints more bearable. This aligns with the science that both CB1 and CB2 receptor agonists have analgesic effects. Muscle cramps or tension (for example, neck and shoulder complaints due to stress) can also decrease due to Cannabis’ muscle-relaxing properties.

Hot flashes and thermoregulation

This is perhaps the most unique symptom of menopause and also the hardest to treat. Anecdotes provide mixed evidence. As described above, some women swear that Cannabis (especially THC-containing oil or vaping flower) makes their hot flashes almost disappear.

The mechanism is not entirely clear. It is speculated that activation of CB1 receptors in the hypothalamus (the temperature regulation center), can increase vasomotor stability, or that Cannabis simply reduces the stress and triggers that lead to a hot flash.

On the other hand, doctors such as Dr. Lorenz observe that CBD alone has little influence on hot flashes. Possibly, THC is the key; THC can dilate blood vessels and slightly lower blood pressure, which could temper the intensity of a hot flash.

In addition, the mild euphoria/relaxation of THC may counterbalance the panic or discomfort that accompanies a hot flash, making the experience less intense.

In practice, some women indicate that a small vape session at the first tingling of a hot flash can nip it in the bud or make it shorter and less severe. However, it is important to mention that this is still anecdotal; formal research into Cannabis specifically for hot flashes is, for now, still lacking.

Sexual well-being (libido and dryness)

A much underexposed, but extremely important aspect is the influence of menopause on sexual well-being: reduced libido, vaginal dryness, and discomfort during sex (dyspareunia). Here we see strikingly positive stories around Cannabis use.

First, women, even outside menopause, report that Cannabis enhances their sexual experience. Cannabis can sharpen the senses, lower inhibitions, and make orgasm more intense.

For menopausal women, in whom libido loss is often hormonal, Cannabis can function as a kind of aphrodisiac, it makes “the head turn off and the body turn on”, as one user described it.

Research confirms a link, Cannabis use is associated with improved sexual function and satisfaction in women. Regarding vaginal dryness, a result of thinning mucosa due to estrogen deficiency, it is often thought that Cannabis worsens this (because of “cotton mouth” and the assumption that the whole body dries out). However, an extensive review found no strong evidence that Cannabis causes vaginal dryness.

In fact, because Cannabis increases sexual interest, it can indirectly actually promote better natural lubrication. In addition, Cannabis lubricants and CBD oil suppositories now exist that are applied directly locally. Women such as Mary Jane Rose (who used Cannabis oil “intimately”) reported less pain and more pleasure with sex.

Dr. Lorenz has used vaginal CBD suppositories in her practice and has seen good results, even comparable to estrogen creams. CBD is a powerful vasodilator (blood vessel dilator), which means it locally promotes blood circulation, crucial for arousal and moisture formation.

The anti-inflammatory and healing properties of cannabinoids can also reduce vaginal atrophy and irritation. In short, although not everyone will benefit, many experiences suggest that Cannabis can contribute to a more enjoyable sex life during and after menopause - either through increased desire or through local relief of dryness and pain.

Safety, Side Effects and Points of Attention

When considering Cannabis extracts for menopausal complaints, it is essential to also reflect on the possible risks and side effects, especially since this is for educational purposes.

No remedy - no matter how "natural" - is without potential downside. Below are the main points of attention:

Intoxicating effects

Products with THC can cause a high or altered consciousness. This is desirable for some women (relaxing, mood-improving), but unpleasant for others. In addition, THC can temporarily affect memory, reaction time and coordination. Older users should be careful with activities such as driving under the influence.

Always start with a low dose of THC to see how you respond.

Anxiety and palpitations

As mentioned earlier, too high a dose of THC can paradoxically trigger anxiety, restlessness or palpitations. Women in menopause may be more sensitive to this, especially if they already suffer from panic feelings or palpitations due to hormonal fluctuations. If you notice that Cannabis use makes your heart beat faster or you feel uncomfortable, lower the dose or switch to a CBD-rich product. CBD on its own actually has a soothing influence on palpitations and can help lower heart rate and blood pressure under stress.

Cognitive functions

Long-term daily Cannabis use, especially with THC, could have subtle effects on cognitive functions (memory, concentration) in older adults. Although many women use Cannabis without problems as a medicinal aid, long-term safety in postmenopausal users has not yet been extensively studied. Moderation is therefore advisable, and consultation with a physician in the case of existing cognitive problems (such as early dementia) is wise.

Interactions with medications

CBD and other cannabinoids can interfere with the breakdown of certain medicines. Dr. Lorenz warns, for example, that CBD can increase blood levels of agents such as beta blockers, opioids, blood thinners (warfarin) and certain antidepressants. Also noteworthy, CBD can reduce the effectiveness of tamoxifen (a drug used in breast cancer) by changing liver enzyme activity.

Women who use hormonal therapies because of breast cancer should therefore consult first before taking CBD oil. In general, if you use medication, consult a physician or pharmacist to check whether cannabinoids can be safely combined with it.

Side effects at high dosage

Cannabis extracts, and especially CBD at high doses, can cause mild side effects. These include dizziness, drowsiness, dry mouth, a slight drop in blood pressure and sometimes headache.

In practice, these symptoms usually occur at very high dosages (e.g. >300 mg CBD per day) and are relatively rare. Still, it is good to know, build up the dosage slowly, listen to your body, and if side effects occur take a lower dose or a break.

Not as a complete replacement without consultation

Although Cannabis extracts are very promising, do not abruptly replace prescribed treatments (such as hormone therapy) with Cannabis without medical guidance. Especially if you use HRT for osteoporosis prevention or severe complaints, discuss with your doctor whether gradually tapering off and trying Cannabis is an option.

For many, Cannabis can be an additional treatment or an alternative if conventional remedies do not work/cannot be used, but if possible involve a physician who is open to cannabinoids in your decisions.

Finally, remember that every woman responds uniquely. What is a miracle remedy for one may do little for another or cause unwanted effects. That is why experts emphasize the importance of more research before Cannabis is broadly recommended for menopause. Fortunately, this research is underway, and in the meantime, with knowledge and caution, it can be assessed case by case whether Cannabis extracts are valuable.

Conclusion

Interest in Cannabis extracts, from CBDa to THC and other cannabinoids as an aid for menopausal complaints, is growing by the day. Based on the available evidence and experiences, we can conclude that Cannabis is a promising, though not miraculous, remedy for various aspects of menopause. Scientific research supports the idea that cannabinoids can have beneficial effects on mood, sleep, pain and perhaps even on weight and bone health. Anecdotal reports add stories of vanished hot flashes, restored libido and generally improved well-being thanks to Cannabis.

CBD in particular stands out as safe and versatile; it is anti-inflammatory, anxiety reducing, and can be used daily without a high effect. CBDa, the raw form, adds extra potential due to its strong anti-inflammatory properties and could be useful for some women in the context of pain and mood. THC-containing Cannabis seems mainly to help with stubborn symptoms such as insomnia, mood disorders and possibly hot flashes, but comes with intoxicating effects that are experienced differently per person.

In addition, we should not forget the terpenes and flavonoids in Cannabis; these can contribute synergistically to, for example, relaxation (linalool, myrcene) or pain relief (caryophyllene), which is why many women swear by full-spectrum products.

It is important that every woman finds her own balance. Some will already benefit sufficiently from a few drops of CBD oil for their sleep or mood, while others may need a combination of a THC oil in the evening and CBD during the day.

Listen to your body and build up carefully. If you have severe complaints or doubts, always consult a doctor, especially since menopausal complaints and their treatment are tailor-made.

Until there is more hard data, we find ourselves at the intersection of traditional well-being and modern science. Cannabis offers a new chapter in the book of menopause care, one in which the emphasis lies on restoring balance in a period of change. The preliminary conclusion is that cannabis extracts (including CBDa) are, for many women, a hopeful option to get through menopause in a more natural and pleasant way, provided they are used well-informed. As one experienced expert put it, "It turns out you don't have to accept the symptoms of menopause. Cannabis is there for you!”

Cannabis, Menopause and Relation to Estrogen

1. Cannabis, menopause and relation to estrogen 1. Peri- and post-menopause: use of medical cannabis (survey, Menopause 2022). Study on why women use cannabis around menopause (sleep, mood, pain, vasomotor symptoms). https://pubmed.ncbi.nlm.nih.gov/35917529/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9422771/ 2. 3. 4. 5.

2. Systematic review: cannabis and menopausal symptoms (Climacteric 2021) Overview of the available literature on cannabis/cannabinoids for hot flushes, sleep, mood and sexuality. https://pubmed.ncbi.nlm.nih.gov/33759668/

3. Population study: women 35+ and cannabis for menopause (BMJ Open 2023) Cross-sectional data on use patterns, motives and perceived effects, no evidence equivalent to HRT. https://pubmed.ncbi.nlm.nih.gov/37344107/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10314536/

4. Qualitative study: women’s experiences with cannabis around menopause (Menopause 2024) In-depth interviews about reasons, expectations, perceived effects and barriers. https://pubmed.ncbi.nlm.nih.gov/38980742/

5. Endocannabinoid system and estrogen: mechanistic link (Int J Mol Sci 2021) Review on how estrogens and the ECS influence each other (receptors, signaling pathways, tissue effects). https://pubmed.ncbi.nlm.nih.gov/34433866/ 16 6.

6. (Phyto)cannabinoids and reproductive hormones (Frontiers in Endocrinology 2023) Review on effects on the HPG axis (GnRH, LH/FSH) and the relation to hormonal balance. https://pubmed.ncbi.nlm.nih.gov/36578200/

7. Estrogen decline and cannabinoid-related vascular function (CNS Neurosci Ther 2023) Animal model showing how estrogen status and CB1/ECS may be involved in vascular regulation. https://pubmed.ncbi.nlm.nih.gov/38003619/

8. Anti-estrogenic effects of marijuana smoke condensate (Endocrinology 2005) Important nuance: anti-estrogenic effects were linked to smoke condensate (mixture), not automatically to isolated cannabinoids. https://pubmed.ncbi.nlm.nih.gov/15814806/

9. Thermoregulation and the ECS in the hypothalamus (Mol Psychiatry 2002) Foundational review relevant to hot flushes because hypothalamic thermoregulation and the ECS are connected. https://pubmed.ncbi.nlm.nih.gov/12052044/

10. Postmenopausal dyspareunia: treatment overview (Menopause 2023) Review on pain during sex after menopause; discusses treatment options and mentions cannabidiol as a possible approach. https://pubmed.ncbi.nlm.nih.gov/37040586/

11. Topical CBD + myrcene in vestibulodynia (RCT, Biomedicines 2025) Clinical trial on local application for vulvar pain, relevant as a “local approach” for complaints such as pain and irritation. https://pubmed.ncbi.nlm.nih.gov/41153723/

12. Hemp seed oil: “estrogen-like effect” in a perimenopause rat model (J Oleo Sci 2023) Preclinical and about hemp seed oil, not THC/CBD extracts, but interesting for endocrine context. https://pubmed.ncbi.nlm.nih.gov/37704445/

13. Hempseed in an ovariectomy rat model (2010) Older animal study with an OVX model of menopause, mainly nutritional and preclinical. https://pubmed.ncbi.nlm.nih.gov/21069097/

14. HRT reference: NAMS Position Statement hormone therapy (Menopause 2022) The key reference for estrogen therapy (HRT) and risk-benefit evaluation. https://pubmed.ncbi.nlm.nih.gov/35797481/ https://doi.org/10.1097/GME.000000000000202

About Peter Vermeul

Peter Vermeul is the CEO of CBD Spain and a pioneer in developing stable, full-spectrum Cannabis extracts for medical use. With a background in horticulture and advanced biotech, he recognized early that conventional extraction methods were compromising therapeutic integrity by degrading key compounds. He led the creation of a patented low-temperature process that preserves terpenes, flavonoids, and acid forms of cannabinoids, enhancing both stability and bioactivity. Through ongoing collaboration with research institutions, Peter continues to advance precision extraction technologies that expand the clinical potential of medical Cannabis.

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