Recently, I was asked to be a guest on PBS’s SciencePub to discuss cannabis and women’s health. As a practicing clinician and a “woman of a certain age”, I always appreciate the opportunity to share my knowledge and insights I have with my patients, students, and anyone who is interested. As we celebrate Women’s History Month, I feel inspired to talk about my personal experience with cannabis and how it’s impacted my health. This story isn’t about my journey as much as it is about addressing the health inequities and uplifting women’s lived experiences. As a woman and feminist in her 50s, I can attest how women feel dismissed by some healthcare providers and that their voices are not legitimate. There is a scarcity of information, support, and guidance for women as they age. When talking about women’s lives, its vital to include a diversity of voices in the media, and one voice that is often not heard as much is the older female voice. As a result, women are often woefully misinformed and unaware of their bodies. Every female will experience approximately 10-20 years of their life going through perimenopause, menopause, and post menopause. These stages impact the mind and the body in significant ways. Sadly, this is not a topic that many women discuss, so they go through this time unaware, uncertain, unprepared, and frankly isolated. In my mother’s time, it was considered taboo to discuss “the change of life.” As I age and work my way through this very personal and disruptive experience, I feel emboldened to smash the stigma to educate all women about this powerful shift in our lives. In this article, I am going to discuss perimenopause and menopause, and how I have used cannabis to address the very real symptoms that coincide with this biological, psychological, and social change. It’s been my professional experience as a clinician that the lack of knowledge about what is happening to us often results in people being misdiagnosed or thinking that there is something inherently wrong or dysfunctional in them. I have experienced both the positives and negatives that cannabis can offer.
The stages of perimenopause, menopause, and post menopause bring significant symptoms that can feel highly disruptive and are often overlooked or treated as mental health disorders. However, these shifts are the direct result of reduced sex hormones, which creates something like puberty-in-reverse. Common symptoms include irregular or infrequent periods (during perimenopause), heavy bleeding (during perimenopause), hot flashes, brain fog, increased irritability, increased depression, increased anxiety, memory loss, night sweats, sleep problems, vaginal dryness, reduced sexual libido, painful sex, vaginal atrophy, chronic muscle or joint pain, loss of bone density, and skin thinning. I have experienced all these symptoms, although I’m not sure about the bone density, and it has been impacted me significantly. Frankly, going through this shift has been one of the most challenging, but also one of the most healing, times in my life. This is a huge shift in a female’s life when biological changes, psychological factors, and social shifts take place. We enter this stage as smart women; we leave as wise women. We rarely discuss how hormones impact the mind and body. Interestingly, we are starting to understand how the endocannabinoid system may influence hormone production and regulation as well. It’s an exciting time regarding the research on the ECS and cannabis, but there’s very little science to drive products and practices. Regardless, we know historically that cannabis was used to improve women’s health for thousands of years.
A recent study of middle-aged female veterans found that half of the women (n=232) found that 27% of respondents reporting menopausal symptoms such as hot flashes and night sweats, insomnia, genitourinary symptoms used cannabis to relieve their symptoms. The cannabis products were most often used to address hot flashes and night sweats, researchers said. In addition, roughly 37% were interested in using cannabis for the treatment, compared to only 19% who used hormonal treatments for symptom relief. This reflects an interesting shift in the acceptance of cannabis as a medical/therapeutic treatment for menopause. Unfortunately, there are no reliable clinical studies looking at cannabis use to aid menopausal symptoms. Anecdotally, many women have found cannabis products to be effective in treating menopause symptoms — particularly insomnia and hot flashes. We know that hot flashes are due to the hormonal ups and downs of menopause and caused by the loss of estrogen and progesterone. We also know that the body’s endocannabinoid system impacts hormone production as well. Since both CBD and THC are known for their sedative effects, it has been widely reported to be effective in treating insomnia. CBD is reportedly used to treat feelings of anxiety. Currently, if not in a legal cannabis state, women can use over the counter supplements like black cohosh, which is not regulated or highly tested, or hormone replacement therapy (HRT). However, not every female can take HRT due to its risk for women with genetic predispositions to breast and ovarian cancers. Beyond hormone replacement therapy, mainstream medicine offers little in the way of relief to women suffering from menopause symptoms other than psychiatric medication, benzodiazepines, NSAIDs, opioids, and sleep medications.
As a clinician and educator, I rely heavily on evidence-based practices to inform my decision making. As a woman who has gone through perimenopause and is now officially menopausal, I have studied these changes to determine how best to use plant medicine and other supplements in the most beneficial way possible. I can say that there has been trial and error, but I’ve observed some interesting results from my experience. First, nothing prepared me for the significant impacts I experienced during perimenopause. I couldn’t tolerate things as I had before. I was exhausted and my sharp thinking went dull. I later learned from a provider that the more stress your body has endured, the more intense your symptoms will be. During this phase, my joint and muscle pain level increased significantly; some days I’d have a hard time getting out of bed. I also started experiencing increased anxiety. I’ve always struggled with anxiety but have always been able to keep it at bay with my meditation and mindfulness practices. However, it increased significantly in ways that sometimes felt too overwhelming. My sex drive dissipated completely, and if I had sex, it was painful. The sleep interruptions became almost hourly for many nights, but, at a minimum, every night was interrupted by hot flashes, aches and pains, or anxiety. I experimented with THC, CBD, CBN, and CBD; edibles, flower, vapes, and tinctures. What I discovered it that THC helped with the pain and alertness, but it added negative side effects if taken solely. I felt increased anxiety, and I found that adding CBD provided more benefits than THC alone. CBD alone helped diminish my anxiety and adding CBN and CBG improved my sleep greatly. Due to the power of the cannabis plant, I began researching other hacks for my menopause. I became more focused on improving the vitamins and nutrients from the foods in diet. I began ingesting multi-vitamins and other supplements like curcumin (which is a cannabinoid), omega-3s, and eventually bioidentical-plant-derived hormones to help with the reduction of my menopausal symptoms. I feel much better now than I did before I started using them. For many women, the stage when we experience menopause can also be a time of coming to terms with parts of themselves that they’ve kept hidden or have repressed. It’s also a time of a great personal identity shift as well. Our roles as mothers, partners or spouses, and children to our parents begin to change for most of us. But that’s not necessarily bad news. As bell hooks said, “Aging allows [women] to move from object to subject. It’s an interesting, exciting time…change happens through the aging process- you realize that you don’t want to stay in this character that you were.” This time of expansion and growth is often met with fear and great psychological distress. As a clinician, I know that times of great change can be painful, but that doesn’t mean it is necessarily bad. With aging comes experience, and I’ve learned that the hardest times of my life have led to the most growth if I was spiritually connected. I had studied the spiritual aspects of cannabis and wanted to use it for the purpose of growth, insight, and healing. I am a believer that spiritual connection is an essential component to wellbeing, and I decided to use cannabis to be more connected to my spirit as others have for thousands of years before me. At the appropriate times, I used it before yoga, before going out in nature, before going on walks in Central Park, and before meditation. I feel much more aligned with my mind, body, and spirit; I feel stronger, wiser, and more emboldened to make a difference in this world. While I still struggle with hot flashes and sleepless nights, cannabis strangely has helped me grow personally in many unexpected ways like letting go of things that no longer serve me. As a result, I am happier, feel more empowered, and my relationships have shifted in beneficial ways. To sum it up, I have become wiser. And I believe that’s the goal of menopause.
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