Numerous preclinical and clinical studies into the therapeutic effects of cannabidiol (CBD) have shown that this compound can be used as an effective, safe, non-addictive, and non-intoxicating treatment for numerous psychological and physiological conditions. For example, CBD can be used to treat neurological disorders and seizures, symptoms associated with multiple sclerosis like spasticity and muscle spasms, chronic pain, inflammation, anxiety, arthritis, and neurodegenerative disorders like Alzheimer’s disease, just to name a few.
However, with all of this attention now surrounding CBD, many people are wondering: can it be used to treat symptoms of menopause as well?
To date, we are not aware of any studies that have been conducted to specifically test the efficacy of CBD on menopausal symptoms. That being said, numerous studies have demonstrated that the endocannabinoid system (ECS) is intricately involved in menopause and may represent an exciting new therapeutic target for the treatment of several related symptoms.
What is menopause?
Menopause is defined as the time in a woman’s life when menstrual periods stop. It is usually confirmed when a woman has missed her period for 12 consecutive months. According to the North American Menopause Society, most women experience menopause between the ages of 40 and 58 while the average age is 51.
Menopause results in lower levels of estrogen and other hormones. Estrogen is the primary female sex hormone and one of its main functions is to promote the development and maintenance of female characteristics in the human body.
Physical changes begin years before the final menstrual period.
Premenopause is a term used to mean the years leading up to the last period, when the levels of reproductive hormones are becoming more variable and lower, and the effects of hormone withdrawal are present.
Perimenopause refers to the menopause transition years, a time before and after the date of the final menstrual period. This transition phase is called perimenopause and may last for 4 to 8 years.
Finally, postmenopause refers to the time of a woman’s life following menopause. During this time, many of the bothersome symptoms a woman may have experienced before menopause gradually decrease.
During and after menopause, women can experience a wide range of symptoms. These can include:
- hot flashes – short, sudden feelings of heat, usually in the face, neck and chest, which can make the skin red and sweaty
- heavy night sweats – hot flashes that occur at night
- interrupted sleeping patterns
- lack of energy
- weight gain
- a reduced sex drive (libido)
- painful intercourse
- problems with memory and concentration
- vaginal dryness
- palpitations – heartbeats that suddenly become more noticeable
- joint stiffness, aches and pains
- reduced muscle mass
- recurrent urinary tract infections (UTIs), such as cystitis
- urinary incontinence
- anxiety and depression
- mood swings
- inability to concentrate
Furthermore, menopause can also increase a person’s risk of developing osteoporosis (weak bones).
However, because menopause is a natural stage in life and is not considered a disease or disorder, it doesn’t automatically require any kind of medical treatment. That being said, some cases where the physiological and psychological symptoms are more severe, medical therapies may be warranted.
Hormone replacement therapy (HRT) is one of the most commonly prescribed therapies for women in menopause. It involves the use of estrogen (or estrogen plus progestogen for women who have an intact uterus) to replace the decline of hormones in the body. Unfortunately, although it is very effective in treating menopausal symptoms and can help prevent bone loss and osteoporotic fracture, HRT has been linked to an increased risk of breast cancer, blood clots, dementia, stroke, and heart attack. Today, doctors recommend it be used for the shortest time possible and at the lowest dose possible.
Other suggested treatments for menopausal symptoms may include selective estrogen receptor modulators (SERMs), vaginal moisturizers, vaginal estrogen products, and counseling. Lifestyle changes may help with hot flashes while smoking cessation, adequate vitamin D intake and weight-bearing exercise may help with osteoporosis.
We’ve written before about the roles that the endocannabinoid system and CBD play in people with osteoporosis. To quickly recap, preclinical studies in mice have shown CBD to be effective in protecting against age related bone loss.
However, that’s not the only symptom of menopause that CBD’s capable of treating. Researchers are beginning to study the link between menopause and the ECS – which could open up new pharmaceutical targets to explore.
How menopause and the endocannabinoid system are linked
The endocannabinoid system (ECS) consists of the cannabinoid receptors CB1 and CB2, the endocannabinoid ligands anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and their metabolic enzymes. Endocannabinoids and their receptors are found throughout the body: in the brain, connective tissues, glands, immune cells, and organs. The main goal of the endocannabinoid system is homeostasis or the maintenance of a stable internal environment in the body. It is recognized as probably the most important modulatory system in the human body and plays a very important regulatory role in the secretion of hormones related to reproductive functions.
Of course, endocannabinoids and their receptors are also found in the female reproductive organs called the ovaries. The ovaries are the prime location for estrogen production.
In a study published in 2009 in the journal PLOS One, researchers from the U.K. aimed to localize the endocannabinoid system in the ovary and to investigate whether follicular fluid or plasma AEA levels were related to physiologically important ovarian events. These events included folliculogenesis (the maturation of the ovarian follicle, which is a fluid-filled sac that contains an immature egg, or oocyte), growth of the size and maturity of preovulatory follicle, oocyte maturity, and ovulation.
The researchers found that the ECS was present and widely expressed in the ovaries. They also found that concentrations of the endocannabinoid AEA would vary depending on follicle size and maturity.
The authors concluded that AEA is produced in the ovary, that it is under hormonal control, and and it plays a major role in folliculogenesis, preovulatory follicle maturation, oocyte maturity and ovulation.
So how does this tie in to CBD and its potential treatment for menopausal symptoms?
Well for starters, the ovaries produce estrogen.
But in addition to promoting the development and maintenance of female characteristics in the human body, it has also been shown to elicit anxiolytic (inhibits anxiety) and antidepressant effects as well. Previous studies have demonstrated that estrogen administration to post-menopausal women results in an improvement in mood and reductions in measures of anxiety and depression.
Unfortunately, as we discussed earlier, estrogen administration through HRT has been linked to an increased risk of breast cancer, blood clots, dementia, stroke, and heart attack. If there was a solution to bypass HRT’s negative affects, but also improve mood, and reduce anxiety and depression, that would be a major breakthrough in treating menopausal symptoms.
Some researchers believe they’re close to finding that solution.
In a study published in 2007 in the journal Psychoneuroendocrinology, researchers from the University of British Columbia in Canada examined if the anxiolytic and antidepressant effects of estrogen implicated the ECS.
In the first experiment, rats were injected with estrogen and a CB1 receptor antagonist and then were tested for anxiety levels using either the open field test, elevated plus maze or the forced swim test. They found that estrogen treatment resulted in a significant decrease in anxiety levels. They also found that co-treatment with the CB1 receptor antagonist reversed these effects. The results suggest that endocannabinoids are integral to the anxiolytic effects of estrogen.
In the second experiment, the researchers tried inhibiting the enzyme fatty acid amide hydroxylase (FAAH) which is the enzyme responsible for breaking down the endocannabinoid AEA. Blocking FAAH generally leads to elevated levels of AEA and the researchers found that administration of an FAAH inhibitor reduced anxiety and elicited an antidepressant response. They concluded that estrogen may elicit changes in emotional behavior through an endocannabinoid mechanism, and suggested that inhibition of FAAH represents a therapeutic target for anxiety and depression in women.
Keep in mind, studies have shown that CBD is a potent FAAH inhibitor.
Although there have been no studies on the subject to date, CBD’s mechanisms of action could open up doors to new research into relieving at lease some of the symptoms of menopause, such as osteoporosis, anxiety, and depression.
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