Menopause and Medical Cannabis

What is Menopause?

Menopause is the point when periods stop permanently because the ovaries no longer release eggs and make much less oestrogen. It is confirmed after 12 months in a row without a period, when there is no other cause.

The changes usually start gradually. In a large British study, perimenopause began on average between the ages of 46 and 50 [1].

Menopause before the age of 45 is called early menopause. About 1 in 10 women have menopause before this age [2]. Menopause before 40 is called premature ovarian insufficiency (POI). This is when the ovaries stop working normally at a younger age [3]. Studies estimate that POI affects between 1 and 4 in every 100 women [4,5].

Menopause can affect women, trans men, non-binary people and anyone who has periods.

What are the Stages of Menopause?

• Perimenopause– the years leading up to menopause. Hormone levels go up and down, periods often become irregular and symptoms may start.
• Menopause – the point when you have gone 12 months in a row without a period.
• Postmenopause – the time after menopause. Some symptoms ease, but others can carry on for several years.

What Causes Menopause?

Natural menopause happens as the ovaries gradually stop working with age. They make less oestrogen, progesterone and testosterone. These changes cause most menopause symptoms.

Some things can cause menopause to happen earlier:

• Surgery – removing both ovaries brings on menopause straight away. Removing the womb (a hysterectomy) stops periods but does not cause immediate menopause if the ovaries are left in place. One study found that menopause tended to happen a few years earlier after a hysterectomy [8].
• Cancer treatments – chemotherapy and radiotherapy can affect the ovaries and may bring on menopause early.
• Certain hormone medicines – certain treatments that affect the ovaries can bring on menopause or menopause-like symptoms.
• Smoking – people who currently smoke are about twice as likely to have an early menopause as people who have never smoked [2].
• Family history – early menopause can run in families.

What are the Symptoms of Menopause?

Menopause symptoms vary a lot from person to person. They can begin months or even years before periods stop. Some people have many symptoms, while others have very few.

Common symptoms include [9]:

• Hot flushes and night sweats
• Difficulty sleeping and fatigue
• Low mood, anxiety, irritability and mood swings
• Memory and concentration problems (sometimes described as ‘brain fog’)
• Heart palpitations
• Joint and muscle aches
• Headaches or migraines that may become more frequent or severe
• Changes to periods during perimenopause
• Vaginal dryness and discomfort during sex
• Reduced sex drive
• Recurrent urinary tract infections (UTIs)
• Bloating
• Changes in weight or body shape

A review of 321 studies from around the world looked at 19 menopause symptoms. Joint and muscle aches were the most common, affecting around 65% of midlife women [10].

How is Menopause Diagnosed?

If you are over 45 and have menopause symptoms, a GP can usually diagnose perimenopause or menopause from your symptoms alone [11]. You will not normally need a blood test. This is because hormone levels go up and down during perimenopause, so a test does not give a clear answer.

You have reached menopause when you have not had a period for 12 months in a row. This does not apply if you use hormonal contraception, which can affect your periods.

If you are under 45, your GP may suggest a blood test for a hormone called follicle-stimulating hormone (FSH). This helps check for early menopause or POI.

Your GP may also suggest other tests, such as a thyroid blood test. This is because some other health conditions can cause similar symptoms.

How is Menopause Treated?

HRT is the main treatment for menopause symptoms. It is the most effective treatment for hot flushes and night sweats. Other options include lifestyle changes, CBT and non-hormonal medicines. The right choice depends on your symptoms, your health and what you prefer. A GP or menopause specialist can help you decide:

• HRT – replaces the hormones your body makes less of during menopause. In clinical trials, HRT reduced how often hot flushes happened by about three-quarters compared with a dummy treatment (placebo) [12]. It can also help with low mood, joint aches and sexual problems [13]. HRT is not suitable for everyone, and your doctor will talk you through the benefits and risks.
• Vaginal oestrogen – a low-dose hormone used inside the vagina. It comes as a cream, tablet, pessary (a small soft tablet) or ring. It can ease vaginal dryness and discomfort. You can use it alongside HRT.
• CBT (cognitive behavioural therapy) – a type of talking therapy. It can help with hot flushes, night sweats, sleep problems and low mood.
• Lifestyle changes – a healthy diet, regular exercise, drinking less alcohol and stopping smoking all support your long-term health. If you are overweight, losing weight may also help reduce hot flushes.
• Non-hormonal medicines – a doctor may suggest other medicines if you can’t take HRT or would rather not.
• Testosterone – a specialist may offer this if you have a low sex drive and HRT alone has not helped.

How does Menopause Affect Daily Life?

Menopause can affect sleep, energy, mood, relationships and work. Symptoms such as tiredness, anxiety and poor concentration can make everyday tasks harder.

A UK study included 409 women who were working during menopause. Around 1 in 4 (27%) said they had at least moderate problems coping at work because of their symptoms. Psychological symptoms, severe headaches and joint pain were most strongly linked to difficulty at work [7].

“Life before medical cannabis was full of anxiety. It felt like I was existing. I was on survival mode.”

Fatma, Curaleaf Clinic Patient diagnosed with chronic pain

Medical Cannabis and Menopause-Related Symptoms

There are no cannabis-based medicines licensed for menopause in the UK. Medical cannabis is not a treatment for menopause itself, and it is not an alternative to HRT. It does not reverse menopause or replace the hormones your body no longer makes.

Specialist doctors can prescribe cannabis-based medicinal products that are not licensed for a particular condition if they judge this is right for an individual patient. This is usually only considered after licensed treatments have been tried.

A specialist may consider medical cannabis for some people whose menopause-related symptoms continue to affect daily life despite other treatments. These symptoms may include:

• long-term sleep problems
• anxiety or low mood
• joint and muscle pain

These are the symptoms that people in surveys most often say they use cannabis for [14,15]. There is not yet good-quality clinical trial evidence showing whether medical cannabis improves these symptoms during menopause [14,15].

In 2023, The Menopause Society (then called the North American Menopause Society) reviewed the evidence for non-hormonal treatments. It did not recommend cannabinoids for hot flushes and night sweats, as the evidence was limited or inconsistent [16].

The endocannabinoid system is a signalling system found throughout the body. It is involved in processes such as sleep, mood, anxiety and body temperature. Laboratory studies suggest that oestrogen affects this system, but it is not yet clear what this means for menopause symptoms in people [14].

Like any medicine, medical cannabis can cause side effects. Common side effects reported in clinical trials include dizziness, dry mouth, feeling sick, tiredness and drowsiness [17]. It can also interact with other medicines. A specialist will review your medical history and current medicines before any decision about treatment is made.

Research Regarding Medical Cannabis and Menopause

Research into medical cannabis for menopause is at an early stage. Most of the evidence so far comes from surveys of people who already use cannabis, rather than clinical trials.

A 2022 US survey included 258 perimenopausal or postmenopausal women. They were recruited through online adverts aimed at people interested in women’s health and cannabis. Most (86%) currently used cannabis, and 203 (79%) had used medical cannabis for menopause-related symptoms. Sleep problems (67%) and mood or anxiety (46%) were the symptoms it was most often used for [14].

A 2023 Canadian survey included 1,485 women aged 35 and over living in Alberta. About two-thirds were perimenopausal or postmenopausal. Around a third (34%) currently used cannabis. Among them, the most common reasons were sleep (65%), anxiety (45%) and muscle or joint aches (33%) [15].

These studies show how and why some people use cannabis during menopause. Both relied on what volunteers reported about themselves, and neither can show whether medical cannabis is effective or safe for menopause symptoms [14,15].

You can read more in our article, The Use of Medical Cannabis During Perimenopause and Postmenopause

Can I be Prescribed Medical Cannabis for Menopause?

Since November 2018, specialist doctors in the UK have been able to prescribe cannabis-based medicinal products. The first prescription must come from a doctor on the General Medical Council (GMC) Specialist Register. Access through the NHS remains very limited, so most patients are seen at private clinics.

A specialist may consider medical cannabis for persistent menopause-related symptoms. This is usually only when other treatments have not helped enough or have caused side effects that are hard to manage. It is not suitable for everyone.

If you would like to find out whether you may be eligible, you can complete an eligibility assessment with Curaleaf Clinic. A clinician will review your medical history and records. If appropriate, you will be invited to a consultation with a specialist doctor. They will discuss all of your treatment options, including whether medical cannabis may be suitable.

References

[1] Hardy R, Kuh D. Reproductive characteristics and the age at inception of the perimenopause in a British National Cohort. Am J Epidemiol. 1999;149(7):612-20. doi:10.1093/oxfordjournals.aje.a009861

[2] Zhu D, Chung HF, Pandeya N, Dobson AJ, Cade JE, Greenwood DC, et al. Relationships between intensity, duration, cumulative dose, and timing of smoking with age at menopause: a pooled analysis of individual data from 17 observational studies. PLoS Med. 2018;15(11):e1002704. doi:10.1371/journal.pmed.1002704

[3] Hamoda H, Sharma A. Premature ovarian insufficiency, early menopause, and induced menopause. Best Pract Res Clin Endocrinol Metab. 2024;38(1):101823. doi:10.1016/j.beem.2023.101823

[4] Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol. 1986;67(4):604-6.

[5] Golezar S, Ramezani Tehrani F, Khazaei S, Ebadi A, Keshavarz Z. The global prevalence of primary ovarian insufficiency and early menopause: a meta-analysis. Climacteric. 2019;22(4):403-11. doi:10.1080/13697137.2019.1574738

[6] Avis NE, Crawford SL, Greendale G, Bromberger JT, Everson-Rose SA, Gold EB, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531-9. doi:10.1001/jamainternmed.2014.8063

[7] D’Angelo S, Bevilacqua G, Hammond J, Zaballa E, Dennison EM, Walker-Bone K. Impact of menopausal symptoms on work: findings from women in the Health and Employment after Fifty (HEAF) study. Int J Environ Res Public Health. 2022;20(1):295. doi:10.3390/ijerph20010295

[8] Farquhar CM, Sadler L, Harvey SA, Stewart AW. The association of hysterectomy and menopause: a prospective cohort study. BJOG. 2005;112(7):956-62. doi:10.1111/j.1471-0528.2005.00696.x

[9] NHS. Menopause and perimenopause. Last reviewed May 2026. nhs.uk/conditions/menopause

[10] Fang Y, Liu F, Zhang X, Chen L, Liu Y, Yang L, et al. Mapping global prevalence of menopausal symptoms among middle-aged women: a systematic review and meta-analysis. BMC Public Health. 2024;24(1):1767. doi:10.1186/s12889-024-19280-5

[11] NICE. Menopause: identification and management (NG23). Updated 2024. nice.org.uk/guidance/ng23

[12] MacLennan AH, Broadbent JL, Lester S, Moore V. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes. Cochrane Database Syst Rev. 2004;(4):CD002978. doi:10.1002/14651858.CD002978.pub2

[13] Sarri G, Davies M, Lumsden MA; Guideline Development Group. Diagnosis and management of menopause: summary of NICE guidance. BMJ. 2015;351:h5746. doi:10.1136/bmj.h5746

[14] Dahlgren MK, El-Abboud C, Lambros AM, Sagar KA, Smith RT, Gruber SA. A survey of medical cannabis use during perimenopause and postmenopause. Menopause. 2022;29(9):1028-36. doi:10.1097/GME.0000000000002018

[15] Babyn K, Ross S, Makowsky M, Kiang T, Yuksel N. Cannabis use for menopause in women aged 35 and over: a cross-sectional survey on usage patterns and perceptions in Alberta, Canada. BMJ Open. 2023;13(6):e069197. doi:10.1136/bmjopen-2022-069197

[16] The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023;30(6):573-90. doi:10.1097/GME.0000000000002200

[17] Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313(24):2456-73. doi:10.1001/jama.2015.6358