Menopause is not a brief event. The transition commonly runs for several years, and for a significant proportion of women the symptoms are disruptive enough to affect work, relationships and sleep for most of that time.
A lot of women are already using cannabis to manage it usually without medical supervision. This article sets out what the research supports, what it does not, and what a supervised medical approach looks like in Canada.
How many women are actually doing this
More than most clinicians assume. A survey published in Menopause, the journal of the North American Menopause Society, found that the large majority of participants were current cannabis users, and that most of those endorsed using it specifically for menopause-related symptoms.
Crucially, the survey also identified which symptoms women were targeting. Sleep disturbance came first by a clear margin, followed by mood and anxiety symptoms. Other survey work has reported similar patterns, with sleep consistently at the top.
Why sleep and mood, and not hot flashes
This is the most useful finding in the whole literature, and it is the one most marketing content gets wrong.
Hot flashes are the symptom most associated with menopause in the public mind but in survey data they improve less than people expect. One explanation offered by clinicians is that the brain region governing temperature regulation is not thought to be substantially affected by cannabis.
Sleep and mood are a different matter. Both are processes the endocannabinoid system is involved in regulating, and both are among the symptoms women most consistently report improving. Our comparison of CBN, CBD and CBG covers which cannabinoids are most associated with sleep.
If you are considering medical cannabis primarily to stop hot flashes, the evidence is weaker than you may have been led to believe. If you are considering it because you have not slept properly in eight months, you are on firmer ground.
The hormonal mechanism
Estrogen is closely involved in regulating the endocannabinoid system in particular the enzyme that controls how quickly anandamide, one of the body’s own cannabinoids, is broken down. As estrogen declines through perimenopause and after menopause, researchers have described corresponding changes in cannabinoid receptor expression and endocannabinoid levels, and reduced efficiency in that signalling.
This is a plausible mechanism, not a proven treatment pathway. It explains why the question is being studied. It does not by itself demonstrate that cannabis relieves menopause symptoms.
Where the evidence runs out and why we are telling you
Almost everything above comes from survey and observational data. What does not exist is long-term controlled trial evidence. Harvard’s reporting on this literature quotes clinicians making exactly that point: there are no studies following middle-aged women using cannabis over the many years menopause symptoms can last, so long-term effects on memory or lung function are not established.
Researchers have also raised the issue of expectancy that some of the reported benefit in surveys reflects what participants expected to happen. That does not make the relief unreal to the woman experiencing it, but it does mean the honest summary is: promising, widely used, insufficiently studied.
If a clinic tells you medical cannabis is a proven treatment for menopause, they are ahead of the evidence. What can be said fairly is that a large number of women report benefit, particularly for sleep and mood, and that a supervised trial with a practitioner is a reasonable option to discuss especially where hormone therapy is unsuitable or unwanted.
What a medical approach adds over doing it yourself
- Practitioner oversight, including review of your other medications for potential interactions.
- Product consistency known cannabinoid content rather than variable product.
- Structured titration, starting low and adjusting slowly. Our guide to using cannabinoid oil covers the practical side of this.
- Access to coverage routes that do not apply to recreational purchases see eligible for coverage and how insurance coverage changed access to medical cannabis.
- Documentation, which matters for employment and insurance situations.
What to expect from a consultation
A practitioner will want to understand which symptoms are affecting you most, what you have already tried, your full medication list and your medical history. Cannabis is not appropriate for everyone a history of psychosis, certain cardiovascular conditions, and pregnancy or breastfeeding are all reasons a practitioner may advise against it or proceed differently.
The step-by-step prescription guide sets out the full sequence, and our article on mistakes to avoid when applying covers the errors that cause delays.
If you do proceed, expect the process to take weeks rather than days. Finding a workable dose is a gradual adjustment, not a single decision.
Frequently asked questions
Does cannabis help with hot flashes?
Less than most people expect. Survey data consistently shows sleep and mood symptoms responding more than vasomotor symptoms such as hot flashes and night sweats.
Can I use medical cannabis alongside hormone therapy?
This needs to be discussed with your prescriber. They are not alternatives to one another, and any combination should be supervised by someone who knows your full medication list.
Is medical cannabis for menopause covered by insurance in Canada?
Some private and employer benefit plans include medical cannabis, though annual maximums vary considerably. Our guide to applying for medical cannabis coverage explains the process. Coverage is not automatic and depends on your specific plan.
Do I need to smoke it?
No. Oral formats are commonly used, particularly where sleep is the main concern. See our beginner’s guide to cannabinoid oil for how these work.
How long before I know if it is working?
Because dosing is adjusted gradually, most practitioners will want several weeks before assessing whether it is helping.
Next step
If sleep, mood or persistent discomfort through perimenopause or menopause is not responding to what you have tried, a consultation will tell you whether medical cannabis is a reasonable option in your specific situation including if the answer is no. Apply now or contact our team.