Effect of cannabis use in peri- and post-menopausal women: a systematic review

Objectives Objective Menopausal patients often report using cannabis as an adjunct to their hormonal replacement therapy or by itself to alleviate menopausal symptoms such as insomnia and anxiety. There are no guidelines addressing the use of cannabis in peri- and post-menopausal women. The objective of this systematic review is to evaluate the published data on the effect of cannabis use in peri- and post-menopausal women. Methods The following databases were searched: Ovid MEDLINE, PubMed, Ovid EMBASE, Web of Science, Scopus, CINAHL, PsycINFO, Cochrane Central Register of Control Trials and Cochrane Database of Systematic Reviews, LILACS, and AMED. Searches were conducted in ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and the International Standard Randomised Controlled Trial Number Registry. The first 200 results were imported from Google Scholar. Selected studies assessed peri- or post-menopausal women, the impact of cannabis use, and menopausal symptoms. All study designs were included. Review articles, letters to the editor, non-clinical studies, and case reports were excluded. There were no restrictions on study time period or language. Results 564 studies were retrieved. Nine studies were selected for full text review and three met inclusion criteria. One study controlled for participant cannabis use and reported on the effects of cannabis and placebo cigarette smoking on mood in 10 postmenopausal women. Another study assessed associations between drug use with hot flashes and insomnia in 120 HIV-infected women and found that menopausal status and cannabis use was crudely associated with hot flashes. The last study evaluated expectancies of 115 menopausal patients who endorsed lifetime cannabis use and reported that women expected cannabis to improve depression, anxiety, hot flashes, and problems with sleep but not sexuality. Conclusions There is limited research on the impact of cannabis use on menopausal symptoms in peri- and/or post-menopausal women. None of these studies assessed quality of life as an outcome and no study was performed by a group of menopause specialists. Research into cannabis use in menopause is essential, as it is currently being utilized to alleviate symptoms without objective proof of its benefits.