WASHINGTON, DC — Several menopause symptoms, including alterations in mood, were significantly associated with women’s use of cannabis in the past month, particularly for those who met the criteria of cannabis use disorder, according to research presented at the annual meeting of the American College of Obstetricians and Gynecologists May 2. 

“Our multivariable models showed that almost all menopause symptoms were associated with cannabis use,” Emily Zhao, a medical student at Case Western Reserve University in Cleveland, Ohio, told attendees. “These findings suggest that high-risk cannabis use may be an indicator of bothersome, untreated menopause symptoms. Furthermore, clinicians should be aware that their patients may be self-medicating with cannabis for their menopause symptoms.”

The researchers conducted a national, cross-sectional, web-based survey of 5174 U.S. women aged 45-64 (response rate 62%) about their menopause symptoms, mental health comorbidities, and cannabis use in the past 30 days. The average age of the respondents was 55; 63% of them were non-Latina White, and 68% were postmenopausal. 

In the previous month, 42% of the women reported vasomotor symptoms, 35% reported sleep difficulties, 27% reported sexual symptoms, 25% reported urinary symptoms, and 25% reported mood swings and irritability. Further, 1 in 10 women reported moderate to severe anxiety, clinically significant depressive symptoms, moderate to severe clinical insomnia, and current cannabis use. 

After adjusting their results to account for age, race, ethnicity, education level, menopause status, and current use of menopausal hormone therapy, the researchers found that vasomotor symptoms, sexual symptoms, mood swings and irritability, moderate to severe anxiety, depressive symptoms, and sleep difficulty were all significantly associated with cannabis use (P < .001).

The researchers further divided cannabis use into any use in the past 30 days, daily or near-daily use (20 or more days of the month), and meeting the criteria for cannabis use disorder, defined as a score of 10 or greater on the Cannabis Use Disorder Identification Test-Revised.

They found daily or near-daily smoking to be significantly associated with depressive symptoms (P < .001), mood swings and irritability, and moderate to severe anxiety (P < .01). In addition, daily or near-daily edible use was significantly associated with sexual symptoms and moderate to severe anxiety (P < .05). 

The researchers also identified a significant association between cannabis use disorder and vasomotor symptoms (P < .05) as well as moderate to severe anxiety, depressive symptoms, and mood swings and irritability (P < .001).

Genevieve Neal-Perry, MD, PhD, professor of reproductive endocrinology and infertility at the University of North Carolina in Chapel Hill, told Medscape Medical News that she was not surprised that more women are using cannabis to attempt to manage menopause-related symptoms, but it’s important for providers to help women understand the potential effects of that use.

“Providers should be asking patients what they’re using because cannabis can be depressing of the central nervous system,” Neal-Perry said. “Women could be presenting with signs of depression and it’s related to cannabis use” as opposed to the other way around, where the cannabis is treating the depression. “The symptoms of menopause overlap with the side effects of cannabis, and it’s important that providers actually query their patients about the use of cannabis so that their symptoms are appropriately attributed.” 

The research was funded by the UCOP Tobacco-Related Disease Research Program, the Medical Student Training in Aging Research Program, and a Research Career Scientist Award from the Department of Veterans Affairs. Zhao and Neal-Perry had no disclosures. 

Tara Haelle is a science/health journalist based in Dallas.