PHILADELPHIA -- One in 10 midlife women said they used cannabis in the past month, some of which was to manage menopausal symptoms, a researcher reported here.
In a nationally representative sample of U.S. women, ages 45 to 64, 42% said they had ever used cannabis either recreationally or for medical purposes in their lifetime, according to Carolyn Gibson, PhD, MPH, of the San Francisco VA Health Care System at The Menopause Society annual meeting.
When used medicinally, midlife women said the most common motives behind reaching for cannabis included chronic pain (28%), anxiety (24%), sleep (22%) and stress (22%).
Around 6% of women said they specifically used cannabis in order to manage symptoms related to menopause, and mostly to manage menopause-related mood disturbances and sleep issues.
"I suspected that cannabis use was pretty common among women in midlife and we do not know much about it," Gibson told 51˶, citing the intersection of increasing legalization (now legal in 38 states and D.C.) and normalization of cannabis use and widespread use of cannabis to manage symptoms and conditions that are common in the menopause transition (anxiety, pain, and insomnia), as well as targeted marketing of cannabis products for menopause symptoms.
"I am particularly interested in the clinical implications of self-medicating with cannabis, which is linked to more frequent use," she added. "It is important to recognize and discuss cannabis use in the healthcare setting, clarify what we do and do not know about the benefits of use, provide psychoeducation about potential risks like dependence, and talk about any ways that regular use may affect other treatments."
"This discussion can also be an opportunity to point patients toward evidence-based approaches for symptom management," Gibson said. She advised clinicians to keep that in mind when speaking with midlife women.
"These findings highlight the need for recognizing and discussing cannabis use in the healthcare setting" commented Stephanie Faubion, MD, MBA, director of the Mayo Clinic's Center for Women's health in Jacksonville, Florida, and Rochester, Minnesota. Faubion, who is medical director of The Menopause Society, wasn't involved in the study, but said in a statement that "Additional research is needed to evaluate the potential harms and/or benefits of use."
Echoing this, Susan Reed, MD, MPH, MS, of the University of Washington Medicine in Seattle and president and CEO of The Menopause Society, told 51˶ that the high number of women reporting daily cannabis use is "concerning."
"These individuals are at risk for dependence and health risks related to marijuana use," added Reed, who wasn't involved with the study. But she also said to keep in mind that people who respond to surveys like this may not be representative of the general population.
Of midlife women in the study who said they were current users, more than half said they smoked (56%) and/or used edibles (52%). Around 40% said they used more than one form of cannabis. Also, more than 30% said they smoked cannabis every day, while around 20% said they took edibles everyday.
"Based on anecdotal evidence, I assumed edibles would be the most commonly reported form of current use," Gibson added. "The data did support prevalent edible use, but I was a little surprised that smoking -- particularly daily smoking -- remains so common."
Less commonly used forms of cannabis included vaping (around 25%), topical forms (around 19%), and dab (around 5%).
About half of women said they didn't know the THC potency -- the psychoactive component of cannabis -- of what they were smoking or vaping. Of the women who did know, THC potency was widespread across the board, the most common of which was 21% to 40% (over 15% is considered "high" THC potency). Fewer women were unaware of the THC potency of their edibles, with the majority consuming 10 mg or less (10+ mg considered "high" THC potency).
The cross-sectional survey included responses from 5,174 women with an average age 55. Most were white (63%), 16% were Hispanic women, and 13% were Black. Most were postmenopausal experiencing menopause symptoms.
"We need research that will help us understand the potential benefits and harms of cannabis use -- in the forms, frequency, and THC potency that individuals are actually using it," Gibson added. "As women are using cannabis to manage things like anxiety, sleep, stress, and menopause symptoms, we need research that clarifies whether it is actually helping or hurting for those purposes."
Disclosures
The study was funded by the Tobacco-Related Disease Research Program, VA Health Services Research & Development (HSR&D) Career Development Award, and VA Research Career Scientist Award.
Gibson disclosed relationships with the VA HSR&D, NIH, UC Office of President Tobacco-Related Disease Research Program, and Astellas Pharmaceuticals.
Primary Source
The Menopause Society
Gibson CJ, et al "Medical and recreational cannabis use in the menopause transition: evaluation of trends from a large, nationally representative sample of midlife women" Menopause Society 2023; S-18.