Premenstrual syndrome, perimenopause, and menopause are all natural parts of women’s reproductive cycles and each come with their own set of discomforts, disruptions, anxieties and challenges. The fact that they’re natural, however, doesn’t mean they need to go unattended. There is powerful help in the form of plant medicine for each of these life stages. All you have to do is find the solution/s that work for you!.
Though there is still so much we don’t know about the causes of premenstrual syndrome (PMS), it is generally thought to be caused by hormonal fluctuations, including drops in serotonin levels. Common symptoms and side-effects of PMS can include mood swings, anxiety, sleep disruption, physical pain, depression, bloating, joint pain, heaches and more. There is no “cure” for PMS-- it’s a natural part of life and not an illness. But there is help and hope to be found in the world of plant medicines.
Cannabis and PMS
In a recent interview, Psychiatrist Dr. Julie Holland, a psychopharmacology specialist and bestselling author said, “I started asking my patients about their cannabis use and learned many of them were using it for cramps, and some for PMS...Cannabis can potentially help with many symptoms that women who take antidepressants (as well as those who don’t) experience—including irritability, insomnia, depression, and anxiety.”
Dr. Holland goes on to explain that when it comes to PMS, cannabis, which most often contains both CBD and THC, can be a one-stop-shop for many women. ”CBD can help with anxiety and THC can help with mood swings, irritability, and low resilience (your ability to handle stress). Both can help relax the uterine muscle where cramps occur, and alleviate many PMS symptoms.” Many patients seeking pain relief seem to benefit from the use of the whole plant or from products that feature both CBD and THC. But, Dr. Holland is quick to note, “if you don’t like the altered feeling of THC, you can get a lot of PMS relief just using CBD.”
If you’re ready to try cannabis for relief of your PMS symptoms, but are unsure where to start, Dr. Holland recommends smoking or vaping, as it can bring the quickest relief. If this sounds like a plan, you might find this list of go-to strains compiled by Portland-based cannabis shaman, Meryl Montgomery helpful.
“For cramps, I recommend a beta caryophyllene or pinene terpene dominant strain, such as Sour Diesel. CBD (cannabidiol) also acts as a muscle relaxant and is anti-inflammatory.
To alleviate fatigue, I recommend pinene or limonene dominant strains, such as Super Lemon Haze or Blue Dream.
For malaise or moodiness, I recommend linalool and limonene heavy strains such as Lavender and Pink Kush.”
This is what works for Meryl, but keep in mind it may take a few tries to find which strains work for you. The common practice around cannabis is to start low and go slow, especially if you opt for edibles over inhaling. Low doses taken over longer periods of time can help you monitor your reactions and avoid the unpleasant experience of adding cannabis-induced annoyances like anxiety, hunger, irritability or horniness to your already PMS-filled day.
Supplements for PMS
A study published in the Journal of Caring Sciencespoints to magnesium and b6 supplements as effective ways to calm PMS symptoms. Other studies recommend calcium supplements as a way to reduce moodiness, and vitamin D as an anti-inflammatory supplement that may reduce cramping, aches and bloating.
In their 30s and 40s, when estrogen levels rise and fall less predictably, women may experience perimenopause: the phase leading up to menopause. During this time women may retain some of the symptoms of their PMS, gain new symptoms of PMS or begin to experience symptoms of menopause such as hot flashes, vaginal dryness and problems sleeping.
As with PMS symptoms and solutions, each woman will have her own. Cannabis and supplements, however, can be a great place to start.
Cannabis and Perimenopause
When interviewed, Dr. Holland offers encouraging advice saying “the symptom cluster associated with perimenopause can be relieved with cannabis.” It’s not surprising then, that at the 2020 Virtual Annual Meeting of The North American Menopause Society (NAMS) it was announced that more women than ever are considering the use of cannabis for relief of common menopause symptoms.
Women turn to cannabis in perimenopause for the same mood-regulating, and anti-inflammatory benefits mentioned earlier, but in this perimenopause cannabis has something additional to offer: phytoestrogens. This plant-based hormone is similar to human estrogen in many ways and can help to make up for the estrogen dip experienced during perimenopause.
Here’s how it works. We all have an endocannabinoid system in our bodies that helps us regulate homeostasis: general physical, mental and emotional stability. This system is made of receptors that respond to the cannabinoids made by our bodies. Estrogen, a hormone found in both women and men, helps break these cannabinoids down so the receptors can use them as efficiently as possible. When estrogen decreases, so does access to these stabilizing cannabinoids. This natural process may be to credit (or blame, depending on how you look at it) for the symptoms that arise during perimenopause. This is where cannabis’ phytoestrogen saves the day with it’s endocannabinoid-activating powers!
If you’re ready to give cannabis and its hit of phytoestrogens a whirl, you may consider trying cannabis strains containing higher CBD ratios to THC.
Supplements and Perimenopause
Compelled by studies linking phytoestrogens to relieve symptoms of perimenopause, but not sure cannabis is for you? Great news! Other supplements and plant medicines are ready to rise to the challenge, but there are a few things you should know.
Don’t be lulled into thinking that “plant medicine” means “safe medicine”. There is some thought, and a growing body of evidence, suggesting that phytoestrogen supplements may carry with them the same risks of estrogen supplements. For advice, you may want to do some research and consider expert advice.
A safer alternative would be to add foods containing safe doses of phytoestrogens to your diet in slightly larger amounts. Chances are, you’ve been eating phytoestrogen-rich foods like broccoli, carrots, beans, peas, peanuts, oranges, tofu, tempeh, miso and soy milk all of your life! Red clover, green and black teas and coffee are phytoestrogen-rich too and easy to incorporate into your diet. These small changes can have big benefits. Give them a try!
After perimenopause comes menopause, complete with hot flashes, mood swings, insomnia, pain, low libido, weight gain, fatigue, osteoporosis and anxiety. Due to a history of shame around aging and menopause there has been a lack of education (among girlfriends, family members and even the medical community!) that can add to this anxiety. While they won’t cure hot flashes, pain or insomnia, books, lectures and other forms of education may relieve anxiety and remind you that this phase of life is experienced by every biological woman with the privilege of making it to middle age.
For the things that education can’t calm, there’s always plant medicine!
Cannabis for Menopause
The use of cannabis helps relieve menopause symptoms in the same ways it helps relieve symptoms of perimenopause. This is for all the reasons explored above, only more so. Hot flashes that were occasional during perimenopause may become a more regular occurrence. Vaginal dryness that was just inconvenient earlier may cause pain during menopause. As symptoms change, it can be beneficial to tweak your cannabis use to suit. Whether it means increasing THC levels to combat hot flashes or trying an indica strain to enhance intimacy, help can be just a toke, gummy or vape away.
Hot Flashes and Menopause
During menopause anandamide, a temperature-regulating neurotransmitter made by the body, decreases. It is thought that this is one of the reasons women experience hot flashes during menopause. Cannabis doesn’t contain anandamide, but it does contain THC which binds to the same heat-regulating receptors. Research shows that increasing THC doses can relieve hot flashes by having a cooling effect on the body.. Ann Arbor’s Bloom City Club suggests taking “a few small draws on a cannabis vape pen is a discreet way to manage the onset of hot flashes.” But you should experiment to see what works best for you.
Bonus: Anandamide can also increase feelings of happiness or bliss. That may be the sexiest thing to happen to menopause since Claire Underwood took a moment to cool her hot flashby the freezer.
Hormone Driven Weight Gain
Like THC and CBD, THCV is a cannabinoid found in cannabis. It’s superpower when it comes to menopausal weight gain is its ability to suppress appetite. Bloom City Club recommends craft cannabis strains and cartridges like Durban Poison, [XJ-13](https://www.leafly.com/strains/xj-13_, and Blue Dream as go-to sources of THCV.
Headaches from Hormones
Hormonal fluctuations can cause intense headaches. Lucky for you, cannabis can bring intense relief. A recent study published in the Journal of Pain found that the severity of headaches was decreased by 50% for women who used cannabis. The study also found that cannabis concentrates appeared to offer more significant relief than whole plant preparations.. There is a wide range of concentrates on the market today. Whether you try dabbing a bit of concentrate through a dab rig, e-ri or vaporizer or add a little resin to your bowl, it’s important to remember that concentrates are more powerful than flower. Start low and slow and proceed gently until you find a solution that works for you.
Vaginal Dryness from Menopause
Taking cannabis in the usual ways is widely known to support arousal, feelings of love and relaxation. This can go a long way toward easing vaginal dryness and supporting sexual pleasure. Other alternatives include microdosing cannabis with an arousal focused product like 1906 Love Drops or Chocolates, using a cannabis-infused lubricant like Foria or an intimate oil like Night Moves from Quim. If you live outside California or in an area where cannabis is not yet legally sold, try Quim’s CBD-infused Smooth Operator or Happy Clam which is billed as an “eye cream for your vagina.” All three topical products are focused on relaxation, moisturization and lubrication that can make sex more pleasurable for all involved--even those not yet in menopause!
Menopause and Osteoporosis
A recent study reveals that cannabis can help prevent osteoperosis and is shown to stimulate bone formation and protect against age-related bone loss. What a great way to guard against frailty and injury. It’s certainly more fun than broccoli or milk.
Supplements to Ease the Transition
There are as many supplements and herbal remedies for menopause as there are grains of sand on the beach. Dipping your toes in this market can be daunting at best. Whether you look for a single-ingredient supplement or a multi-ingredient product formulated to address a range of symptoms, you’ll benefit from knowing some of the more tried and true vitamins, herbs and plants to try.
The Mayo Clinic’s recommendations include plant estrogens like soy, which may reduce hot flashes and other symptoms, ginseng which may help stabilize mood and promote healthy sleep patterns and vitamin E which can offer some relief from mild hot flashes. St. John’s Wort is a popular herbal remedy shown to even mood swings that may come with menopause.
If you want to take things to the next level, consider Bioidentical Hormone Replacement Therapy.
Bioidentical Hormone Replacement Therapy (BHRT)
BHRT uses hormones derived from plants to work with the endocannabinoid system to reduce the symptoms of menopause. The goal is to replace the naturally decreasing hormones with plant-derived hormones so that the system is supported in working as it did before. These hormones include estriol: a weaker form of estrogen; progesterone: associated with menstruation cycles and pregnancy; dehydroepiandrosterone (DHEA): a hormone that supports production of estrogen and testosterone; and melatonin: which helps regulate the sleep cycle. BHRT medications are available in the form of (FDA)-approved medications or as custom-compounded BHRT medications, which can be tailored by your doctor to suit your needs. Both sources offer medications in the form of pills, creams, gels, sprays, and vaginal inserts.
In recent years BHRT has become quite popular. The North American Menopause Society (NAMS) reports that about 1.4 million women are using BHRT and that 40% of those women are in menopause. BHRT comes with risk of some side effects like weight gain, blurred vision, facial hair, tiredness, acne, bloating and even bleeding, but these side effects sometimes disappear after the first few doses. Charting pros and cons, listening to your body and working with a professional can help you find solutions that work for you.
If you are new to cannabis and want to learn more, take a look at our Cannabis 101 post. HelloMD can help you get your medical marijuana recommendation; it's 100% online, private and efficient.