Can Cannabis Replace Risky Hormone Replacement Therapies (HRT) for Menopause?
Menopause involves dysregulation in the endocannabinoid system, so it makes sense that cannabis may be able to replace higher risk therapies, like HRT.
Life expectancy of women has almost tripled over the last two centuries, rising from 25 years to 70 years of age. Aging in women is associated with the gradual loss of the female reproductive hormones, estrogen and progesterone. These diminish until the point that menopause is reached; men do not experience the same hormonal decline requiring HRT.
There are additional health care challenges this hormonal change brings, including increased risk of certain types of cancer. On the other side of this, treatment for cancers in women has been shown to accelerate entry into menopause.
Estrogen is a steroid hormone and as such, is involved in regulation of many cellular processes. It is essential in bone health and female sexual health. Therefore, it is expected that the loss of estrogens will be detrimental on these important aspects of physiology. Therefore, replenishment of the lost estrogen in menopause is expected to mitigate these detrimental effects. Although replacement of estrogen and progesterone has proven to be highly effective in alleviating menopausal symptoms, including hot flashes, night sweats, sexual disorders, and insomnia and in preventing bone loss (osteoporosis), it doesn’t come without a price. Indeed, an expensive one, some might say.
It has been suggested that the endocannabinoid system (ECS) balance is perturbed in menopause, suggesting that estrogen and progesterone interact with the ECS somehow and keep each other in balance. One of the estrogens, called 17b-estradiol, or E2 for short, has been suggested to be involved in the regulation of the ECS, albeit the evidence still lacks robustness. E2 has the potential to both stimulate and inhibit the release of anandamide (AEA), depending on the tissue in question.
The question then arises, can the reversal of depletion of endocannabinoids with exogenous cannabinoids bring the system into balance? Indeed, this may be just the explanation provided by several promising studies showing beneficial effects of cannabinoids on comorbidities that occur with menopause. It has been shown that cannabinoids provide protection from osteoporosis in menopause.