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Risky Hormone Replacement Therapies (HRT) for Menopause

Dragana Komnenov PhD
cannabis, menopause, hormones, HRT, hormone replacement therapy, estrogen, medical cannabis, cancer risk, women, legalization

Menopause involves dysregulation in the endocannabinoid system. It makes sense then, that cannabis may 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 commonly associates with the gradual loss of the female reproductive hormones, estrogen and progesterone. These diminish until the point women reach menopause.

This hormonal change brings additional health care challenges, including increased risk of certain types of cancer. On the other side, treatment for cancers in women sometimes accelerates entry into menopause.

Estrogen is a steroid hormone. As such, it helps with the regulation of many cellular processes. It is essential in bone health and female sexual health. Therefore, doctors expect the loss of these estrogens to detrimentally effect important aspects of physiology. They also expect replenishment of the lost estrogen in menopause 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.

cannabis, menopause, hormones, HRT, hormone replacement therapy, estrogen, medical cannabis, cancer risk, women, legalization

Preclinical data highlights estrogen and progesterone as likely involved in the induction and progression of breast, endometrial, and epithelial ovarian cancers. This, coupled with aging’s increased risk of cancer, does not bode well in the eyes of women seeking relief of menopause with HRT or ERT. What are the alternatives?

The Endocannabinoid System and Menopause:

Doctors suggest that the endocannabinoid system (ECS) balance is perturbed in menopause, meaning that estrogen and progesterone interact with the ECS somehow and keep each other in balance. Doctors suggest one of the estrogens, called 17b-estradiol (or E2 for short) might control the regulation of ECS. However, this evidence is inconclusive. 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.

cancer, cannabis, apoptosis, menopause, cancer treatment, HRT, hormones, CBD, THC, women's health

Currently, there are no studies directly investigating cannabis use in relieving menopausal symptoms. Nevertheless, some important studies have highlighted the benefits of cannabinoids in comorbidities occuring during menopause. These include bone loss and risk of cancers (particularly breast cancer). Each woman experiences different symptoms during menopause. Therefore, doctors would have to individualize the therapeutic approaches. It looks like there’s relief on the horizon for women reluctant about taking HRT and ERT, and especially who are cancer survivors.

Dragana Komnenov
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