BACKGROUND:
The menopausal transition is associated with several adverse symptoms, and most approved treatments rely on hormonal therapy, which can have significant side effects and risks. Research suggests that many midlife women use cannabis to manage perimenopause- and menopause-related symptoms, yet the effects of cannabinoids on these symptoms remain largely unexplored. Existing literature in other populations indicates that cannabinoids such as cannabidiol (CBD) and cannabigerol (CBG), and minor terpenes like linalool, may alleviate symptoms commonly reported during menopause, including anxiety, depression, sleep disturbances, and pain. Some cannabinoids (e.g., CBG) may even reduce cognitive symptoms like brain fog. Given that many women feel inadequately supported during this transition, assessing the therapeutic potential of cannabinoid products addresses a critical public health gap and may meaningfully inform symptom management decisions.

METHODS:
Using a longitudinal, double-blind, placebo-controlled clinical trial, we assessed the impacts of a hemp-derived formulation containing minor cannabinoids (e.g., CBD, CBG) and terpenes (e.g., linalool) on psychological, emotional, and cognitive symptoms of perimenopause and menopause. One hundred healthy midlife women were randomized to the cannabinoid or placebo conditions in a double-blind manner. Participants completed several cognitive and symptom assessments across three months, including twice daily ecological momentary assessments (EMAs) of symptoms, weekly EMA cognitive assessments, monthly cognitive assessments via Zoom and monthly surveys assessing symptoms via Qualtrics. The first month of the study served as a no-treatment baseline period. Following this baseline period, participants were instructed to take their assigned product orally, following a meal, twice daily for two months.

RESULTS:
Preliminary mixed factorial ANOVAs with product condition (cannabinoid vs. placebo) as the between-subjects factor and time as the within-subjects factor revealed two significant interactions, several main effects of time, and no main effects of product. Specifically, there was a significant product x time interaction for daily EMA depression severity ratings such that the placebo group endorsed higher severity during the baseline month than the remainder of the study (ps < .05). A second interaction emerged on the false memory paradigm, with the group randomly assigned to take the cannabinoid product falsely recalling more unrelated words after starting treatment (ps < .05). However, no other interactions or main effects of product were significant. Side effects were minimal and did not differ significantly between conditions. Neither group reported feeling intoxicated or impaired.

DISCUSSION:
Although preliminary analyses do not suggest significant cannabinoid effects on menopausal symptoms, these results are limited by an incomplete sample and analytic constraints. Collapsing the EMA symptom data into month-long “blocks” for ANOVAs oversimplifies the longitudinal data, so we plan to apply multilevel modeling once data collection is complete to assess potential treatment effects in a more sensitive manner and to examine potential moderators such as menopausal status (menopause vs perimenopause) and hormonal therapy use.

CONCLUSION:
Though these preliminary findings are not promising, they underscore the need for more nuanced analyses to detect subtle changes over time. Given that many women use cannabis products for symptom relief, and existing menopause treatments often overlook psychological and cognitive symptoms, continued research on cannabinoid-based interventions must remain a priority in women’s health.