By
Taylore Passero PA-C
Frank Michalski DC CFMP
As women, our bodies can do some many amazingly wonderful things! We can grow human life and then, in turn, give birth to (hopefully) a beautiful, healthy baby. Although pregnancy and motherhood may not be for all, our bodies are equipped with the most prestigious organs to make this all happen. Because of this, over time our female organs begin to age and lead to the oh so wonderful time we call menopause! Menopause can be a real buzz kill and is unfortunately unavoidable but rest assured ladies you are not alone! There are several lifestyle modifications, medications, vitamins, and supplements that can help ease you into this transition. CBD oil is a great supplement that can help make this time in your life a little more manageable.
Before we can begin to understand how CBD can help to alleviate menopausal symptoms, we must first understand menopause itself.
The exact definition of menopause is considered "ovarian failure." To understand what ovarian failure means, we must first understand the basics of female reproduction.
When females are born, they are born with a fixed number of eggs. As opposed to males who can regenerate their sperm cells almost daily, females are not able to regenerate their egg cells at all. I like to use the example of a bank that will only allow withdrawals and not accept deposits. Every time you go to this bank and withdraw money, your bank account decreases. Now imagine doing this every single month. Eventually, your money is going to run out! The same theory applies to a woman's "egg bank." Over time their egg supply decreases. At the time of birth, females have around 1-2 million eggs. Once young girls begin puberty and they reach menarche, age of their first menstrual period, this supply decreases to about 400,000.
Each time females go through a complete menstrual cycle and ovulate; their egg supply decreases even more. The average women will ovulate around 400 times during their reproductive life. Each time a woman goes through a full cycle, they are losing several hundred eggs per month. Now you may be thinking how in the world is this possible to lose all those eggs if I only release 1-2 eggs each time I ovulate? The answer that question in simple terms is yes; unfortunately, this is correct.
Women do only release 1-2 eggs per ovulation but ovulate follows the rules of survival of the fittest. Only the healthiest of eggs get released from the follicle each month. Several hundred to upwards of a thousand immature eggs will die off due to a process that we call Atresia or natural cell death.
As you can see, the number of eggs women have drastically decreases over time. Between the ages of 30-35, females have as low 100,000 eggs. As women age, not only are they losing egg cells, but their remaining eggs are beginning to dysfunction and age as well. These eggs are starting to become resistant to a particular hormone called FHS, otherwise known as follicle stimulating hormone. In simple terms, a follicle acts as the mother and the household for the egg within the ovary. This specific hormone stimulates the follicle to mature the egg and eventually lead to its release, which is considered ovulation.
Again, we can compare FSH to the mother of the household. Once the mother nurtures and child and cares for it, it is then ready to be set free and travels on it own (or down the fallopian tube prepared for fertilization) When the eggs are older, they become increasingly resistant to FSH and the process of ovulation in general. We can call these eggs rebellious teenagers who over time, get themselves into trouble. The eggs no longer release a healthy level of estrogen, and in turn, FHS levels rise in the blood and estrogen levels decrease. Eventually, this leads to what we call "ovarian failure" or menopause.
As a woman, when your body starts to age and prepares for menopause, specific changes are to be expected. One difference to note is great variations in your cycle. These varieties are unpredictable and can be quite bothersome for women. Menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent until eventually, they stop altogether. These variances can make planning and traveling a nightmare for women! Not being able to predict and track your cycle is inconvenient. Not only are cycle irregularities a common occurrence, but women can also start to experience typical menopausal symptoms.
This time is considered perimenopause. The average time a woman spends in perimenopause is four years; however, for some women, this can last for as little as six months or for as long as ten years. During the time of perimenopause, estrogen levels are gradually decreasing. Decreased estrogen is what leads to the many symptoms that women can experience during this time in their lives. Once estrogen levels hit an all-time low, we have the complete cessation of menses for a full 12 months. The termination of menses is then considered menopause.
When talking to patients, I don’t like to describe menopause as the absence of menstrual periods for a full 12 months. The reason being is some women go months to even years without getting a period. As IUD's are becoming more popular for contraception, women are getting less and fewer periods. We also have some ladies who take continuous birth control, meaning they are skipping their placebo pills and going right to the next OCP pack. Some women do this for symptom control during their menses. In cases such as this, women are not getting a period each month. Therefore, if women are relying on tracking their cycles for menopause, this can make that very challenging. Never the less, menopause will occur at some point in a woman's life.
Now let’s look at some menopausal statistics:
- The average age of menopause in America is 52
- 95% of women will experience menopause between the ages of 45-55
- With life expectancy increasing, women typically spend 1/3 of their life in menopause
- 6,000 women reach menopause every single day in America
- Each year there are over 2 million new cases of menopause in America
What a lot of women don't know is that perimenopause and menopause have a strong familial linkage. Although this time in a woman's life is so unpredictable and bothersome, there is a chance for some clarity! For those ladies who are reading this and are quickly approaching menopause, I urge you to talk to any older female veterans in your family. There is a very high chance that whatever they experienced during their journey through menopause, you will experience as well. Now, of course, some circumstances are excluded from this prediction. If your mother, grandmother, aunt, or older sister when through menopause early in life due to an unforeseen medical condition such as cancer requiring surgeries, chemotherapy, and hormonal therapy, than this thought would not apply. Same goes for a woman who has had her ovaries surgically removed. As soon as a woman has both of her ovaries removed, she is automatically sent into menopause. However, for the typical healthy female in her mid to upper 40s, she can pretty safely rely on this prediction.
Now that you have a better understanding of menopause, in general, let's move on to every woman's favorite topic: The symptoms!
As stated above, the symptoms associated with perimenopause and menopause are due to a decrease in ovarian estrogen. The most common symptom women complain about is the ever so dreaded hot flashes! These can range from quick episodes or facial flushing and an overwhelming sensation of warmth to soaking night sweats. It is reported that 3 out of every four women will experience some degree of hot flashes during menopause. Hot flashes can quite literally put a damper on things! Other common symptoms include headaches, fatigue, insomnia, mood swings, mental fogginess, weight gain, irritability, anxiety, and depression.
Other symptoms to consider is decreased bone mineral density leading to osteopenia and osteoporosis. Because estrogen helps to decrease bone resorption, when estrogen levels begin to decline in the blood, the bones start to break down at a faster rate. Increased bone loss is why it is recommended to start DEXA scans after menopause.
Lastly, let's talk a little bit about sex after menopause. Sex is a topic that I know is on a lot of women's minds, but nobody likes to talk about it. As levels of ovarian estrogen decrease in the blood, this leads to vaginal dryness, vaginal atrophy (which is the thinning of the skin), pain with intercourse, and in some cases spotting after sex. I like to use the example of dry, damaged skin during the winter time. We all have experienced the skin on our hands became very sensitive and dry, leading to the small fissures and cracks in the skin that bleed. As we all know, this can become very painful and bothersome. The same concept applies to the vaginal canal during perimenopause and menopause. Not only does sex become increasingly uncomfortable and in some cases, painful, but women can also experience low sex drive. Decreased sex drive can cause tension in a relationship and leave women feeling upset and frustrated.
Rest assured ladies; there is help on the way! Several different treatment options can help you navigate your way through this journey in life. Because the effects of menopause are so widespread, I like to use a layered approach when treating women. When talking to patients, I always start with recommending lifestyle modification such as healthy diet, exercise, yoga, smoking cessation, and decreased alcohol consumption.
Next, I recommend incorporating vitamins into your daily routine. Magnesium is one of my favorite vitamins! Not only does it help decrease hot flashes, but magnesium helps to promote a healthy gut, contributes to decreased headaches and migraines, helps to reduce anxiety, and helps to combat insomnia. After recommending healthy lifestyle changes and magnesium to patients, I then tailor my treatment plans to each woman. If women are complaining of mood issues, we can consider trying an antidepressant such as an SSRI or an SNRI. If women are complaining of hot flashes, we can consider trying hormone replacement therapy. If women are complaining of vaginal dryness, atrophy, and pain with intercourse, we can consider trying a vaginal estrogen cream or suppository. And the list of pharmacological agents goes on!
Last on the list of treatment options is supplementation! Supplementation is one of my favorite conversations to have with women because of the effectiveness of treatment and the minimal amount of side effects. CBD oil is a fabulous option for women suffering during menopause.
CBD OIL AND MENOPAUSE1
CBD oil has gained a lot of buzz due to its benefits surrounding women’s health. It is essential to understand that the endocannabinoid system (ECS) has an intimate connection with our endocrine system. The endocrine system controls the pituitary gland, which in turn regulates a female's reproductive system and hormones. It should be noted that endocannabinoids can be found in the cells of the uterus and reproductive system.
As women enter menopause estrogen levels decrease. One of estrogens many jobs is calling on the ECS to regulate emotions such as anxiety and depression. If estrogen drops, so the does the function of our ECS. For this reason, many women experience insomnia, hot flashes, anxiety, decreased stress response, and reduced libido.
CBD oil taken orally stimulates the ECS. Once the ECS is stimulated, women usually experience a decrease in anxiety, hot flashes, depression, and insomnia. Did I mention perhaps even an increase in sex drive?
Another potential benefit for women entering menopause is the effect of CBD on bone health. Women who are underweight or anorexic tend to enter menopause early. One reason for this early onset of menopause is due to decreased endocannabinoid levels. It has been shown that women who are underweight or entering menopause are at an increased risk of osteoporosis. The ECS regulates bone loss. Yes, even your bones have cannabinoid receptors. CBD has been shown to positively benefit bone health by balancing out one’s endocannabinoid levels.
Most women see to respond to 5mg-100mg daily for menopause symptoms taken daily. It is always best to start slow and monitor your symptoms. Pay close attention to things like anxiety, sleep, and of course, decreased hot flashes! Like anything with CBD find your "sweet spot" serving size. I have noticed clinically; the serving amount of CBD varies significantly among women; some find CBD may energize them while others find it helps them sleep. The time of day and amount will depend on the individual. Please refer to our serving size tables for more information.
Lastly, if you are concerned that your hormonal levels are “off”, seek out the care of a functional medicine physician today. Instead of guessing what is high and what is low seek testing! Saliva testing can provide an excellent snapshot of active hormonal changes.
After reading this, I hope you found all the information helpful! If you feel as if you are suffering from a host of different perimenopause and menopausal symptoms, I urge you to contact your local health care provider today and start this conversation. As you can see, menopause is an unavoidable event, and the typical American woman will spend around 1/3 of her in menopause. Don't suffer in silence! As you can see, there are several different treatment options available. I know the right treatment plan is out there for you!
*This content is strictly the opinion of Dr. Frank Michalski and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Frank Michalski nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
References:
CBD A Patients Guide to Medicinal Cannabis by Leonard Leinow & Juliana Birnbaum