Medicinal Cannabis and Sleep Improvement in Menopausal Women: Integrating Nocturia, Genitourinary Syndrome of Menopause, and Endocannabinoid Regulation

Patricia Beck Eichler-Barker.

Abstract

Sleep disturbances represent one of the ost prevalent and disruptive symptoms experienced during menopause, affecting nearly half of women during the menopausal transition. Hormonal changes associated with declining estrogen and progesterone levels contribute to vasomotor symptoms, mood disturbances, and genitourinary syndrome of menopause (GSM), which includes urinary frequency and nocturia. These factors collectively lead to fragmented sleep and reduced sleep quality. Recently, medicinal cannabis has emerged as a potential therapeutic option for sleep disorders due to its interaction with the endocannabinoid system, which plays a key role in circadian regulation and sleep physiology. This review examines current evidence regarding sleep disturbances in menopausal women, emphasizing the combined impact of nocturia and hormonal changes. It also explores the therapeutic roles of vaginal estrogen therapy for urinary symptoms and cannabinoid-based treatments for sleep regulation. The integration of these approaches may provide a novel strategy for improving sleep quality and overall quality of life in menopausal women. Despite promising evidence, clinical trials specifically evaluating cannabis based therapies in menopausal populations remain limited. Future translational research should prioritize interdisciplinary studies that integrate neuroendocrinology, urology, and sleep medicine to develop targeted interventions for menopausal sleep disorders.