CBD for hot flashes

What are hot flashes and how do they occur during menopause?

Hot flashes, also called vasomotor symptoms or hot flushes, are among the most common and distressing complaints during the menopause. They typically manifest as a sudden feeling of warmth in the face, neck, and upper chest area, accompanied by skin redness, sweating, and sometimes palpitations or dizziness. These episodes can last from a few seconds to several minutes and occur both during the day and at night (so-called Night sweat attacks).

Pathophysiology: Why do hot flashes occur?

The exact cause of hot flashes is not yet fully understood scientifically, but there is a close connection with the declining estrogen levels in peri- and postmenopause:

• Estrogen deficiency affects the central temperature regulation center in the hypothalamus.
• This center interprets minimal temperature fluctuations as hypersensitive and then triggers compensatory heat release through vasodilation (expansion of blood vessels) and sweating.
• Additionally, neurotransmitters such as serotonin and noradrenaline change, further lowering the threshold for thermoregulatory reactions.
• CGRP (Calcitonin Gene-Related Peptide) – a vasodilatory messenger substance – also appears to be involved.

How common are hot flashes?

• Up to 80% of women experience hot flashes during the menopause.
• In about one third, they are moderate to severe and can significantly impair quality of life.
• The symptoms often begin already in perimenopause, peak around the age of 50, and typically subside after about 7 years – but in some cases much later.
  

Impact on Daily Life

Hot flashes can have a variety of impacts on daily life:

• Sleep disorders (due to night sweats)
• Concentration problems and fatigue the following day
• Emotional stress, irritability, or depressive moods
• Social limitations, for example due to fear of visible sweating

These symptoms are expressions of a hormonally induced dysregulation of the autonomic nervous system. Therefore, research is increasingly focusing on non-hormonal therapeutic approaches such as CBD – especially for women who do not want or cannot tolerate hormone replacement therapy.

What role does the endocannabinoid system play in hot flashes?

The endocannabinoid system (ECS) is a complex regulatory network involved in a variety of physiological processes – including thermoregulation, hormone balance, and stress processing. During menopause, when estrogen levels drop, the ECS appears to play a modulatory role in the development of hot flashes.

Physiological basics of the ECS

The ECS consists of three main components:

Endocannabinoids such as anandamide (AEA) and 2-AG (2-arachidonoylglycerol)
Cannabinoid receptors

• CB1 receptors: mainly in the central nervous system, including the hypothalamus
• CB2 receptors: primarily in the immune system and peripheral tissues
  

Enzymes responsible for the synthesis and breakdown of endocannabinoids

Thermoregulation in the hypothalamus

• The hypothalamus is the central control center for temperature regulation.
• CB1 receptors in this brain region modulate neuronal activity and influence vasomotor responses, such as the dilation of blood vessels and sweat production.
• A disturbed balance of endogenous cannabinoids in the hypothalamus can lead to hypersensitivity of the thermoregulation system – which is discussed as a possible contributing cause of hot flashes.
  

Connection with hormonal fluctuations

• Estrogens influence the activity of the ECS: For example, they increase the synthesis of anandamide and the expression of CB1 receptors.
• In menopause, the decline of estradiol leads to a reduction of endocannabinoids and CB1 expression – which can promote reduced neuronal stability and disturbed heat regulation.
  
• In animal models, it has been shown that CBD and anandamide can exert estrogen-like effects on vasomotor function.

Significance for therapeutic approaches

• CBD (cannabidiol) does not act directly on CB1/CB2 but influences the ECS through other mechanisms:

• Inhibition of anandamide degradation

• Modulation of TRPV1 receptors, which are also involved in temperature perception

• These effects could help restore neuronal balance in the hypothalamus and thus alleviate hot flashes.

The endocannabinoid system is closely linked to hormonal control and heat regulation. In menopause, the decline in endogenous cannabinoid activity caused by estrogen deficiency may contribute to the development of hot flashes – a therapeutic target that CBD as a regulatory substance could address.

What mechanisms of action of CBD could help with hot flashes?

Cannabidiol (CBD) possesses a variety of therapeutic properties that can be particularly important for hot flashes during menopause. Studies – including preclinical research by Sui et al. (2022) and clinical data on the use of CANNEFF® VAG SUP – indicate that CBD contributes to the relief of vasomotor symptoms through multiple mechanisms: antioxidant, neuroregulatory, anxiolytic, and hormone-stabilizing.

Antioxidant and anti-inflammatory effects

• The animal study by Sui et al. shows that CBD inhibits inflammatory processes in estrogen deficiency-related stress and reduces oxidative stress, a relevant factor in hot flashes.
  
• CANNEFF® Vaginal suppositories additionally contain Hyaluronic acid, which through their mucous membrane-regenerating properties also has anti-inflammatory effects – especially in the urogenital area, which is often affected by estrogen deficiency.

Neuroregulation of the temperature center

• CBD interferes with the endocannabinoid system by increasing the availability of anandamide increased – an important endogenous regulator in the hypothalamus that helps control body temperature.
  
• Also TRPV1 receptors, which are involved in the sensation of heat, are modulated by CBD. These mechanisms of action could dysregulation of heat perception positively influence during menopause.

anxiolytic and stress-reducing effect

• According to studies (e.g. Dahlgren et al. 2022, Babyn et al. 2023) many women report using CBD against inner restlessness, sleep problems, and irritability – all factors that can intensify hot flashes.
  
• In the CANNEFF® RCT study occurred with regular use of the vaginal suppositories over 30 days significant reduction of climacteric symptoms, including hot flashes, exhaustion, and emotional instability.

stabilization of the microbiota-hormone axis

• CBD showed in preclinical studies a improved gut flora composition, about the so-called Microbiota-Brain Axis can indirectly influence hormonal balance and thermoregulatory control.
  
• The local application of CANNEFF® VAG SUP additionally offers the advantage, to avoid systemic side effects, as the active ingredients act specifically in the pelvic area.

CBD unfolds its therapeutic potential for hot flashes through multiple synergistic mechanisms. The use of CANNEFF® VAG SUP, which combines CBD with hyaluronic acid, offers a targeted, hormone-free treatment option with proven efficacy for menopausal symptoms – especially vasomotor complaints.

Are there scientific studies on CBD for hot flashes or menopausal complaints?

What do women themselves say about the use of CBD against hot flashes?

Women in both studies mostly report positive effects of CBD and cannabis products on their menopausal symptoms – especially for hot flashes, sleep disturbances, and emotional instability. The use is often self-initiated and symptom-oriented, highlighting the need for evidence-based guidelines and medical advice.

In what form can CBD be used to relieve hot flashes?

CBD (cannabidiol) is available in various forms, from dietary supplements, aromatic oils, smoking products to medically approved products. However, for the targeted treatment of menopausal complaints such as hot flashes, the choice of application form is crucial, as it significantly influences effect, safety, and tolerability.

Particularly noteworthy are CBD vaginal suppositories, such as those available with CANNEFF® VAG SUP, as they allow targeted, safe, and medically tested application. Please note that CANNEFF suppositories contain a patented combination of CBD and hyaluronic acid and are not comparable to homemade or other CBD suppositories.

Is CBD a safe alternative for hot flashes – especially in cases of contraindications for hormone therapy?

Yes, CBD is considered a safe, non-hormonal alternative for relieving hot flashes, especially for women for whom hormone replacement therapy (HRT) is contraindicated or who reject hormone preparations for personal reasons. Both preclinical and clinical studies, especially on CANNEFF® VAG SUP, demonstrate a favorable safety profile and good tolerability.

What dosage and duration of use are documented in studies?

The effective dosage of CBD for hot flashes varies depending on the form of application. High systemic doses are used in preclinical studies to demonstrate effects. In clinical studies such as the one on CANNEFF® VAG SUP, a significant relief of menopausal symptoms was already observed with 100 mg of CBD per day over 30 days, without side effects. The combination with hyaluronic acid enhances the local effect and tolerability.