Is CBD an Alternative to Alcohol during Perimenopause?
Let's back up on how we got here.
We're wrapping a massive review of CBD on perimenopause across multiple pathways.
The default way to manage this period appears to be alcohol for many women and we were curious as to why.
You know it's a thing when terms like "mommy juice" start creeping into the culture.
Wait till you see the connection between wine and estrogen below. Goodness.
It's all right there in the research!
We'll get into that below but the clues are everywhere...especially in the symptoms.
One huge complaint with perimenopause (and menopause) is anxiety (see CBD and perimenopause anxiety).
That's why benzos are such a popular drug for ladies during this period...with the unfortunate side-effect of crushing withdrawal and addiction (Thanks, Doctor!).
Benzos are a hammer on a substance called GABA which acts as the "brake" in our nervous system.
Then there's serotonin, our "feel-good" neurotransmitter.
Estradiol (our main estrogen) is a master controller of its creation and removal.
So...to connect the dots…
- Progesterone directly props up GABA and estradiol directly props up serotonin
- Estradiol and progesterone drop
- Anxiety and depression are common results
Guess what other substance is a massive booster to GABA levels and also stimulates serotonin?
Good work. Alcohol.
Millions of women over the age of 40 (we'll explain that number below) are essentially self-medicating.
Of course, not being habit forming, normalizing, causing hangovers, or making you sleep with your ex is a bonus.
That then invites so many other questions.
We want answers!
Here's what we'll cover:
- Why women in perimenopause use alcohol
- Does alcohol increase estrogen?
- Alcohol versus CBD for GABA (hello allopregnanolone)
- Alcohol versus CBD for serotonin connection
- Can you take CBD with alcohol together
- Does CBD protect the liver from alcohol
- Can CBD help with alcohol withdrawal or addiction
- How much CBD to take to replace alcohol
- What's best CBD to take for GABA and serotonin support during perimenopause
Let's get started.
Why women in perimenopause use alcohol
We gave a quick run through above but let's really flesh it out a bit.
Perimenopause is really about the drop in two key hormones:
- Estradiol (E2) - our main estrogen
Women (and even doctors) mistakenly relegate these to functions of reproduction and monthly cycles.
Couldn't be further from the truth!
They have critical roles across almost every pathway in your body.
Check out our review on estradiol or better yet...look at our CBD and perimenopause master page.
Just take a look at the symptoms!
- Heart. Check
- Brain. Check
- Pain. Check
- Digestion. Check
We didn't even cover bones and muscles.
Here's the net takeaway:
- Estradiol is both a promoter of growth and repair as well as a master regulator of many other systems
- Progesterone is a powerful anti-inflammatory and calming agent across many systems
Let's look at just two very baseline systems that are critical to making you feel "well".
- GABA - our nervous system brake
- Serotonin - a master regulator of every behavior humans exhibit
That may sound grandiose but check out our study on tryptophan (its precursor) and behavior.
If your serotonin is low, you're more likely to accept an unfair offer!
Yes...all the little social and behavioral quirks we exhibit somehow draw from serotonin.
As for GABA, it's much more straight forward.
Not only how you feel but at the cellular level.
Benzo's are a great proxy for GABA since that's they're a primary target.
This is the new addiction crisis to follow opioids...you may know the names:
Here's the general trajectory as we increase GABA levels via benzos doses:
- Dead (heart stops)
Like we said…"brake" pedal.
Why are these two pathways so impacted by perimenopause (and of course, menopause)?
Progesterone starts to drop in your mid 30's and by age 40, it's at about 50% of your max younger level.
Another big hit comes with perimenopause.
The act of releasing the egg is how the body also releases the progesterone.
As you get into perimenopause, you actually start to have anovulatory periods...a period without a release of an egg (and consequently...progesterone).
Why does this matter for GABA?
It's the basis behind the new blockbuster postpartum depression medication which costs $25,000.
Allo is literally a governor of GABA function:
Allopregnanolone is a potent positive allosteric modulator of GABA action on the GABAA receptor.
What happens when its levels are too low?
Allopregnanolone exerts neurogenetic, neuroprotective, antidepressant, and anxiolytic effects. Reduced levels of allopregnanolone are found to be associated with major depression, anxiety disorders, premenstrual dysphoric disorder, and Alzheimer’s disease.
Anxiolytic means of anti-anxiety (reduced GABA levels are directly implicated in anxiety issues - see CBD and GABA for anxiety).
Did you notice the other "symptoms" of low ALLO?
It's a who's who of perimenopause issues:
- Depression (see CBD and perimenopause depression)
- Anxiety (see CBD and perimenopause anxiety)
- PMS symptoms
There's a marked risk from loss of hormones during perimenopause (specifically the earlier years) and dementia risk.
Like we said...we've researched this to pieces!
- Allopregnanolone is a metabolite of progesterone
- Progesterone is leaving the scene and literally drops out during perimenopause
- Calamity ensues
We'll look at alcohol's effect there below.
What about serotonin?
Hello, estrogen!. (estradiol to be exact).
Serotonin has widespread roles to fill but let's look at just two.
- It's a master controller of how we respond to stress.
- It directly promotes brain repair and growth (see CBD and BDNF)
The latter is very important since chronic stress, overactive immune response, and a host of other insults are busy doing damage that needs repair.
Why bring up immune response?
Remember that progesterone keeps our immune system under control and it's flighty for about a decade now.
That's one reason autoimmune hits women predominantly and really hits around...you guessed it...late 40's.
Back to serotonin...what's connection with estradiol?
Estradiol literally sits at bookmarks on both the creation and removal of serotonin.
Estradiol is especially nurturing towards serotonin – it stimulates TRPH expression to ensure that enough serotonin is made and suppresses MAO A levels to prolong the longevity of the neurotransmitter.
Goodness. It boosts the level of our "feel good" neurotransmitter and during perimenopause, it can be on a roller coaster ride for roughly 25% of women that have debilitating transitions.
For the lucky ones, it just drops through the floor until the body compensates by making more fat (also a source of estrogen).
So...we're losing GABA (calm) and Serotonin (good).
Let's turn our attention to alcohol and CBD now.
What do they do in these two pathways?
Does alcohol increase estrogen?
We looked at drill-down pathways of GABA and serotonin but we can actually cut out the middle man (woman??) here.
Really read this next bit slowly to understand why millions of women are self-medicating with alcohol.
Alcohol directly increases estrogen levels!!
Total alcohol intake was not associated with total EM but was positively associated with estradiol (26 % higher among women consuming >15 g/day vs. non-drinkers; P trend=0.03).
Estradiol is our most potent flavor of estrogen...the heavy lifter of the bunch.
Also...what's the drink of choice for women as they get older?
Mommy juice (wine).
Wine consumption was positively associated with a number of EM measures including estradiol (22 % higher among women consuming ≥5 drinks/week vs. non-drinkers, P trend < 0.0001).
Other researchers even looked at blood samples from women after perimenopause.
The same trend but specific to European and American women:
Of the six blood sample studies, only two--one in American women and one in European women--reported significant increases (p < 0.05) in estradiol levels in response to alcohol consumption.
And the mommy juice effect in strong in America:
In the American women study, estradiol levels increased only with wine and not with beer or whiskey.
So...just like putting on more weight which is a secondary source of estrogen (see CBD and perimenopause weight gain), the body may be craving alcohol as a workaround for losing estrogen.
That's the top-level process.
CBD has not been shown to boost estrogen the same way (see Does CBD increase estrogen) but the better way is to supplement hormones.
There's no good way to band-aid such critical players as estradiol and progesterone. See our review on estradiol regarding the safety and importance of this.
Let's look at those subcomponents...GABA and Serotonin.
Alcohol versus CBD for GABA
So we touched on how alcohol can increase GABA, our calming neurotransmitter.
One of alcohol's main effect in the brain is via the GABA pathway:
At the single-channel level, ethanol enhanced the frequency of GABA-mediated channel opening events, mean open time, open time percentage, frequency of opening bursts, and mean burst duration.
It's a veritable explosion of GABA activity.
Of course, with such an explosion, the brain goes the other way to offset this which is why the hangover may involve opposite effects (irritability, feeling unsettled, etc).
If alcohol is used chronically, GABA pathways become suppressed and this shows in the withdrawal symptoms.
What about CBD?
GABA and its opposing force, Glutamate, were really one of the first stars of the CBD show centering around seizures.
Seizures can result from too much glutamate (gas pedal) and not enough GABA.
CBD works in the endocannabinoid system which is all about balancing other key systems:
- Immune system - inflammation and stress response
- Endocrine system - hormones like estradiol and progesterone
- Nervous system - neurotransmitters like….GABA and Serotonin!!
CBD's effect on GABA:
Preclinical evidence suggests that one aspect of the polypharmacy of CBD is that it modulates brain excitatory glutamate and inhibitory γ-aminobutyric acid (GABA) levels.
What about GABA levels specifically when low.
An interesting study speaks to why CBD is popular right now.
It exerts its effect depending on the state of the system.
In the study below, it found the following (we'll explain after):
Across regions, CBD increased GABA+ in controls, but decreased GABA+ in ASD; the group difference in change in GABA + in the DMPFC was significant.
ASD is code for autism spectrum disorder.
In ASD, there can be too much glutamate (gas pedal) in the prefrontal cortex (DMPFC).
- In non-ASD brains, CBD would increase GABA across the spectrum
- In ASD brains, CBD would actually DECREASE GABA in the specific brain area it was needed.
We see this effect across many pathways and it speaks to why there aren't overdoses recorded on very high levels of CBD.
CBD acts as a constraint on high and low ends of various pathways.
As for GABA, it can increase it especially in situations where it's exhausted (as in anxiety or seizures).
The real star of the show may be serotonin though. Our lead actress left the stage during perimenopause by the way!
Let's go there now.
Alcohol versus CBD for serotonin connection
First, it's hard to find alcohol's effect on serotonin pathways without ties to alcoholism.
There's a good reason for that.
The serotonin system has been directly implicated in the development of alcoholism.
Here's the lay of the land.
Alcohol directly primes the serotonin receptors to be extremely "receptive".
In fact, it can overstimulate them with too much alcohol or over too long a period of time.
This literally damages the receptors and brings down what's called "tonic" or background levels (as opposed to spikes when needed).
We see this with many drugs that hammer one system.
- Amphetamines can do it acetylcholine receptors (thanks to Doctor for that ADHD medication)
- Nicotine is the same
It's like revving the engine into the red zone.
Yes, you'll go fast temporarily but if you take it too high or for too long, you'll burn out the engine.
That engine is the serotonin receptor in our case.
Both short- and long-term alcohol exposure also affect the serotonin receptors that convert the chemical signal produced by serotonin into functional changes in the signal-receiving cell.
Here's the sad part.
- Low serotonin is tied to alcohol craving (self-medicating)
- Alcohol use will slowly depress serotonin function
To put a point to it:
Acute alcohol exposure produces an increase in extracellular 5-HT levels, while chronic exposure causes an overall decrease in 5-HT neurotransmission as evidenced by lower levels of 5-hydroxy indole acetic acid (5-HIAA), the primary metabolite of 5-HT, in cerebrospinal fluid of alcoholics.
It's a vicious cycle.
We're doing a huge review psilocybin which showed powerful effects for alcohol addiction before they made it illegal.
It did this primarily by boosting BDNF, our brain's fertilizer and serotonin's real magic trick.
Is there another way to normalize serotonin function and boost BDNF instead of alcohol?
We don't want to just hammer serotonin levels like SSRIs do.
The brain inevitably pushes back by decreasing natural production.
It doesn't like constant, outside interlopers to key systems.
That's the whole basis for "normalization"...where a substance has less and less effect with use (such as with alcohol).
What about CBD and serotonin?
Researchers subjected mice to a nerve injury which caused a down-regulation of serotonin function.
They then gave CBD to part of the group. The effect:
Seven days of treatment with CBD reduced mechanical allodynia, decreased anxiety-like behavior, and normalized 5-HT activity.
Allodynia is general pain sensitivity. The anxiety we know all too well (especially in perimenopause).
But the most important word there is "normalized".
Normalized 5-HT activity. 5-HT being serotonin.
You'll see this throughout the research.
Normalize. Modulate. Not boost or drop.
Another study looked at CBD's effect on depression and pinpointed how it worked:
Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels.
Look...we followed the breadcrumbs and went deep into NIH research.
What we found is this:
- Estradiol boosts serotonin
- Serotonin boosts BDNF
- BDNF helps repair, replenish, and rebuild the brain and nervous system
You block BDNF, and all the effects of SSRIs go away.
More telling, you block CB1 receptors (main receptor for our endocannabinoid) and ALL of it goes away!
So...to BDNF...the worker behind the curtain.
Can CBD boost BDNF?
Cannabidiol Induces Rapid and Sustained Antidepressant-Like Effects Through Increased BDNF Signaling and Synaptogenesis in the Prefrontal Cortex.
This is the key to neurogenesis (think dynamic brain) and CBD all over it.
That may be the real take-away and it shows how estrogen loss is tied to Dementia and other debilitating brain diseases.
Ladies, they just pulled the rug out from under our mental feet and scared us about hormone replacement therapy based on bogus research from 2002 with horse hormones and synthetics.
It's enough to make a perimenopausal woman angry (see CBD and perimenopause irritability).
Let's look at some practical questions.
Can you take CBD with alcohol together
This is a very popular question.
There are a few ways to look at this:
- Do CBD and alcohol affect each other's effect
- Can CBD protect against effects of alcohol
First, CBD itself does not impair motor or cognitive functions like alcohol.
It doesn't get you "high" (see how will CBD make me feel).
However, it also doesn't reduce the impairment that comes with alcohol.
In studies, the found similar impairment with alcohol alone or with alcohol and CBD.
Another study on healthy volunteers:
They found that there was no difference in feelings of being “drunk”, “drugged”, or “bad” in alcohol-alone and alcohol plus CBD groups.
Interestingly, it does appear to reduce the alcohol level in the blood:
The combination of alcohol plus CBD resulted in significantly lower blood alcohol levels compared to alcohol given alone, however, there were few differences observed between the pharmacological effects of the two alcohol conditions.
This makes sense since the liver is our primary metabolizer of alcohol and its main weapon is glutathione.
CBD has been sown to boost glutathione (see CBD and glutathione here).
On a side note, glutathione is our primary anti-oxidant and poison removal system.
It goes down as we get older so any boost to glutathione is a good thing.
Everything from skin damage to cancer detection/removal rests on this antioxidant.
The primary "poison" that results from alcohol is called Acetaldehyde.
Our lucky livers are tasked with removing that poison. Let's go there now.
Does CBD protect the liver from alcohol
There is interesting research showing CBD's effect to protect the liver from the effects of alcohol.
Cannabidiol attenuates alcohol-induced liver steatosis, metabolic dysregulation, inflammation, and neutrophil-mediated injury.
That's a mouthful. Let's break it up a bit.
Steatosis is essentially fatty liver accumulation...a known result of alcohol abuse.
The liver is a key player in metabolism (fat, cholesterol, energy, etc).
This also gets impaired when the liver is under assault (alcohol).
Finally, the detox elements get exhausted and you start to see signs of damage (also in the brain). That the inflammatory markers and neutrophils.
- All these pathological changes were markedly attenuated by CBD treatment
- Goodness. You can almost argue that if someone does drink alcohol, they should use CBD as a protective measure.
Maybe more exciting for reducing suffering...
Can CBD help with alcohol withdrawal or addiction
Remember how serotonin increases craving for alcohol and after a short term burst, chronic alcohol will depress serotonin levels?
The vicious cycle from above.
This really requires a full, deep-dive which we'll do but just some hight lights.
Researchers looked at alcohol and cocaine craving or relapse for rats fed either.
The effects of CBD:
CBD attenuated context-induced and stress-induced drug seeking without tolerance, sedative effects, or interference with normal motivated behavior.
Attenuated is a fancy word for reduced.
Here's the interesting part (to us, anyway):
Following treatment termination, reinstatement remained attenuated up to ≈5 months although plasma and brain CBD levels remained detectable only for 3 days.
Read that again.
The gave one dose of CBD which was out of the system days later.
The anti-craving effects lasted 5 months.
In a rat's life, 5 months is gigantic!
This speaks to structural change (hint hint...BDNF, etc).
We're seeing this effect across a range of different addictions with opioids being the latest.
In addition to the liver protection and even protection of the brain from alcohol, we look forward to more research on CBD for alcohol addiction:
Experimental studies found that CBD reduces the overall level of alcohol drinking in animal models of AUD by reducing ethanol intake, motivation for ethanol, relapse, anxiety, and impulsivity.
What about the nasty effects of alcohol the next day (thanks Acetaldehyde)?
Can CBD prevent or help or with alcohol hangovers
There are a few things occurring which makes you feel so bad the morning after drinking:
- Ethanol is a diuretic and will dehydrate you
- Acetaldehyde is a poison
- Alcohol juiced up your GABA (calm) and Serotonin (good) chemicals so there's a natural rebound drop
The latter really speaks to feeling anxious or on edge. Maybe even depressed.
Anytime a neurotransmitter is boosted or spiked by a drug, there's an "exhaustion" of that pathway which follows.
First, CBD can definitely help with the acetaldehyde effect.
CBD is a powerful antioxidant (the pathway for clearing out poisons):
Consistent with reports that CBD has antioxidant activity, we found that CBD can reduce ROS production in HepG2 cells expressing CYP2E1 and that CBD inhibited the increase in ROS induced by alcohol treatment.
ROS is short for reactive oxygen species, the little kamikaze's in the body that needs to be mopped up or they cause damage (to cells and DNA alike).
Alcohol creates a ton of oxidation and ROS.
This oxidation is especially damaging in our brains.
CBD's effects there:
This study provides the first demonstration of CBD as an in vivo neuroprotectant and shows the efficacy of lipophilic antioxidants in preventing binge ethanol-induced brain injury.
We already discussed above how CBD can "rescue" or "normalize" serotonin and GABA function.
The study literally said "rescue 5ht" activity.
Some practical questions.
How much CBD to take to replace or balance alcohol
This is tricky as there's not hard research.
In the animal study, they used 5 or 10 mg per kg of body weight.
That's a high dose.
For a 160 pound human, that's about 350 or 700 mg.
Research is showing that 300 mg is the peak level for neurogenesis (brain repair).
That's very important during perimenopause but also for protection from alcohol use or addiction.
People generally replay back with 50 - 150 mg as being ideal.
Studies on sleep (critical after alcohol since depth is disrupted) showed benefits at 160 mg.
The starting dose is usually 25-30 mg to test how your body will respond.
Let us know what works for you below so we can help others on this point.
What about the type of CBD?
What's the best CBD to take for GABA and serotonin support during perimenopause
First, we want the cleanest CBD available.
- Organically grown in the US at an FDA registered farm
- 3rd party tested (we test ours twice)
- No THC (Alcohol can increase the levels and effects of THC)
- No Pesticides
- No Heavy Metals
- No Solvents
- No Bacteria
- No Mold
This is really important as there are a lot of bad products on the market.
Then there's the question of full-spectrum versus CBD Isolate.
The first hint is that all the research is on CBD isolate itself.
More importantly, the histamine issue for women in perimenopause.
With progesterone on the decline, this is peak histamine and allergy response.
We don't want all the plant material in full-spectrum to make this worse.
It's already estimated that 40-60% of the population has histamine issues and women in perimenopause are on the high end.
Alcohol already increases histamine reactions in the body:
Beer, wine, and liquor contain histamine, produced by yeast and bacteria during the fermentation process.
When we first tried 3-4 of the biggest brands of CBD, we have lots of histamine issues.
CBD Isolate made those go away. Like we said, research.
Let us know your responses below and how much CBD so other people can learn from our experience.
Get specific links for CBD and Perimenopause symptoms and questions here.
Always work with a doctor or naturopath with any supplement!
The information provided here is not intended to treat an illness or substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.