Frequently Asked Questions

Medically reviewed by Dr Will Parkyn and Shannon Norton

Women’s Health Week, Te Wiki Hauora Wāhine, runs from Monday 10 to Sunday 16 August, and this year’s theme, Me aro koe ki te hā o Hineahuone, is about paying heed to the wellbeing of wāhine. One of the most useful things any of us can do for our own wellbeing is understand the hormonal rhythm our bodies run on, because so many symptoms that feel random are actually following a pattern.

You know your own body, and if you have been diagnosed with something like endometriosis, PMS, or PMDD you will already know it well. So, this post is less about naming conditions and more about the rhythm underneath them: what shifts across the month and across midlife, why it happens when it does, and how knowing the timing helps you plan around it. It is general education rather than medical advice, and if you want to work out what suits your situation, that is a conversation for your GP or a registered prescriber.

The rhythm behind the month

A menstrual cycle is driven by hormones that rise and fall in a fairly predictable order.¹ In the first half, the follicular phase, oestrogen climbs, and many people feel steadier and more energetic. Oestrogen peaks around ovulation, roughly the middle of the cycle. In the second half, the luteal phase, progesterone rises and then, unless you fall pregnant, both hormones drop away in the days before your period.¹

That late luteal drop is when a lot of familiar symptoms cluster: lower mood, irritability, disrupted sleep, sore breasts, bloating and headaches.¹ Taken on their own they can feel like they come from nowhere. Mapped against the cycle, they start to make sense, and that can provide some sight and comfort.

Your body has its own cannabinoid rhythm

Here is a piece that often surprises people. Alongside oestrogen and progesterone, your body runs an endocannabinoid system, a signalling network involved in pain, mood, sleep and inflammation, and it shifts across the cycle too. Research measuring the endocannabinoid anandamide through the month found it was highest around ovulation and lowest in the late luteal phase, closely tracking oestrogen.² The activity of this system in the lining of the uterus also changes across the cycle in step with hormones.³

This is emerging science rather than a settled story, and it is part of why researchers have become interested in the endocannabinoid system in women’s health. For now the useful takeaway is simpler: the ups and downs you feel are real and physiological, and your body’s own systems are moving with them.

Knowing your pattern helps you manage it

The practical value of all this is anticipation. When you can see roughly when your harder days are likely to land, you can plan for them rather than be caught out by them.

A simple symptom diary is the most reliable way to find your pattern. For a couple of cycles, note your period dates and a quick daily line on pain, sleep, mood and energy. Most people start to see the shape of their own month. Once you know your pattern, small adjustments help: protecting sleep in the luteal phase, easing off on commitments where you can, gentle movement, and warmth and rest for cramps.

Tracking also tells you when something is worth a closer look. If your pain is severe or getting worse, or if the low mood in the days before your period is intense enough to affect your relationships or daily life, that is a good reason to see your GP. They can talk through diagnosis, the treatments with the best evidence, and mental health support if you need it. Help is available and you do not have to push through on your own.

When the pattern changes: perimenopause

For most people in Aotearoa, menopause arrives around the age of 52, and the transition before it, perimenopause, can begin years earlier and last a long time.⁴ The signature of perimenopause is not a steady decline but unevenness: oestrogen and progesterone rise and fall unpredictably, so cycles shorten or lengthen and symptoms come and go from month to month.⁴ It is common for PMS-type symptoms and hormonal headaches to become more pronounced during this stage, simply because the swings are bigger.

Because the pattern itself becomes less predictable, tracking is even more useful here. Noting changes in your cycle, sleep, mood and hot flushes gives you and your GP something concrete to work with. And the GP is the right first stop, since the established treatments for menopausal symptoms, including menopausal hormone therapy for those it suits, are decisions that belong with your doctor and your history.

Where medicinal cannabis fits

Some people ask us about medicinal cannabis for hormone-related symptoms such as pain, sleep and mood. It is one option among several, the evidence is still being built, and that includes some early local work here in New Zealand.⁵ It is not a first answer and it is not a cure-all.

Where it does fit, the boundaries matter. Diagnosis and the overall management of period problems and menopause sit with your GP and specialist team. A medicinal cannabis clinician has a narrower role, which is to talk with you about whether medicinal cannabis may be an appropriate option to explore as part of your wider care. If it is, the approach is supervised and gradual, and reviewed over time so it only continues if it is genuinely helping.

Women’s Health Week is a good prompt to start paying attention to your own rhythm, and to ask for help early rather than waiting it out. If you would like to talk through whether medicinal cannabis may suit you, you can book a consultation, or read more about how the process works.

Ngā mihi.

 

References

1. Cleveland Clinic. Menstrual Cycle and Follicular Phase. https://my.clevelandclinic.org/health/body/23953-follicular-phase
2. El-Talatini MR, Taylor AH, Konje JC. The relationship between plasma levels of the endocannabinoid, anandamide, sex steroids, and gonadotrophins during the menstrual cycle. Fertility and Sterility. 2009. https://pubmed.ncbi.nlm.nih.gov/19200965/
3. Gene expression of the endocannabinoid system in endometrium through the menstrual cycle. Scientific Reports. 2022. https://www.nature.com/articles/s41598-022-13488-4
4. Healthify He Puna Waiora. Menopause and early menopause. https://healthify.nz/hauora-wellbeing/m/menopause-early
5. Henry C, et al. Perceived impact of medicinal cannabis on pelvic pain and endometriosis related symptoms in Aotearoa New Zealand: an observational cohort study. BMC Complementary Medicine and Therapies. 2026;26(1):60. https://link.springer.com/article/10.1186/s12906-025-05189-y
6. NZ Ministry of Health. Medicinal Cannabis Scheme: Information for patients. 2026. https://www.health.govt.nz/regulation-legislation/medicinal-cannabis/information-patients