This study implements a randomized, double-blind, placebo-controlled, observational field
experiment design to examine the impact of hemp-derived minor cannabinoids on symptoms of
menopause/perimenopause. The study will require 3 months to complete.
Healthy adult women (between the ages of 40-60) experiencing psychological and physical
symptoms of menopause or perimenopause will be recruited via advertisements on social
media, physicians' offices, in the community, at menopause conferences/conventions, and
on internet forums. Prospective participants will complete a brief online screening
survey to determine whether they meet eligibility requirements. Eligible participants
will be asked to provide their first name and phone number if they want to be contacted
via text message to participate.
Initial Zoom Session: Eligible participants who agree to participate will be asked to
schedule an initial Zoom session, during which they will provide informed consent, review
the study requirements, and complete cognitive tests including tests of memory and verbal
fluency. Tests include the Rey Auditory Verbal Learning Test (RAVLT), FAS Verbal Fluency
Test, Digit Span Forward and Backward (DSF, DSB), Deese-Roediger-McDermott Paradigm
(DRM), Corsi Forward and Backward, and Prospective Memory (PM) Tasks. They will also be
given the contact information for a company that manufactures and distributes
hemp-derived cannabinoids. Participants will be asked to contact the company and request
that they directly ship the product to them (the participant). The product will be
provided at no cost to the participant (or to the PI or their lab). The PI will randomize
each participant to the active or placebo condition and will subsequently contact the
distributor to inform them of which product to ship (active or placebo). Participants
will be given a link to an online Qualtrics survey that will be used to assess
demographic characteristics, medications, and menopause/perimenopause symptoms, including
depression, anxiety, perceived stress, physical and emotional health, insomnia, and
everyday memory problems (Beck Depression Inventory [BDI], Beck Anxiety Inventory [BAI],
Perceived Stress Scale [PSS], Short Form Health Survey [SF-36], Insomnia Severity Index
[ISI], and Everyday Memory Questionnaire [EMQ], respectively).
Baseline: Participants will then complete four weeks of baseline assessments via
ecological momentary assessment (EMA). Specifically, twice a day: shortly after they eat
breakfast, and shortly after they eat dinner participants will complete a brief survey on
their phone. For each EMA survey, they will be asked to indicate whether they experienced
various emotional/psychological symptoms of menopause as well as whether they experienced
various physical symptoms of menopause since their last EMA assessment. For each endorsed
symptom, they will be asked to rate its severity as well as how much it interfered with
their life using a 0 to 10 visual analog scale. In the morning survey, they will also be
asked to indicate how well they slept the night before. Once a week, participants will
also complete a series of EMA cognitive tests, including tests of verbal memory, spatial
memory, working memory, inhibition, psychomotor speed, and attention (assessed using
NeuroUX's Memory List, CopyKat, 2-Back, Digit Symbol Substitution, Color Names, Quick Tap
Level 1and 2, and Trail Making A and B). Participants will be sent text messages with a
link to the tests and will be instructed to complete them on their smartphone. At the end
of the month, participants will meet a researcher over Zoom where they will complete
additional cognitive tests (RAVLT, FAS, DSF/DSB, DRM, Corsi, PM). Cognitive tests
involving word lists or letter sets (i.e., RAVLT, FAS, DRM) will be counterbalanced using
a Latin Square design. At the end of the session, they will be sent a link to complete an
online survey that will be used to assess menopause/perimenopause symptoms, including
depression, anxiety, perceived stress, physical and emotional health, insomnia, and
everyday memory problems (BDI, BAI, PSS, SF-36, ISI, EMQ, respectively). This period of
time constitutes the baseline assessment period.
Phase 1: Phase 1 will begin after 4 weeks of baseline assessments and will continue for 4
weeks. During this phase, participants will be asked to take a single dose of the active
or placebo version of the product (in a double-blind manner) twice a day (once after
breakfast and again after dinner) and to complete EMA survey assessments twice a day
(after orally ingesting each dose). Participants will be sent reminders and links via
text message. For each EMA survey, they will be asked to indicate whether they took the
study product, and if so what time they took the product. If they indicate they have not
taken the product yet they will instructed to do so or provide a reason why they cannot
do so. Next, they will be asked to indicate whether they experienced various emotional
symptoms of menopause/perimenopause as well as whether they experienced various physical
symptoms of menopause/perimenopause since their last EMA survey assessment. For each
endorsed symptom, they will be asked to rate its severity as well as how much it
interfered with their life using a 0 to 10 visual analog scale. In the morning survey,
they will also be asked to indicate how well they slept the night before. Participants
will also report on whether they experienced any side effects. Once a week, participants
will also complete a series of EMA cognitive tests, including tests of verbal memory,
spatial memory, inhibition, psychomotor speed, and attention (assessed using NeuroUX's
Memory List, CopyKat, 2-Back, Digit Symbol Substitution, Color Names, Quick Tap Level
1and 2, and Trail Making A and B). Participants will be sent text messages with a link to
the tests and will be instructed to complete them on their smartphone. At the end of the
four weeks, participants will meet a researcher over Zoom where they will complete
additional cognitive tests (RAVLT, FAS, DSF/DSB, DRM, Corsi, PM). They will also be asked
if they would like to double the dose of the tincture for Phase 2 and additional product
will be sent to participants who indicate they want to increase the dose. At the end of
the session, they will be sent a link to complete an online survey that will be used to
assess menopause/perimenopause symptoms, including depression, anxiety, perceived stress,
physical and emotional health, insomnia, and everyday memory problems (BDI, BAI, PSS,
SF-36, ISI, EMQ, respectively).
Phase 2: Phase 2 will begin after 4 weeks of phase 1 assessments and will continue for 4
weeks. During this phase, participants will be asked to take two doses of the active or
placebo version of the product (in a double-blind manner) twice a day (once after
breakfast and again after dinner) if they indicated they wanted to increase the dose of
the product. Otherwise, they will continue taking a single dose twice a day. They will
complete the same EMA survey assessments twice a day (after orally ingesting each dose).
Participants will be sent reminders and links via text message. For each EMA survey they
will be asked to indicate whether they took the study product, and if so what time they
took the product. If they indicate they have not taken the product yet they will
instructed to do so or provide a reason why they cannot do so. Next, they will be asked
to indicate whether they experienced various emotional symptoms of
menopause/perimenopause as well as whether they experienced various physical symptoms of
menopause/perimenopause since their last EMA survey assessment. For each endorsed
symptom, they will be asked to rate its severity as well as how much it interfered with
their life using a 0 to 10 visual analog scale. In the morning survey, they will also be
asked to indicate how well they slept the night before. Participants will also report on
whether they experienced any side effects. Once a week, participants will also complete a
series of cognitive tests using EMA, including tests of verbal memory, spatial memory,
inhibition, psychomotor speed, and attention (assessed using NeuroUX's Memory List,
CopyKat, 2-Back, Digit Symbol Substitution, Color Names, Quick Tap Level 1and 2, and
Trail Making A and B). Participants will be sent text messages with a link to the tests
and will be instructed to complete them on their smartphone. At the end of the four
weeks, participants will meet a researcher over Zoom where they will complete additional
cognitive tests (RAVLT, FAS, DSF/DSB, DRM, Corsi, PM). At the end of the session, they
will be sent a link to complete the online survey (including the BDI, BAI, PSS, SF-36,
ISI, and EMQ). The study ends after phase 2.