Yes, I AM on my period! The Menstrual Cycle and Psychedelics
Turning to psychotropic drugs in order to relieve suffering from a mental health concern, albeit in coordination with a professional, can be daunting
Add to that some psychedelics and a promise of a life-altering experience, and you can bet most people would be a nervous wreck. There is almost unanimous agreement in the community of psychedelic research that one of the most imperative aspects of using mind-altering drugs in order to have a favorable experience is set and setting; the mindset one comes into the experience with and the physical setting that you inhabit during. So how can women safely partake in psychedelic mental health treatment when a key part of their overall mood and mental health is not being taken into account?
For women, a crucial part of mindset is their reproductive cycle, no matter one’s experience with it; it will most certainly affect our interactions with the world
This is one of the more obvious differences between men and women; a lifelong expression of the human sexual reproductive organs, which from about age 13 to age 50 will manifest through the menstrual cycle in the female body. This includes the period and the ovulation as the two key events during the cycle (which can last from around 21-35 days in a healthy population), a period marking the start of the cycle which leads into the follicular phase, where the egg is formed and released around day 14, marking the start of the luteal phase. If the egg is not fertilized during ovulation, the egg will prepare to leave the body together with the uterine lining at the start of the cycle; another period has arrived, and the cycle starts again.
During the menstrual cycle, a woman’s experience of daily life can drastically change due to fluctuations in hormones
Estrogen and progesterone - changing both mood, energy levels, sleep quality, digestive processing, and even causing pain in different parts of the body such as the breasts, lower abdomen and lower back area at certain times. This is a general example of how the female endocrine system that affects the daily life of all women. However, this is a very bare-bones explanation of the menstrual cycle, and most women would consider themselves lucky if it was that simple. On top of this, many women consider birth control, pregnancy, menopause, and disorders pertaining to reproduction such as endometriosis, PCOS (Polycystic Ovary Syndrome) and PMDD (Premenstrual Dysphoric Disorder), all which have a disturbance in, or affect, the balance of progesterone and overall hormone production.
Studies have shown that oestrogen can further affect mental health
By reducing dopamine sensitivity when imbalanced and lessen overall dopamine stimulation, increasing vulnerability to many mental health issues, such as depression and psychosis (Arad & Weiner, 2010). Oestrogen naturally increase and decrease during different phases of one’s menstrual cycle, and research shows that mental health outcomes can vary depending on the phase a woman is in. There is a 26% risk increase in suicide deaths, 17% greater risk of suicide attempts and a 20% increase in psychiatric admissions during menstruation, when oestrogen levels are at their lowest. (Jang & Elfenbein, 2019). What if a woman had a particularly challenging experience with psychedelics during their most at-risk week for negative mental health outcomes? Although psychedelic research to date have overwhelmingly not considered female menstruation and hormonal effect on mental health, recent research has demonstrated that not only is it key to consider for risk, but there could be a potential link between psychedelic experiences and menstrual cycle outcomes. In looking at case histories, Gukasyan & Narayan (2022) found that 3 women had seen improved menstrual regularity after experiences with psychedelic compounds. Could it be that a positive psychedelic experience improves the menstrual cycle due to reduction in stress hormones thus balancing hormone levels?
To ignore menstrual cycles and hormonal effects in psychedelic research would be to deny the female experience
By not looking to these factors in studies looking at psychedelic treatment for mental health, female-specific set and setting cannot be fully accounted for. At the very least, the scientific community must endeavor to not harm female participants who partake mind-altering experiences by considering the mood shifts and sensitivities that come with having a womb. At the very best, by focusing on these effects, we can be able to establish further links between the menstrual cycle, female mental health and how psychedelic experiences can be affected by these factors, but also how psychedelic compounds can help improve poor mental health outcomes from hormone imbalances.
References
Arad, M., & Weiner, I. (2010). Contrasting effects of increased and decreased dopamine transmission on latent inhibition in ovariectomized rats and their modulation by 17β-estradiol: an animal model of menopausal psychosis?. Neuropsychopharmacology, 35(7), 1570-1582.
Jang, D., & Elfenbein, H. A. (2019). Menstrual cycle effects on mental health outcomes: a meta-analysis. Archives of suicide research, 23(2), 312-332.
Gukasyan, N., & Narayan, S. K. (2022). Menstrual Changes and Reversal of Amenorrhea Induced by Classic Psychedelics: A Case Series. Journal of Psychoactive Drugs, 1-6.