The study of psychedelics and women’s health has taken bigger steps forward in recent years, and has become one of the positive things coming from the rush to embrace psychedelics as a new mental health wellness treatment for everybody.
There are clear differences between how men and women process psychedelics, in part because of the different hormones that come into play. But there have been other interesting discoveries that researchers are continuing to explore.
For example, one study found evidence to support a main impact of sex hormones on brain development in women, and plasticity interactions between sex hormones and the dominant neurotransmitters, such as serotonin, dopamine, and glutamate. These are intriguing insights into women and how they are rewired slightly from men, encouraging more research into women’s mental health and treatment options with psychedelics.
But there is also a shadow issue when it comes to women and psychedelics that has to be overcome—lack of attention to their specific mental health needs from the scientific community.
For example, in 2019, the editorial board of the new Journal of Psychedelic Studies, is 78 percent male. And MDMA is often described as having been discovered by American chemist, Alexander Shulgin in 1976—yet there is scant mention that he worked alongside Claudio Naranjo, a Chilean psychiatrist and anthropologist to examine the efficacy of MDMA in conjunction with psychotherapy.
Today, all that is changing.
There are more women emerging as CEOs of psychedelic companies or as clinical researchers, as shown in Business Insider’s first ever listing of the Most Influential Women in Psychedelics.
Finally, it can be said that the future for women and psychedelics is bright. “I always hesitate to have these conversations that seemingly could pit genders against one another,” Kelsey Ramsden, president and CEO of Mind Cure Health, Inc., said during a webinar about the potential of psychedelics and ketamine in women’s health. “But when we talk about it, we just recognize that the lived experience of different genders can be quite different.”
Neurologist Dr. Rachel Dalthrop believes that someone working with women and psychedelics—which for now, is mostly about using ketamine—should be looking at a patient through a lens that’s informed by their reproductive physiology. “When I’m assessing a patient, we’re going to diagnose depression and anxiety disorders, and other psychiatric disorders,” she said. “But we take it a step further (with women). We’re going to look at the potential impact of contraceptives or hormone replacement. And definitely pay attention to those ovarian hormone fluctuations that are happening in the naturally cycling woman, or a woman experiencing reproductive lifecycle transition like pregnancy postpartum or perimenopause. So it’s just a more informed approach. It’s more personalized.”
She said that with women, there are pharmacokinetic dynamics that are different, gender to gender, and that sex hormones can modulate serotonin and can influence brain activity in women. “We even know that in certain women, their hormonal status can affect their response to a traditional antidepressant,” Dalthrop said. “So there are things that we know, but there’s so much that we don’t know.”
When overlapping psychedelics with mental health care for women, there should be a greater understanding or attention paid to the integration process for psychedelics, Ramsden said. “I think a lot of people have this perception of psychedelics is that it’s like this silver bullet thing, and you just go in and you have a session and voila, you walk out and everything is solved and wonderful,” she said. “That’s really not the case. It’s not just what happens in the session, but it’s more how you integrate and monitor, post session and into the following session. What that can look like for women can vary a fair amount over a period of time.”
A women’s brain function during their menstrual cycle is going to vary, Dalthrop said. “There are some studies looking at imaging, and a woman’s brain across that cycle, and how different it is from one phase to another,” she said. “And it makes me think, well, why are we treating someone with the same medicine across that entire cycle when their brain is so different, but we expect it to help them in the same way across that cycle? So it’s complicated. I think that’s why we struggle and haven’t made more progress is because it’s so complicated. But it’s worth it, right?”
Regarding using ketamine, Dalthrop said that she thinks it is very effective at increasing vulnerability and emotional intimacy. “I had a patient’s husband tell me, gosh, this should be a couples therapy medication, because he was able to have a conversation with his wife during treatment, and on an emotional level that she hadn’t been able to get to in a very long time, because her walls were built up so high. So I think it has that ability to really open someone up in a way emotionally that they wouldn’t be able to do without that psychedelic on board.”
“Wouldn’t it be lovely if there was just one thing that worked for everyone, and we could do it quickly and easily?” Ramsden said. “But the degree of nuance, the timing, the relationship, and the individual kind of history and physiology—we have the tools today to be able to adequately afford the insight into those different things and to help inform the process. So I’m just so positive about what we’re about to take on and the things we can already do. It’s really transformational for women, starkly contrasting with even five years ago.”