Fun fact: Women report more frequent use of some psychedelics than men. A not-so-fun fact: In the Global Drug Survey 2020,1 women cite depression, anxiety, relationship issues, trauma, and post-traumatic stress disorder (PTSD) as their main reasons for using psychedelics. Additional reasons include other mental health disorders, grief, distress over medical conditions, and chronic pain. The truth is that more women report self-treating with some psychedelics than men, whereas men (not all) tend to use psychedelics for recreational purposes.
None of this surprises me. And it’s why I wrote the Psilocybin Handbook for Women: How Magic Mushrooms, Psychedelic Therapy, and Microdosing Can Benefit Your Mental, Physical, and Spiritual Health. I wanted to provide accurate info about psilocybin (more commonly known as magic mushrooms) and its intersection with women’s health—because our bodies are not the same, nor are our lived experiences. The following content includes excerpted material from the book.
People assigned female at birth are two to three times more likely to develop PTSD than those assigned male at birth.2 And most chronic-pain conditions are more prevalent in people assigned female at birth.3 Yet healthcare providers, and people in general, are more likely to take women’s pain less seriously than the pain of men.4 For decades, medical science has either underrepresented women or left us out entirely in studies.5 Women were even excluded from early-stage clinical trials—for the most part—until the 1990s.6 Yes, the 1990s, people! Research on conditions that either disproportionally affect those assigned female at birth or that solely affect them is also woefully underfunded.7 Plus, research on women’s health often takes what’s been referred to as a “bikini approach.”8 When research does focus on us, it tends to home in on reproductive health, ignoring other aspects.9
In this article, you will read about disparities in healthcare for women, the connections between fungi and women, whether psilocybin can help with sexual dysfunction and menopause symptoms, and whether psilocybin affects the menstrual cycle.
Disparities in healthcare for women
Here’s an example of how delayed research—or the absence of research altogether—has created disparities in healthcare for women.
Roughly 40 percent of women of reproductive age endure some type of sexual dysfunction, whether that’s with libido, the enjoyment of sex, or reaching orgasm.10 And for those who’ve surpassed the menopause milestone, 85 percent experience sexual dysfunction.11 The World Health Organization says, “Sexual health is fundamental to the overall health and well-being of individuals, couples and families, and to the social and economic development of communities and countries.”12 A hallmark of female sexual dysfunction is personal distress, which contributes to reduced quality of life.13
At the same time, barriers exist for people assigned female at birth to receive treatment for sexual dysfunction, and many barriers involve gaps in our healthcare system. These include a lack of healthcare-provider education and training on the topic and the individual biases they bring to the exam table. Sexual medicine objectives aren’t widely included in residency programs.14 Plus, medicine didn’t even have a complete understanding of clitoral anatomy until 2005, when Helen O’Connell, MD, a urologist, and her colleagues used functional magnetic resonance imaging (fMRI) to map out, for the first time, the full clitoris, including its internal structures.15 The penis, however, has received much more research attention. The FDA approved the first medication for erectile dysfunction, one of the most common male sexual concerns, in 1998.16 The most common form of sexual dysfunction for women is hypoactive sexual desire disorder (HSDD), basically a severe lack of sex drive. The FDA approved the first medication for female HSDD nearly 17 years later in 2015.17 So, to recap, a drug for male sexual dysfunction existed seven years before the medical establishment even had a complete concept of the clitoris. Then, it took an entire decade before a drug for female sexual dysfunction hit the market. Clearly, women’s sexual health and pleasure have not been a priority in the medical field. These disparities in care lead to stigma. Can psilocybin help with female sexual dysfunction? Find more on that below.
A shroom of one’s own: why a book for women?
In writing The Psilocybin Handbook for Women, I’m not suggesting that everyone who has a physical or mental health condition run out and start using psilocybin. That would be irresponsible of me.
And I’m not that kind of girl.
I am the type of girl who does her research—like a lot of it. I’m a medical journalist and fact-checker, and I’ve researched psilocybin at length, specifically how psilocybin affects and may help women or people assigned female at birth, whether therapeutically, spiritually, or recreationally. In my book, you’ll find a synthesis of that research—along with personal stories, including my own.
When people find out I’ve written a book about psilocybin, some have asked, “Why is it for women?”
Preliminary research suggests that magic mushrooms may affect people assigned female at birth differently than those assigned male at birth.18 Plus, a host of health conditions impact people assigned female at birth disproportionately, differently, or solely. And we deserve a book that addresses what role, if any, psilocybin therapy may be able to play.
On women and fungi: society’s and nature’s nurturers
Women perform some of the most crucial roles in society. When compared to men, women do disproportionately more of the unpaid work of general life.19 Yep, that’s not true in every situation. Many men out there do their fair share of unpaid domestic and emotional labor, as well. But, hey, I’m trying to draw a cool parallel between women and fungi. So just go with it (and don’t increase my emotional labor by sending me hate DMs, please). Women tend to be some of society’s biggest doers, nurturers, and connectors. And fungi perform these same roles for nature, specifically for plant and soil ecosystems.
An estimated 5.1 million species of fungi exist, and many are crucial for the survival of up to 80 percent of plant species.20 Fungi grow filaments of hyphae that form mycelium, ultimately connecting plants to each other in the soil. A whole forest, for example, is connected by a mycorrhizal network, or what’s been dubbed the “wood wide web.” Writing her doctoral thesis at the time, Suzanne Simard, PhD, now a professor of forest psychology, discovered the network in 1997.21 Go, Dr. Simard! Why the wood wide web? Fungi exchange nutrients with soil and plants and even transfer nutrients from plant to plant, sending resources where they’re needed most. If one area of the forest has struggling trees, for example, those trees can get a nutrient infusion from another section, all via this natural nexus—thanks to fungi, which also benefit from the community and collaboration.22 When I think about magic mushrooms and the way they can sometimes make us feel more connected to each other and nature at large, my mind is officially blown.
Just to recap, though: Women are super busy doing unpaid labor in addition to all their paid labor. Meanwhile, they’re disproportionately affected by chronic-pain conditions and certain types of trauma. Yet society and the medical establishment have a history of ignoring women’s health. Wow. Maybe fungi—nature’s nurturers—can help us gals out.
Chapter Eleven of the book includes an alphabetized section on these health conditions and their intersection with psilocybin research thus far, plus Chapter Six includes content on sex life and psilocybin. Here are some details to consider.
Can psilocybin help with female sexual dysfunction?
Research on psilocybin is still ongoing in many areas. So far, I haven’t found research directly linking magic mushroom use to enhanced sex life for people assigned female at birth. But I think there’s potential in this area. Many factors—including physical, psychological, and social—can contribute to female sexual dysfunction. And in no way would I want to present shrooms as some sort of sexual-health panacea. I hope research ensues in a safe and productive way.
In the meantime, I think there are some things to consider. Low libido is linked to depression.23 And we know that psilocybin has mood-elevating potential, so it’s not a stretch to hypothesize that a mood boost might potentiate a bedroom boost. Factors that can contribute to sexual dysfunction include sexual abuse or rape.24 A history of sexual and emotional abuse is associated with vaginismus, which is the involuntary tensing or contraction of vaginal muscles upon penetration. And a history of sexual abuse is associated with dyspareunia—painful intercourse.25 A meta-analysis of more than 2,000 survivors of sexual assault found that nearly 75 percent met the criteria for a PTSD diagnosis within the first month after the assault.26 More research is needed regarding psilocybin’s potential to help with trauma.27 But early clinical trials on psilocybin and PTSD are in the works.28 Research shows that factors that help protect against sexual dysfunction include intimate communication and having a positive body image.29 And experts suggest psilocybin may be able to help in those areas. For example, researchers are studying whether psilocybin can help with anorexia nervosa,30 an eating disorder, and they’re seeing some promising results in clinical trials.
For expertise, I reach out to Michele Ross, PhD. She’s a neuroscientist who wrote an article about sex and shrooms.31 Psilocybin can aid with self-discovery, which can then lead to new discoveries when you’re partnered up. “I always think that solo work and solo trips are really important,” Ross explains, “because when you are in touch with yourself and you’re more confident, when you go into the bedroom, you bring that confidence. You’re more able to voice what you need with your partner, you’re more able to connect—bring your authentic self.”
Whether you’re tripping with another person or solo, you may feel an enhanced sense of connection in the moment or post-trip to the people you love, and that, too, may have benefits in the bedroom. “When you’re more connected to your partner,” Ross says, “obviously sex can be better—when you’re more attentive to each other’s needs. It really depends on what you think better sex is.”
As I’ve already mentioned, sexual dysfunction is a common symptom of menopause or the transition.
Can psilocybin help with menopause symptoms?
Globally, about 47 million people assigned female at birth reach menopause per year.32 Menopause occurs when your period has stopped for 12 months. For many, this milestone is naturally reached in one’s early fifties.33 But you may find yourself in natural menopause earlier. Induced menopause occurs in people who take certain medications (such as for cancer treatment) or who’ve had a bilateral oophorectomy (removal of both ovaries). In the years leading up to menopause, you’ll be in perimenopause, also called the menopausal transition. This transition usually begins in one’s late forties, but it could occur earlier. Perimenopause is apparent via changes in sex hormone levels that indicate declining ovarian reserve.34 Your anti-mullerian hormone level is a good predictor of where you are on this trajectory, since it can be hard to gauge on your own.35 You can ask your doctor for a test or order one online. You’re in post-menopause once you’ve crossed the menopause threshold.
Perimenopause may be unnoticeable, especially in the early years of the transition. But it could eventually bring about burdensome symptoms that impact quality of life. These include hot flashes, depression, changes in libido, discomfort or pain during sex, mood changes, and insomnia or other issues with sleep. These symptoms can be so disrupting or frustrating that nearly 90 percent of women undergoing the menopausal transition or who have reached menopause seek guidance from their healthcare provider.36
During your reproductive years, the hormonal changes of your cycle occur along the hypothalamic-pituitary-gonadal axis in a feedback loop. Perimenopause throws a wrench into that whole system. Hormonal changes in perimenopause can shorten your follicular phase, leading to earlier ovulation.37 These factors can lead to extreme hormonal fluctuations that can drive the classic menopausal symptoms. At the time of menopause, estrogen levels will have declined by half when compared to your reproductive years.38 In post-menopause, progesterone is no longer produced.
Can psilocybin help with symptoms? I’d love to tell you I’ve come across definitive evidence. But as of the writing of the book, I’m not seeing studies or clinical trials on whether psilocybin can ease symptoms of menopause. However, we do have some evidence that psilocybin may be able to help with depression. Although more research is needed there as well, I want to focus on the depression aspect of menopause. The North American Menopause Society says people in perimenopause and in the early years of post-menopause seem to be particularly vulnerable to depression, likely because of hormonal shifts.39 An older 2006 study found that women ages 36 to 45 who had no previous diagnosis of major depression in their premenopausal years were twice as likely to develop significant symptoms of depression in perimenopause than those who hadn’t yet entered the transition.40
I contact Julie Freeman, who has her master’s in counseling and psychology. She frequently works with women who are struggling with menopausal symptoms and who microdose psilocybin to help. Microdosing is the practice of following a protocol of taking a super low dose of psilocybin at regular intervals. Microdosing does not produce the classic psychedelic effects we associate with larger doses, or “tripping,” such as visuals, but it may have beneficial effects. Freeman has held forums comparing psilocybin with selective serotonin reuptake inhibitors, or SSRIs, which are often prescribed to treat menopausal depression. “With SSRIs,” she says, “you can blunt the mood lability. So, instead of having super highs and super lows, you can be kind of blunted. But it also blunts affect and it also blunts libido.” Aye, there’s the rub. “As a woman is going through menopause and estrogen declines,” Freeman continues, “usually libido declines as well. That gets tied up in self-esteem. It’s like ‘My body’s changing, my brain’s changing, and now I don’t even want to have sex.’” She notes the whole psychological domino effect that can occur. “Oxytocin is a chemical that’s released during orgasm,” she says, “and oxytocin is really important not only for mood and bonding and connection but it also plays a role in our brain health and our cardiovascular health.” Psilocybin, however, may help address depression, but it does not further blunt libido as may occur with an SSRI, she adds.
In addition, psilocybin is a serotonin (5-hydroxytryptamine) 2A/1A receptor agonist. Psilocybin’s 5-HT2A receptor activation enhances the expression of brain-derived neurotrophic factor. “BDNF plays such a role in our cardiovascular health and our bone health and our brain health,” Freeman says. “Psilocybin—along with some of the other psychedelics—is known to help to improve BDNF. And while your SSRIs do as well, it seems like there’s probably a better opportunity with psilocybin.” Although low BDNF is implicated in depression, more research is needed to determine the association between BDNF levels and depression during the menopausal transition. Research indicates that progesterone and estrogen regulate BDNF levels and that BDNF is lower after menopause because of the decline in hormones, but fluctuating BDNF levels may play a role in mood changes during perimenopause.41 Again, we need more research on this topic.
Freeman notes another way she sees psilocybin helping people during the menopausal transition. “Women will crave carbs and alcohol just as a way of trying to manage their feelings,” she says. “One of the other benefits that’s being looked at in the research with psilocybin is its ability to help with any kind of addictive tendencies.”
An issue with the way women’s health is approached is that doctors rarely consider the complete picture. Women’s health has never really been taken seriously and “has never really been looked at from the totality of a woman’s life,” Freeman says. The whole picture is important, she notes, because of adverse childhood experiences (ACEs). “Women who have ACEs,” Freeman says, “are prone to having more challenges during perimenopause and maybe even into the menopausal years.”
Higher childhood adversity scores are associated with more severe menopausal symptoms, according to results of a large cross-sectional study published in 2020.42 Although the study doesn’t tell us why there’s a correlation, metabolic health may play a role since ACEs can negatively impact metabolic health.43
Metabolic health is often defined as, without the use of medications, having ideal levels of blood sugar, cholesterol, triglycerides, and blood pressure, and having an optimal waist circumference. These biomarkers help signify optimal cellular functioning, which can help stave off chronic diseases. Worsening metabolic health, including high blood sugar and related insulin resistance, is associated with worsening menopausal symptoms.44 By the way, the decline in estrogen toward menopause means we lose some of estrogen’s protective effects against insulin resistance.45 This is another potential reason for the increase in cravings Freeman mentions, and it may be a factor in menopausal weight gain. So, to recap: ACEs can negatively impact metabolic health. Hormonal changes in menopause can also affect metabolic health. Researchers note a correlation between having more ACEs and more severe menopausal symptoms. They also see a correlation between worsening metabolic health and more intense menopausal symptoms. Taken together, we can see why a person’s life history, rather than just their present health or situation, might matter when it comes to their menopause experience.
Freeman says she enjoys working with women in midlife because that is often when they’re examining the big picture for themselves and considering how they want their life to look going forward. “There’s a rebirthing process that’s going on,” she explains.
In a similar vein, Mikaela de la Myco, who focuses on womb-healing facilitation in the Ma’at tradition, says, “A lot of women coming into their menopause time are in their wise-woman era.” For that reason, a psilocybin journey can be synergistic. “What I really hope people can remember about the mushroom,” de la Myco adds, “is that one of its original Indigenous applications was to teach a person what the meaning of their life was and why they came and why they were born.” Psilocybin may be a catalyst for the reframing of how we think about menopause; we can treat the change as a rite of passage rather than something to be dreaded. “Mushrooms are absolute master teachers around transitionary phases,” de la Myco says, “because they are decomposers. They help to literally transition one matter to another matter.” This reframing of what menopause is—a transition—can help one tune into their feelings of self-worth. “When we get down to the purpose of our life,” de la Myco adds, “then we can derive so much meaning.”
I do want to add a word of caution when it comes to depression in midlife. People ages 45 to 54, across all genders, account for 80 percent of suicides in the United States.46 And in Australia, women ages 45 to 54 had the highest suicide rates in 2015.47 Having major depression increases the risk of suicide.48 While we’re seeing hyped and promising results from studies looking at psilocybin and depression, it’s worth noting that suicidal ideation and self- injury have been reported as serious adverse events in psilocybin studies.49 If you’re experiencing depression related to menopause, it’s worth consulting with a mental health professional. Seek immediate help if you’re having thoughts of self-harm.
Before we reach the menopause milestone, we’re in our reproductive years, and many people wonder whether psychedelics affect the menstrual cycle.
Does psilocybin affect the menstrual cycle?
The basics of the menstrual cycle can help us understand how psilocybin may impact it—or how the cycle may impact a trip. A cycle’s hormonal fluctuations occur along the hypothalamic pituitary-gonadal (HPG) axis (sometimes referred to as HPO for ovaries) in a feedback loop where changes in levels signal what happens next.50 The hormones involved include estrogens, progesterone, gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and more.
Menstruation kicks off what’s called the follicular phase. Estrogen starts out low during this phase, and slowly climbs, peaking just before or around ovulation. During the follicular phase, progesterone remains level and low. After ovulation, the luteal phase begins. Here, estrogen dips, forming a valley, before climbing to a gentle peak and then declining toward menses. Meanwhile, progesterone peaks for the first time of the cycle in the middle of the luteal phase and then falls toward menstruation. If you look at a chart of these hormonal fluctuations, they appear like a roller-coaster ride, and the changes around ovulation and in the luteal phase are often what cause premenstrual or other symptoms.
Now add psilocybin to the mix. Consider that psilocybin binds to serotonin receptors. Serotonin activates and regulates the hypothalamic-pituitary-adrenal (HPA) axis, a feedback system that regulates your stress response, among other things.51 And the HPG axis (the one controlling the menstrual cycle) impacts the HPA axis.52 In animal models, estradiol (estrogen) raises cortisol (stress hormone) levels, for example.53 Likewise, evidence suggests that stress response can also impact sex hormone levels, illustrating that these closely intertwined axes affect each other,54 though all the mechanisms of interplay still need much more study. Theoretically, a psilocybin journey or microdosing could impact the HPG axis and therefore, affect your menstrual cycle. But we don’t have definitive answers, just anecdotal reports and case studies that suggest a connection.
Researchers at the Center for Psychedelic and Consciousness Research at Johns Hopkins University School of Medicine did a case study of three women who’ve used psychedelics. All three women in the case study said their cycles came early after consuming psychedelics. Two also reported the reversal of amenorrhea. And one reported a return to menstrual regularity.55
Since the publication of the book, I’ve received anecdotal reports from other women who’ve noticed their cycles came early after they embarked on a psilocybin journey.
The book also includes recommendations from Indigenous wisdom expert de la Myco for the use of psilocybin for womb care, whether macrodosing or microdosing. Remember, Indigenous people have been using psilocybin for hundreds of years, and their wisdom, passed down through generations, is invaluable to the current psychedelic movement.
1 Adam Winstock et al., “Global Drug Survey (GDS) 2020,” accessed December 7, 2022, https://www.globaldrugsurvey.com/wp-content/uploads/2021/01/GDS2020 -Executive-Summary.pdf.
2 Miranda Olff, “Sex and Gender Differences in Post-Traumatic Stress Disorder: An Update,” European Journal of Psychotraumatology 8 (2017), https://doi.org/10.1080 /20008198.2017.1351204.
3 Domingo Palacios-Ceña et al., “Female Gender Is Associated with a Higher Prevalence of Chronic Neck Pain, Chronic Low Back Pain, and Migraine: Results of the Spanish National Health Survey, 2017,” Pain Medicine 22, no. 2 (2020): 382–95, https://doi.org/10.1093/pm/pnaa368.
4 Lanlan Zhang et al., “Gender Biases in Estimation of Others’ Pain,” The Journal of Pain 22, no. 9 (2021): 1048–59, https://doi.org/10.1016/j.jpain.2021.03.001.
5 Anna C. Mastroianni and Ruth Faden, Women and Health Research, Washington, DC: National Academies Press, 1999.
6 Katherine A. Liu and Natalie A. DiPietro Mager, “Women’s Involvement in Clinical Trials: Historical Perspective and Future Implications,” Pharmacy Practice 14, no. 1
(2016): 708, https://doi.org/10.18549/pharmpract.2016.01.708.
7 Chloe E. Bird, “Underfunding of Research in Women’s Health Issues Is the Biggest Missed Opportunity in Health Care,” Rand.org, February 11, 2022, https://www.rand .org/blog/2022/02/underfunding-of-research-in-womens-health-issues-is.html.
8 Nanette K. Wenger, “You’ve Come a Long Way, Baby,” Circulation 109, no. 5 (2004): 558–60, https://doi.org/10.1161/01.cir.0000117292.19349.d0.
9 Laura Hallam et al., “Does Journal Content in the Field of Women’s Health Represent Women’s Burden of Disease? A Review of Publications in 2010 and 2020,” Journal of Women’s Health 31, no. 5 (2022): 611–19, https://doi.org/10.1089/jwh.2021 .0425.
10 Megan E. McCool, “Prevalence of Female Sexual Dysfunction among Premenopausal Women: A Systematic Review and Meta-Analysis of Observational Studies,” Sexual Medicine Reviews 4, no. 3 (2016): 197–212, https://doi.org/10.1016/j .sxmr.2016.03.002.
11 Soheila Nazarpour et al., “The Association between Sexual Function and Body Image among Postmenopausal Women: A Cross-Sectional Study,” BMC Women’s Health 21, no. 1 (2021), https://doi.org/10.1186/s12905-021-01549-1.
12 “Sexual Health,” World Health Organization, accessed November 12, 2022, https://www.who.int/health-topics/sexual-health#tab=tab_1.
13 Sheryl A. Kingsberg et al., “Female Sexual Health: Barriers to Optimal Outcomes and a Roadmap for Improved Patient–Clinician Communications,” Journal of Women’s Health 28, no. 4 (2019): 432–43, https://doi.org/10.1089/jwh.2018.7352.
14 Kingsberg et al., “Female Sexual Health: Barriers.”
15 Helen E. O’Connell, Kalavampara V. Sanjeevan, and John M. Hutson, “Anatomy of the Clitoris,” Journal of Urology 174, no. 4 (2005): 1189–95, https://doi.org/10.1097 /01.ju.0000173639.38898.cd.
16 “FDA’s Clinical, Statistical, and Biopharmacological Review of Viagra Clinical Development,” US Food and Drug Administration, April 1, 1998, https://www.accessdata.fda.gov/drugsatfda_docs/NDA/98/viagra/viagra_toc.cfm.
17 Pugazhenthan Thangaraju, Hemasri Velmurugan, and Sree Sudha TY, “Drug Flibanserin–in Hypoactive Sexual Desire Disorder,” Gynecology and Obstetrics Clinical Medicine 2, no. 2 (2022): 91–95, https://doi.org/10.1016/j.gocm.2022.04.003.
18 Filip Tylš et al., “Sex Differences and Serotonergic Mechanisms in the Behavioural Effects of Psilocin,” Behavioural Pharmacology 27, no. 4 (2016): 309–20, https://doi.org/10.1097/fbp.0000000000000198.
19 Lieke ten Brummelhuis and Jeffrey H. Greenhaus, “Research: When Juggling Work and Family, Women Offer More Emotional Support Than Men,” Harvard Business Review, March 21, 2019, https://hbr.org/2019/03/research-when-juggling-work-and-family-women-offer-more-emotional-support-than-men.
20 Meredith Blackwell, “The Fungi: 1, 2, 3 … 5.1 Million Species?” American Journal of Botany 98, no. 3 (2011): 426–38, https://doi.org/10.3732/ajb.1000298.
21 Suzanne W. Simard et al., “Net Transfer of Carbon between Ectomycorrhizal Tree Species in the Field,” Nature 388, no. 6642 (1997): 579–82, https://doi.org/10.1038/41557.
22 Manuela Giovannetti et al., “At the Root of the Wood Wide Web,” Plant Signaling & Behavior 1, no. 1 (2006): 1–5, https://doi.org/10.4161/psb.1.1.2277.
23 Rosemary Basson and Thea Gilks, “Women’s Sexual Dysfunction Associated with Psychiatric Disorders and Their Treatment,” Women’s Health 14 (2018), https://doi.org/10.1177/1745506518762664.
24 Megan McCool-Myers et al., “Predictors of Female Sexual Dysfunction: A Systematic Review and Qualitative Analysis through Gender Inequality Paradigms,” BMC Women’s Health 18, no. 1 (2018), https://doi.org/10.1186/s12905-018-0602-4.
25 Sinan Tetik and Özden Yalçınkaya Alkar, “Vaginismus, Dyspareunia and Abuse History: A Systematic Review and Meta-Analysis,” The Journal of Sexual Medicine 18, no. 9 (2021): 1555–70, https://doi.org/10.1016/j.jsxm.2021.07.004.
26 Emily R. Dworkin, Anna E. Jaffe, Michele Bedard-Gilligan, and Skye Fitzpatrick, “PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies,” Trauma, Violence, & Abuse (2021), https://doi.org/10.1177/15248380211032213.
27 Lauren Gravitz, “Hope That Psychedelic Drugs Can Erase Trauma,” Nature 609, no. 7929 (2022), https://doi.org/10.1038/d41586-022-02870-x.
28 Gosia Phillips, “Investigating the Therapeutic Effects of Psilocybin in Treatment-Resistant Post-Traumatic Stress Disorder,” ClinicalTrials.gov, last updated December 7, 2022, https://clinicaltrials.gov/ct2/show/NCT05243329.
29 McCool-Myers et al., “Predictors of Female Sexual Dysfunction.”
30 Natalie Gukasyan, Colleen C. Schreyer, Roland R. Griffiths, and Angela S. Guarda, “Psychedelic-Assisted Therapy for People with Eating Disorders,” Current Psychiatry Reports (2022), https://doi.org/10.1007/s11920-022-01394-5.
31 Michele Ross, “Sex on Magic Mushrooms: Is It Safe?” Dr.MicheleRoss.com, last updated March 5, 2022, https://www.drmicheleross.com/sex-on-magic-mushrooms.
32 Alisa Johnson, Lynae Roberts, and Gary Elkins, “Complementary and Alternative Medicine for Menopause,” Journal of Evidence-Based Integrative Medicine 24 (2019), https://doi.org/10.1177/2515690×19829380.
33 Ellen B. Gold, “The Timing of the Age at Which Natural Menopause Occurs,” Obstetrics and Gynecology Clinics of North America 38, no. 3 (2011): 425–40, https://doi.org/10.1016/j.ogc.2011.05.002.
34 Nanette Santoro, “Perimenopause: From Research to Practice,” Journal of Women’s Health 25, no. 4 (2016): 332–39, https://doi.org/10.1089/jwh.2015.5556.
35 Ellen W. Freeman, Mary D. Sammel, Hui Lin, and Clarisa R. Gracia, “Anti-Mullerian Hormone as a Predictor of Time to Menopause in Late Reproductive Age Women,” The Journal of Clinical Endocrinology & Metabolism 97, no. 5 (2012): 1673–80, https://doi.org/10.1210/jc.2011-3032.
36 Santoro, “Perimenopause.”
37 Santoro, “Perimenopause.”
38 Henry Burger, “The Menopausal Transition—Endocrinology,” The Journal of Sexual Medicine 5, no. 10 (2008): 2266–73, https://doi.org/10.1111/j.1743-6109.2008 .00921.x.
39 “Depression & Menopause,” Menopause.org, accessed December 7, 2022, https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause.
40 Lee S. Cohen et al., “Risk for New Onset of Depression during the Menopausal Transition,” Archives of General Psychiatry 63, no. 4 (2006): 385, https://doi.org/10 .1001/archpsyc.63.4.385.
41 Jessica A. Harder et al., “Brain-Derived Neurotrophic Factor and Mood in Perimenopausal Depression,” Journal of Affective Disorders 300 (2022): 145–49, https://doi.org/10.1016/j.jad.2021.12.092.
42 Ekta Kapoor et al., “Association of Adverse Childhood Experiences with Menopausal Symptoms: Results from the Data Registry on Experiences of Aging, Menopause and Sexuality (Dreams),” Maturitas 143 (2021): 209–15, https://doi.org/10 .1016/j.maturitas.2020.10.006.
43 Jennifer Chesak, “Can Trauma Affect Our Metabolic Health?” Levels Health, last updated September 30, 2022, https://www.levelshealth.com/blog/can-trauma-affect-our-metabolic-health.
44 Huseyin Cengiz, Cihan Kaya, Sema Suzen Caypinar, and Ismail Alay, “The Relationship between Menopausal Symptoms and Metabolic Syndrome in Postmenopausal Women,” Journal of Obstetrics and Gynaecology 39, no. 4 (2019): 529–33, https://doi.org/10.1080/01443615.2018.1534812.
45 Monica De Paoli, Alexander Zakharia, and Geoff H. Werstuck, “The Role of Estrogen in Insulin Resistance,” The American Journal of Pathology 191, no. 9 (2021): 1490–98, https://doi.org/10.1016/j.ajpath.2021.05.011.
46 Substance Abuse and Mental Health Services Administration, “People at Greater Risk of Suicide,” SAMHSA.gov, accessed November 12, 2022, https://www.samhsa.gov/suicide/at-risk.
47 Jayashri Kulkarni, “Perimenopausal Depression—An Under-Recognised Entity,” Australian Prescriber 41, no. 6 (2018): 183–85, https://doi.org/10.18773/austprescr .2018.060.
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