Premenstrual dysphoric disorder (PMDD) is a condition experienced by many women throughout their lives in the days leading up to their period. Unfortunately, there are only a few types of treatments for this condition, and most of them are ineffective. However, some women claim that psychedelic microdosing could help them alleviate some of the remaining problems that were not solved through conventional treatments.
Let us explore the potential of these claims.
What is Premenstrual Dysphoric Disorder (PMDD)
PMDD, or premenstrual dysphoric disorder, is a severe form of premenstrual syndrome (PMS). PMDD symptoms include depression, anxiety, irritability, and mood swings, as well as physical symptoms such as fatigue, bloating, and breast tenderness.
What is the Cause of PMDD?
There are many symptoms, and many causes for PMDD, which can interact with one another. Let us review these to better understand how to treat them holistically.
Progesterone & Oestrogen Imbalance
From a scientific perspective, it is not exactly clear what causes PMDD. The most common theory is that it is triggered by an imbalance in the female hormones progesterone and oestrogen. Progesterone is produced before the onset of the menstruation period, and the female hormone cycle is particularly sensitive to its metabolic byproducts. There may also be genetic predispositions in some people, where the interaction between progesterone and neurotransmitters in the brain causes stress reactions.
Some researchers believe that PMDD is also caused by inflammation, as there is clinical evidence for the effectiveness of anti-inflammatory medicines and antibiotics in treating PMDD. Elevated levels of inflammatory biomarkers are also linked to PMDD symptoms, such as anxiety, mood changes, abdominal cramps, muscle pain, and weight gain. For that reason, anti-inflammatories are often used as the first line of treatment.
Altered melatonin levels leading up to menstruation can also be responsible for sleep difficulties. In the second half of the hormone cycle, nocturnal melatonin levels are prolonged and rise only to a much lower rate, thereby disrupting healthy sleep patterns.
Other Health Patterns
Other contributing factors that can worsen PMDD are nicotine and alcohol consumption or the lack of sleep and exercise.
Physical Symptoms of PMDD
PMDD can cause numerous physical symptoms, such as headaches, sleep disorders, abdominal pain, circulatory problems, edema, food cravings, weight gain.
Psychological Symptoms and PMDD
Psychological symptoms include poor concentration, lethargy, exhaustion, irritability, hypersensitivity, and mood swings. Moreover, these symptoms are often accompanied by the worrying thoughts and dread of anticipating that ‘time of the month’. “Will I be able to concentrate at work? Will I be too sick to get out of bed? How will my behavior affect my relationship with others?”
In addition, many times when women come to their doctors and describe how their symptoms affect their daily lives, they are often dismissed as exaggerations. This places an extra psychological burden on women who are already struggling with other PMDD symptoms.
Problems With Conventional Treatments for PMDD
The most common prescription drugs for relieving PMDD are Ibuprofen, birth control pills, and antidepressants. But there are significant issues with this line of treatment, and there is no treatment available that is effective for all women with PMDD.
Ibuprofen & Anti-Inflammatories
Ibuprofen is an anti-inflammatory medication that is most frequently prescribed for treating PMDD. But anti-inflammatory drugs like Ibuprofen do not target mental factors such as stress, leading up to the onset of PMDD and the menstruation cycle.
Women who suffer from stress and trauma are also more likely to develop PMDD, which is why antidepressants are administered in addition to pain-relieving drugs like Ibuprofen.
Birth Control Pills
These types of side effects are also often reported within PMDD, so this treatment is far from being adequate in terms of restoring healthy quality of life.
If PMDD has significant psychological effects – such as depressive moods, feelings of anxiety, and despair – women are typically prescribed SSRI (selective serotonin reuptake inhibitor) antidepressants. These drugs increase the concentration of the neurotransmitter serotonin in the brain. Serotonin is thought to have an impact on how the body responds to certain hormones that are released in excess before menstruation.
Although scientific studies have shown that SSRIs can alleviate psychological symptoms of PMDD, they take too long to take effect before the menstruation period. Moreover, SSRIs can also cause side effects such as nausea, insomnia, and orgasmic disorders.
Can You Treat Premenstrual Dysphoric Disorder (PMDD) With Psychedelics?
As a result of the problem with conventional treatments, women have begun to seek out other alternatives such as psychedelics, which can help treat depression. As of yet, there are no major clinical trials underway, but we can explore potential mechanisms as to why these drugs might have some advantages to existing PMDD medications.
Psychedelics as Fast-Acting Antidepressants
Psychedelics, such as LSD, psilocybin, or DMT, act as serotonin agonists, which means they activate the same receptors as naturally occurring serotonin.
Unlike SSRIs, they do not interfere with the production of our natural serotonin supply, but they activate the receptors for much longer, as they literally get stuck inside the serotonin receptors. For that reason, these drugs are presumably less obtrusive on the production of hormones. More importantly, psychedelics are very fast-acting antidepressants, as their effects kick in within a few hours, unlike SSRIs which take much longer.
A recent study compared the antidepressant efficacy of psilocybin versus SSRIs in combination with psychotherapy and found that just two separate doses of psilocybin could achieve the same level of improvements as using SSRIs daily for 6 weeks. Most importantly, these drugs are fast-acting, their effects kick in within hours, so they are much better suited for treating symptoms of PMDD immediately. And a single dose of drugs like psilocybin, ketamine, or ayahuasca will promote neuroplasticity and an afterglow period lasting for a whole week. This could also have a beneficial effect on sleep.
Overall, psychedelics have numerous properties which make them ideal candidates for treating PMDD, although clinical trials are yet to prove this scientifically.
Benefits of Psychedelic Microdosing for PMDD
In recent years, microdosing drugs like psilocybin or LSD have become a popular trend. Within this practice, people take just a tiny amount of a psychedelic substance and ingest it every three days. By doing so, they hope to gain some of the benefits of psychedelics that are not directly linked to their perceptual effects.
Let’s review some of these benefits with respect to their potential for treating PMDD.
Psychedelics Microdosing Against Inflammation
Next to treating depression, psychedelics also show promise as anti-inflammatory agents. Depression has been linked to inflammation, and psychedelics are believed to dampen inflammatory processes of the immune system via serotonin, which means they can potentially treat a whole range of diseases such as asthma and cardiovascular diseases. Inflammation is an important contributor to PMDD symptoms, therefore psychedelics could potentially treat its symptoms through their anti-inflammatory properties.
Psychedelic Microdosing Against Pain
Many people in the microdosing communities use psychedelics to combat cluster headaches, and a recent study shows that microdosing LSD can decrease pain perception. It is not clear whether this is because of its anti-inflammatory abilities, but it seems that psychedelics could offer a substitute for drugs like Ibuprofen, next to their antidepressant effects. Research on the potential of using psychedelics as a new form of pain medication is still in its infancy, but early results are promising.
Psychedelic Microdosing as an Alternative to Ibuprofen?
Based on the above evidence, psychedelics can potentially treat both pain and inflammation, as well as mental symptoms such as depression and anxiety. Physical symptoms are typically treated by anti-inflammatory drugs like Ibuprofen, and mental symptoms are treated by SSRIs. Psychedelics could potentially treat both, but more research is needed to back up this hypothesis.
Why Are Women Microdosing?
Many women have begun ‘microdosing’ to gain the benefits of psychedelics, at a lower dose that can be readily integrated into their daily life.
One of the main proponents of this trend is the New York Times bestselling author Ayelet Waldman who wrote a practical guide on microdosing titled “A Really Good Day“. She recounts how LSD microdosing saved her life and marriage, as well as helped her move past suffering from PMDD. Her PMDD had been misdiagnosed as a Bipolar disorder, and her marital relationship suffered heavily from frequent mood swings. But once she tried LSD microdosing it turned her into a much more calm and relaxed person. Her positive experiences left her convinced that psychedelics should be considered as safer alternatives to drugs like Adderall or other mood and performance-enhancing drugs.
How To Microdose Effectively For Women?
Since no woman’s menstrual cycle is the same, microdosing is a viable way of starting out with a smaller dose to combat PMDD. Later on, it can be tailored to the symptoms of the body, following a dose range and a frequency that works best.
Currently, there are no established scientific guidelines on how to microdose effectively. For those reasons, we do not encourage anyone to self-medicate with psilocybin without consulting a certified medical professional! Furthermore, we advise you to consider the legal status of these psychedelics in your country to avoid legal consequences and persecutions.
Do Psychedelics & Microdosing Have Side-Effects?
Psychedelics act as powerful medicines at very low doses. Compared to birth control pills and SSRIs they have negligible effects on the hormonal system because they are only intended to be used occasionally. Animal studies have shown that at lower doses, psychedelics such as LSD show virtually no interference with the hormonal system. A microdose is typically defined as one-tenth of a normal dose, but a full dose can also vary from person to person.
Psychedelics are also non-addictive because the body becomes instantaneously tolerant to its effects the next day, which means there is no real risk of overdose. Microdosing may be useful because it does not carry the risk of having a “bad trip”, and because their effects are sub-perceptual, they can be integrated into a regular workday. However, some researchers have raised concern that the long-term effects of chronic microdosing can lead to valvular heart disease, and reduction of neuroplasticity, over time. Other side effects, such as Hallucinogen Persisting Perception Disorder (HPPD), are also still very poorly understood.
New Frontiers for Psychedelic Research and Women’s Medicine
In the current era of research, women are excluded from clinical trials, because researchers aim to minimize the influence of additional factors like the menstruation cycle. As a result, clinical research has neglected biological factors that are unique to women’s health and has stunted innovation in the field of women’s medicine for decades. Psychedelic medicine is not exempt from gender bias, although fortunately, new female-led tech companies are beginning to develop protocols for treating menopause and PMDD.
Women have been suffering from PMS and PMDD without adequate treatment options, and the mental toll of this condition is often overlooked by society. The current means of treatment, such as birth control pills or antidepressants, take a demanding toll through interference with the hormonal system. Psychedelics may offer a less invasive alternative to alleviating these symptoms, although thorough research on this topic is still necessary.
While we do not encourage self-medication with these drugs, many women have begun self-experimenting with psychedelic microdosing as a means of exploring self-tailored treatment options. With time, microdosing psilocybin may perhaps finally turn the tide for finding more effective treatments for PMDD, but more research is necessary to confirm these claims according to the standards of robust clinical science.