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Your History of Trauma Matters for Menopause

May 2, 2024

Plus, how psilocybin may be able to help with symptoms of this major mid-life change

Written By Jennifer Chesak, Author of The Psilocybin Handbook for Women

With severe asthma, I was seriously ill as a child. I was frequently hospitalized,
sometimes in the intensive care unit. At one point when I was about eight, I had only
half a lung functioning, and the situation was touch and go. Hooked up to oxygen and
an assortment of other tubes, I remember crying to my mom, saying, “I just want to be
able to breathe.” But the crying only exacerbated my symptoms. I didn’t know it at the
time, but I was experiencing childhood trauma, and it had the potential to alter the
course of my health as an adult, including my experience with perimenopause in midlife.

If you go to your doctor for help with perimenopause symptoms, one thing they likely
won’t tell you is that your life’s history may be having an impact. If you’ve experienced
trauma, especially in childhood, you’re more likely to have worsened perimenopause
symptoms. Childhood trauma is often collectively referred to as adverse childhood
experiences, or ACEs. ACEs include abuse, neglect, assault, having an incarcerated
parent, bullying, poverty, natural disasters, manmade disasters, severe childhood
illness, and more. ACEs have lasting effects on our stress response. The good news is
that new research shows that psilocybin lessens our psychological response to ACEs.
Therefore, it may help ease perimenopause symptoms.

We have two main arms to our autonomic nervous system. One is the sympathetic
nervous system, often called “fight or flight.” The other is our parasympathetic nervous
system, often called “rest and digest.” They work somewhat in opposition to each other.
Think about a time when you heard bad news or were highly stressed. Maybe you threw
up or had other gastrointestinal issues. This is because when we’re in fight-or-flight
mode, our body directs all resources to helping us manage the threat. Hence, our
digestion temporarily takes a backseat. When the threat is over, our stomach settles

Well, when we’ve experienced a trauma, our fight-or-flight system can get low-grade
turned on all the time, making it harder for us to get back to rest and digest, where we
feel calmer. Instead, we remain in a state of hypervigilance, where even small things
can seem like a threat to our traumatized brain.

The lasting changes to our stress response from our ACEs affect how our or bodies
manage stress hormones, such as cortisol, which can impact how we manage glucose
and insulin. These changes can have profound impacts on our health in adulthood,
including our metabolic health, making us more at risk for type 2 diabetes,
cardiovascular disease, and obesity. What’s more—worsened metabolic health can also
exacerbate menopause symptoms.

About one in six adults has experienced four or more ACEs. And if you’ve experienced
four or more ACEs, you’re more likely to have worsened perimenopause symptoms,
such as depression, hot flashes, sleep disturbances, sexual dysfunction, and more.

Here’s a quick primer on menopause terminology. Menopause is really a blip in time, the
moment where you’ve had an absence of a period for 12 months. The average age of
menopause is 52. After you’ve reached menopause, you’re in post-menopause. Before
menopause, you’re in the state of perimenopause, where you’re experiencing changes
in your cycle as your ovarian reserve declines and your hormone levels shift. You may
notice perimenopause symptoms for even a decade before reaching menopause.

This bears repeating: if you’ve experienced ACEs, you might have worsened
perimenopause symptoms. That seems rather unfair. Not only do you have a history of
trauma and have endured a lot, now you’re facing a potentially more intense situation
with “the change.”

So what can you do? Find ways to train yourself to tap back into rest-and-digest mode.
We have lots of tools at our disposal to do this, including meditation, breathwork, yoga,
regular exercise, engaging in enjoyable hobbies, spending time with people we feel safe
with, cognitive behavioral therapy, etc. We also have psychedelics, like psilocybin.
Research shows that psilocybin has the potential to lessen our negative psychological
responses to our ACEs, which in turn could help ease menopause symptoms.
Psilocybin activates serotonin receptors. Through various mechanisms, serotonin
receptor activation influences the hypothalamic-pituitary-adrenal axis, which manages
our stress response.

Psilocybin may be able to help us in perimenopause in other ways too. A common
perimenopause symptom is depression. If you tell your doctor that you’re depressed in
midlife, likely they’ll prescribe you an antidepressant, such as a selective serotonin
re-uptake inhibitor, or SSRI. SSRIs are great medications that have helped many people,
including myself. By writing this, I do not want to disparage SSRIs or encourage anyone
to go off their meds, especially not without talking to your doctor and finding a safe
tapering protocol—if it’s even safe for you to go off your prescription in the first place.
However, I do have concerns about how many middle-aged people assigned female at
birth are prescribed SSRIs simply because they’ve reached perimenopause and are
experiencing symptoms.

One thing to consider is that SSRIs blunt mood. That’s how they work. Not only do they
blunt your lows (which is what we’re going for) but they also blunt your highs. Survey
research shows that psilocybin doesn’t blunt mood; instead it makes us feel more OK
with our highs and lows. SSRIs also come with side effects, such as low libido, which is
another common symptom of perimenopause and beyond. Additionally, SSRIs must be
taken every day for them to continue working. Research shows that psilocybin, when
taken as a macro-dose in a therapeutic setting, can have lasting effects on major
depression, meaning you don’t need to use it regularly. However, some people do
microdose, which is taking a minuscule amount at regular intervals.

I’m not suggesting that psilocybin is a cure-all for every perimenopause symptom under
the sun or that it’s right for everyone. It’s neither of these things. But it may be a tool
that’s right for you. To find out more, you can check out my book The Psilocybin
Handbook for Women, which has a robust section on menopause.

As for me, I’m 45 and most definitely in perimenopause. My symptoms are noticeable at
times, but they aren’t awful. I have done a lot of work in recent years to really learn how
to tap into my rest-and-digest mode when I feel fight-or-flight trying to take over. One
thing I’ve done is engage in therapeutic use of psilocybin. I can’t say for certain that the
plant medicine has changed my perimenopause trajectory, but I think it has. Additionally,
I do know that I’m now much more able to control my stress response. So again, I say
psilocybin is a tool in my arsenal and it’s done a lot for me in terms of grappling with
traumas old and new.

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