Did you know that on days 5 through 14 of our cycles, we’re more sensitive to pleasure? Or that your biggest risk of relapse is on days 23 to 28? Or that less production of a neuropeptide we possess is linked to less drinking in pregnant rats?
Me either.
The hormonal impact on addiction, relapse, and recovery for those who menstruate is significant—simple actions, such as setting a quit date based on your menstrual cycle, impact the intensity of cravings and the likelihood you’ll abstain.
The fact that I’ve written a book on women and alcohol and am just considering this information now, eleven years into recovery from alcohol addiction, is telling. Why don’t we know these things? Why is there so little research performed on how our periods or changes in our reproductive cycle affect our consumption of drugs, rates of addiction, and treatment outcomes?
In this 90-minute podcast, Dr. Kristen Schmidt, an addiction psychiatrist and researcher who focuses on the intersection of SUDs and hormones, and I discuss what the hell is up, and Kristen provides a wealth of information that every one of us who cycle (past or presently) need to understand.
This is long, there’s a ton of information—here’s the transcript; resources are linked. (Get your notebook and pen!)
Sources, resources, transcript, and additional show notes below. Using psychedelics in recovery, part 3 is coming Monday.
Thanks for being here.
Menopause, perimenopause, and questions for follow up podcast
At 70 minutes in we hadn’t gotten to your questions about peri-menopause or menopause, so we’re doing an entire follow-up episode on it. If you have questions for Kristen about how menopause or perimenopause affects recovery (and vice-versa), or just any questions at all about this subject, please add them to the comments or reply to the email sent to you.
Transcript
Resources
Mayo Clinic Podcast, Read. Talk. Grow., “What you stand to gain when you give up drinking” (this was the podcast we did together, mentioned up front)
Hazeldon/BF Foundation, “Overcoming Addiction: Why It is Different for Women with Dr. Kristen Schmidt”
“The role of GABAA receptors in mediating the effects of alcohol in the central nervous system”
Psychology Today, “Do Estrogen and Progesterone Influence Addictive Behavior?”
Image of cycle with follicular and luteal phase called out
Sources
Schmidt, KA, Aoun, Elie. “Psychoneuroendocrinology and Addiction” chapter of The Assessment and Treatment of Addiction: Best Practices and New Frontiers, edited by Drs. Itai Danovitch and Larissa Mooney. In print. 2019 Jan
Schmidt KA, Ho A, Frye MA, Choi DS. Association of plasma orexin A and ethanol-drinking behaviors in pregnant rats. J Alcohol Drug Depend. 2016;4(5):1e6.
Schmidt KA, Lancia AJ, Alvi S, Aldag J. Alcohol reduction in the first trimester is unrelated to smoking, patient or pregnancy characteristics. Addictive Behaviors Updates. 2017 Apr
Sichel D, Driscoll JW. Women’s Moods: What every woman must know about hormones, the brain, and emotional health. Quill. 1999.
Joyce K et al. Retrospective and prospective assessments of gambling related behaviors across the female menstrual cycle. Journal of Behavioral Addictions 8(1), pp.135-145. 2019.
Hayaki J et al. Menstrual cycle phase, alcohol consumption, alcohol cravings, and mood among women in outpatient treatment for alcohol use disorder. Psychol Addict Behav. 2020: 34(6):680-689.
Joyce KM et al. Changes in coping and social motives for drinking and alcohol consumption across the menstrual cycle. Depression and Anxiety. 2018:5;313-320.
Hmidovic A, Soumare F, Naveed A, Davis J. Mid-luteal progesterone is inversely associated with premenstrual food cravings. Nutrients 2023, 15, 1097.
Holzhauer CG, Wemm SE, Wulfert E, Cao ZT. Fluctuations in progesterone moderate the relationship between daily mood and alcohol use in young adult women. Addict Behav 2020; 101.
Allen SS,Bade T,Center B,Finstad D,Hatsukami D. Menstrual phase effects on smoking relapse. Addiction. 2008; 103:809e821.
Joyce KM, Good KP, Tibbo P, Brown J, Stewart SH. Addictive behaviors across the menstrual cycle: a systematic review. Arch Womens Ment Health. 2021 Aug;24(4):529-542. doi: 10.1007/s00737-020-01094-0. Epub 2021 Jan 6. PMID: 33404701.
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