Cannabis, Psychedelics, and Other Substance Use to Manage Premenstrual Symptoms: A Survey Study

Background: Despite increasing interest in the medical use of substances such as cannabis and psychedelics, little is known about their use to manage premenstrual symptoms. This study assessed self-reported use of substances to manage premenstrual mood and physical symptoms, including among those with premenstrual dysphoric disorder (PMDD) and in perimenopause. Methods: Inclusion criteria were age 18 and older with a menstrual cycle within the past year. Participants responded to an online survey querying the use of substances (alcohol, nicotine, cannabis, psychedelics, cocaine, stimulants, opiates, benzodiazepines) to manage premenstrual or perimenopausal symptoms, including frequency in the follicular and luteal phases of the menstrual cycle. Premenstrual symptoms were assessed via the Premenstrual Symptoms Screening Tool (PSST). Participants were categorized as PMDD if diagnosed by a health care provider via daily symptom tracking for two menstrual cycles. Results: Seven hundred and three individuals responded; 634 reported a menstrual cycle in the past year ( n = 167 PMDD). To manage premenstrual mood symptoms, participants most commonly used cannabis (30.0%), alcohol (16.1%), and psychedelics (5.9%), with higher percentages within the PMDD group (51.5% cannabis, 16.2% psychedelics). PSST score positively correlated with luteal frequency of cannabis and nicotine use ( p s < 0.01). Cannabis ( p < 0.01) and psychedelics ( p < 0.005) were used more frequently in the luteal phase than the follicular. Among n = 45 who reported perimenopausal symptoms, cannabis was most frequently used to manage symptoms. Conclusions: This study was the first to assess psychedelic use across the menstrual cycle. These data underscore the need for research to assess the efficacy of these substances for premenstrual and perimenopausal symptoms.