#18 — Psychedelics and the Feminine: Healing Cycles, Hormones, and the Womb

In this season 2 opening episode of The Trip Lab, I return from maternity leave with a deeply personal exploration of how psychedelic experiences mirror one of the most profound transitions in a woman’s life: motherhood.

From the sudden crash of postpartum hormones to the full dissolution of identity and the slow reconstruction of self, I reflect on how becoming a mother felt strikingly similar to a psychedelic journey — raw, disorienting, expansive, and sacred.

We dive into the neuroscience of hormonal transitions, ego death, and neuroplasticity — exploring how estrogen, the Default Mode Network, and maternal brain remodeling all connect to the psychedelic experience. We also examine the often-overlooked wisdom of the menstrual cycle, the energetic sensitivity of pregnancy, and why the womb may be one of the most powerful maps for understanding transformation and healing.

This episode is for anyone curious about the intersection of psychedelics and the feminine — whether you’ve given birth, are hoping to one day, or simply want to understand how cycles, hormones, and identity shifts can open portals into deeper layers of self.

Topics include:

• Postpartum as ego death and rebirth
• Estrogen, neuroplasticity, and the psychedelic brain
• Psychedelics and the Default Mode Network in women
• Hormonal cycles and their influence on medicine journeys
• Ancestral wisdom, womb intelligence, and the sacred feminine

Transcript

Hi everyone! Welcome back! WOW has it been a while. My last episode was published in 2023. And A LOT has happened for me personally since then. I completed my formal training in integrative medicine. I have recently stepped into the role of Medical Director of the Osher Center for Integrative Medicine at Northwestern (and on that note-- I just add that the views and opinions on this podcast are entirely my own and do not reflect the views and opinions of my employer). But even more importantly than all of that.... I became a mother. I housed a beautiful soul in my body and now he is here in the world and he is the best thing that has ever entered my life. And this transition from maiden to mother is what has sparked the topic for today-- psychedelics and the feminine.

But before we dive into today's topic, I want to start this new season with a quick pulse check on where things stand in the world of psychedelic science and medicine. It has been a busy year-- not just in the research world, but also in how psychedelic medicine is being integrated into mainstream conversations about mental health and healing. 

Let's start with the MDMA news. Back in early 2024, MAPS-- now restructured as the non-profit Lykos Therapeutics-- submitted their Phase 3 data to the FDA for approval of MDMA-assisted therapy for PTSD. The results were promising: in their second Phase 3 trial, published in Nature Medicine, 71% of participants no longer met the criteria for PTSD after only three MDMA sessions combined with therapy, compare to 48% in the placebo group (PMID 37709999). These are remarkable numbers, especially for such a difficult to treat condition. But in a surprising move, the FDA declined approval this spring, issuing what is called a Complete Response Letter. The agency didn't dispute the efficacy outright-- instead, they raised concerns about trial design, functional unblinding, and long-term safety data. In other words, participants could often tell whether they received MDMA or placebo, and the FDA felt that might have influenced outcomes. This raises a pertinent point about psychedelic research-- of course they knew, thats how these medicines work (unlike blood pressure drugs which work more behind the scenes). The placebo response is another interesting point to bring up-- but we will do a deep dive on that topic in another podcast. ... But anyways, the FDA also cited issues with therapist training protocols and potential bias in how some therapists administered the treatment (likely influenced by the unfortunate sexual assault event that came out a few years back). So this is a setback for MDMA, but not the end. Lykos is expected to resubmit data with adjustments-- and this pause gives the field time to refine protocols, improve standardization, and continue making the case for this medicine's safety and long-term impact. 

Meanwhile, psilocybin research continues to gain momentum. COMPASS Pathways has moved into Phase 3 trials for treatment-resistant depression after their earlier Phase 2b study showed that a single high dose of psilocybin significantly reduced depression scores for many participants (PMID 36322843). Additionally, institutions like Johns Hopkins and UCSF are expanding studies into psilocybin for everything from smoking cessation to anorexia nervosa (PMID 25213996). 

In Australia, as of July 2023, authorized psychiatrists can prescribe psilocybin and MDMA for treatment-resistant mental health conditions, making it the first country to officially reschedule these medications for clinical use. Access remains limited, but its a major regulatory milestone that other nations are watching closely.

Beyond clinical trials, there is a shift happening in the field-- from proving that psychedelics work, to asking HOW they work at a deeper level. Studies are exploring mechanisms like increased brain network connectivity, reduced Default Mode Network activity, and enhanced neuroplasticity. We are seeing psychedelic effects not just on mood or trauma, but also on inflammation, cognition, and even the gut-brain axis. 

There's also a growing awareness of integration-- that the medicine alone isn't the magic. It's the container, the preparation, and the meaning-making afterward that often determine whether the experience leads to lasting change. At the same time, the conversation is widening: who gets access? How do we protect indigenous wisdom while navigating a biomedical system built on patents and protocols? The psychedelic renaissance is still alive-- but it's evolving, and with that comes more nuance, more responsibility, and more possibility. So that is the landscape we are stepping into as step back into The Trip Lab.

Now, let's dive into today's topic. We are going to explore the cycles of the feminine and how that relates to psychedelics. 

Let’s begin with the body — because for so long, especially in Western medicine, the body has been treated like a machine: to be diagnosed, managed, or fixed. But what if the body — particularly the female body — is more like a landscape? One that holds memory, cycles, intuition, and grief? And what happens when psychedelics become a way of listening to that landscape more deeply?

For many women, the body is not just a vessel but a site of trauma — medical, sexual, ancestral. And much of that trauma is stored in silence. In the pelvis, the womb, the nervous system. Psychedelics often reopen access to those silent spaces — not just cognitively, but physically. Women describe feeling a deep sensation in their womb or their chest during a psychedelic journey, and only later realize they were releasing something they hadn’t been able to name. Others describe feeling their body speak — in sensation, in image, in metaphor — as if it had been waiting all along for a moment to be heard.

There’s some science to support this. We know that classic psychedelics like psilocybin and LSD act primarily on the serotonin 5-HT2A receptor — and interestingly, those receptors aren’t just in the brain. They’re also found in the gut, in the uterus, and in immune cells. So when we say these substances affect “mind and body,” we’re speaking literally. The entire system gets involved.

And that system is cyclical. The hormonal rhythm of a menstruating person shapes not only mood and energy, but also sensitivity to psychedelics. Estrogen increases 5-HT2A receptor expression (PMID: 7632619), which may explain why some people feel more sensitive to psychedelics during the days before ovulation, when estrogen peaks. Animal studies support this too — with female rodents showing stronger responses to psilocybin during estrus, their version of ovulation.

But the science is just catching up to what many women already know intuitively. Psychedelic facilitators describe how the phase of the cycle shapes the flavor of the medicine. Ovulation, for some, brings expansive clarity — a connection to something archetypally creative, even divine. Premenstrually, the medicine often feels deeper or rawer. This is the phase where shadow work emerges — grief, rage, body image, inherited pain. Some call this the ‘descent’ — the underworld part of the cycle, where truth surfaces whether you’re ready or not.

There’s even a theory — shared in retreats and healing spaces — that psychedelics amplify the body’s innate wisdom during menstruation. That the veil is thinner, the womb becomes more of a psychic channel, and ancestral voices are more easily heard. Whether metaphor or memory, the experiences reported during this time are often intense, sacred, and transformative.

Pregnancy, too, has long been seen as a heightened energetic state in ancient traditions — particularly in Ayurveda, where it’s believed that a woman becomes more porous, more attuned to subtle energy, and more spiritually open. I felt this firsthand when I was pregnant. When treating patients with OMT (hands on osteopathic manipulative treatments-- I have an episode on this), I could feel shifts in energy that I did not notice pre-pregnancy. It’s as if the boundary between physical and subtle became thinner. I imagine it was similar to what a reiki healer might notice. And while this isn’t something we can measure in a lab, many women describe a similar deepening of perception and intuition during this time.

Now, to be clear — I’m not recommending the use of psychedelics during pregnancy. We don’t have safety data, and it’s not something supported in clinical practice. But it’s worth acknowledging that in some indigenous traditions, plant medicine was — and in some cases still is — used ceremonially by pregnant women under the guidance of experienced elders. These weren’t recreational experiences. They were spiritual, relational, and rooted in a worldview where pregnancy was not a pathology to be managed, but a sacred rite of passage.

Postpartum and perimenopause bring another dimension. These are hormonal gateways — periods of radical change in identity, neurochemistry, and embodiment. And while clinical research hasn’t yet explored these phases, stories from mothers and midlife women are starting to shape a new narrative. One woman described her postpartum journey as “meeting herself outside the roles of mother or wife — just her soul, raw and alone.” Another said a psilocybin experience during perimenopause helped her forgive her body for aging — and recognize the wisdom in its changes.

All of this calls us to widen the lens. In psychedelic medicine, we talk a lot about set and setting — mindset, environment, preparation. But what about timing? What about the body’s internal seasons, its hormonal weather, its cyclical invitations?

Maybe it’s not just about finding the right dose or the right playlist. Maybe healing is also about choosing the right moment — a moment when the body is ready, the heart is open, and the veil is thin. The more we honor these rhythms, the more personal, powerful, and embodied our psychedelic healing becomes.

That was a little overview of hormonal shifts and the possibility that these can play on a psychedelic experience. Now, let's dive a little deeper into this and journey into what is actually happening in the body with hormonal fluctuations and a psychedelic experience.

Because I have experienced this recently, I want to really dive into the postpartum portal-- one of the most profound hormonal (and spiritual) transitions a human body can endure. After you give birth, your body goes through a hormonal crash that is most incomprehensible. Within 48 hours, estrogen and progesterone levels-- which have been climbing steadily for 9-10 months-- plummet by over 95%. In fact, the drop in estrogen after delivery is often compared to suddenly stopping 100 birth control pills a day... all at once. It is the most abrupt hormonal shift a person can experience outside of surgical menopause or trauma. But it's not just a chemical change. It's a psychic one. You are grieving the loss of your old life and identify, while simultaneously being asked to fall in love with this tiny human you grew for nearly a year. And really, 40 weeks is closer to 10 months when you track it through lunar cycles, which feels symbolically important. Throughout history, women have been connected to the moon-- not just metaphorically, but biologically. The menstrual cycle, the gestational cycle, the tides of mood and energy-- they all move with the moon. So when that cycle completes-- when birth happens-- it's not just physical. It's mythic. 

I am going to be completely honest, my post-partum experience was very difficulty. Especially when you throw breastfeeding into the mix, which I struggled with the entire time I was doing so. Honest to god this period of my life was darker and harder than going through general surgery residency (IYKYK). But I felt like I joined this sacred circle of mothers that no one truly understands until they have also joined the club. I thought back to all of the babies I delivered and mothers I took care of... all of my co-residents that went through this during RESIDENCY of all times... and all the mothers i passed by on the street that have also experienced this incredibly sacred... but soul destruction and rebuilding that comes with motherhood. Having Oliver is by far the best thing that ever happened to me, but it was a journey, and continues to be one. 

And this leads me to understanding the neuroscience of this expansive experience and how it overlaps so much with a psychedelic trip. 

Both involve massive shifts in the architecture of the brain — especially in regions related to identity, emotion regulation, attachment, and self-other boundaries. In postpartum, the maternal brain undergoes measurable changes in volume and activity. Functional MRI studies show increases in the size and responsiveness of the amygdala, the anterior cingulate cortex, and the prefrontal cortex — all areas that influence vigilance, empathy, and emotional sensitivity.

This is why many new mothers report feeling more tuned in to their baby's emotions, but also more easily overwhelmed, reactive, or existentially fragile. 

In psychedelic states, something similar happens. Brain imaging studies show that under psilocybin or LSD, activity in the Default Mode Network — the hub of self-referential thinking — significantly decreases. This is often called ego dissolution, when the boundary between “me” and “not-me” temporarily softens or disappears. People report feeling interconnected, porous, deeply moved by love, grief, or awe — and in some cases, completely unmoored.

Interestingly, the Default Mode Network is also highly active in rumination and narrative identity — the part of us that says, “I am this person, with this history, and these expectations.” When it quiets down, a kind of psychic rebirth becomes possible. And this is where the overlap gets really interesting.

Because postpartum is, in many ways, its own form of ego death. The identity you knew — your routines, your freedom, your sense of control — dissolves overnight. You don’t sleep, you don’t eat on your own schedule (or unfortunately at all on many days for me), you don’t know who you are. You’re flooded with love one moment, and grief the next. 

Both psychedelic journeys and early motherhood drop you into what anthropologists call a liminal state — a threshold between who you were and who you are becoming. These are neuroplastic windows, where the brain is reconfiguring itself in real time. In both cases, synaptic connections shift, new patterns are formed, and old identities are loosened.

One study from 2018 showed that psychedelics like psilocybin increase dendritic spine growth — those tiny protrusions on neurons that help form new connections — in regions like the prefrontal cortex. Another study found that postpartum women also show enhanced connectivity in these same networks, particularly in response to infant cues. The brain is literally being rewired to prioritize connection, emotional meaning, and responsiveness to life.

And both experiences — whether brought on by birth or by a compound — can make you feel cracked open, vulnerable, and profoundly alive.

Of course, one difference is that postpartum arrives whether you’re ready or not. It’s a biological initiation. Psychedelics, on the other hand, can offer a chosen encounter with these themes — a way to consciously engage with identity, grief, and transformation. But the emotional terrain can be strikingly similar.

So maybe the invitation here isn’t JUST to study psychedelics more — it’s to listen more closely to the body. To ask better questions. What if menstrual cycles, pregnancy, postpartum, and perimenopause aren’t obstacles to research but maps — revealing how consciousness changes when the body transforms? What if these transitional states hold keys to understanding not just healing, but rebirth?

We’re only beginning to scratch the surface. There’s so much we don’t yet know: How does cycle phase influence integration? Could certain windows in the hormonal rhythm be optimal for trauma release or creative insight? How might postpartum and perimenopause be honored as psychedelic in their own right — neurochemically, spiritually, mythologically?

As research moves forward, I hope we start asking these questions. I hope we begin to center women's bodies — not as variables to control for, but as sources of wisdom in their own right.

Because maybe psychedelics don’t just show us something new. Maybe they help us remember what the body already knows. That healing is cyclical. That endings are beginnings. That transformation often feels like unraveling — until we realize we’re being rewoven.