How drugs affect women’s bodies
Harm reduction is about having the knowledge to make safer choices. Understanding how drugs might affect your body can help you recognise risks and make informed decisions.
Drugs during the menopause
For a long time, stigma has made it difficult to talk openly about menopause and perimenopause. Learning about our changing bodies empowers us to make informed decisions about the support we need.
Menopause, perimenopause, and drug or alcohol use can all affect your wellbeing. If you notice changes in your symptoms, substance use, or the way drugs or alcohol affect you, we encourage you to discuss them with a health professional.
What are menopause & perimenopause?
Menopause is when your body has stopped producing eggs, resulting in hormone changes and the end of menstruation (periods) for 12 months in a row. It marks the point when you can no longer become pregnant naturally.
Perimenopause is the transitional phase leading up to menopause, when you may experience symptoms while still having periods.
Menopause and perimenopause can affect both physical and emotional wellbeing. For some women, these changes can make day-to-day life more challenging, which might lead to using drugs more frequently as a way to cope.
Symptoms of menopause
Common symptoms include:
- Low mood
- Anxiety
- Poor sleep
- Hot flushes
- Brain fog
Menopause can have a significant impact on mental health. Some women experience stress, anxiety, low mood or depression for the first time, while women with existing mental health conditions may find they become harder to manage.
How menopause affects alcohol & drug use
During perimenopause and menopause, women will have lower levels of oestrogen. While this does not directly cause someone to use drugs or alcohol, hormone changes may affect the brain and body in ways that increase cravings and vulnerability.
Some women may use alcohol or drugs as a way to cope with menopause or to try and manage their symptoms. Research into menopause and substance use is underexplored, but there is evidence to suggest menopausal and perimenopausal women may find changes to their patterns of alcohol and drug use, and that it feels different to before.
Effects of different drugs
We have prepared this guide to the ways menopause and perimenopause may contribute to increased or more harmful drug use, helping you to better understand potential risks and know where to find support.
Opioids
Long-term opioid use can cause menopause-like symptoms, such as lower levels of oestrogen and other sex hormones, and you may not have regular periods. You may have:
- Hot flushes
- Night sweats
- Low libido
- Vaginal dryness
- Depression
- Sleep problems
This may make it harder to recognise symptoms of menopause and perimenopause if you use opioids.
There is some evidence to suggest that long-term opioid use may contribute to early menopause and reduced ovarian function.
Both opioid use and menopause can increase the risk of bone problems, including osteoporosis.
If you are receiving methadone or buprenorphine, it is important to have regular checks of your symptoms to understand how opioid substitute treatment may be affecting your hormones.
Alcohol
According to one study, menopause and perimenopause can increase alcohol use, even among people who have previously been sober. Studies have also suggested that heavy drinking could lead to an earlier menopause.
The mental health impacts of menopause, such as stress and depression, trigger some women to start consuming alcohol, or to increase the amount they drink.
There is some evidence to suggest that perimenopause can reduce your body's ability to metabolise alcohol. This means your body may process alcohol more slowly, and you may feel its effects more strongly than before.
Different types of alcohol might worsen menopausal symptoms. Binge drinking and regular alcohol use can worsen hot flushes and increase night sweats, and some studies have found red wine can trigger both of these symptoms.
Menopause and perimenopause can make it harder to fall asleep and change sleeping patterns. Alcohol can also make it harder to get a proper rest.
Menopause reduces bone density and increases the risk of osteoporosis. Drinking can accelerate bone loss and make it more likely you’ll have falls.
Stimulants
Evidence about stimulant use is weaker than the evidence about alcohol or opioid use, as there have been far fewer studies in this area.
Declining oestrogen appears to affect dopamine function which is central to stimulant use.
Menopause and perimenopause may increase vulnerability and use of stimulants because of their effects on mood, stress, sleep and the brain’s reward system. Some women may increase stimulant use to cope with mental health difficulties during menopause.
Like other drugs, the symptoms of menopause overlap with the effects of stimulant use, and can also look similar to stimulant withdrawal, which may lead to women who use stimulants getting the wrong diagnosis.
There is some evidence to suggest menopause might be a risk factor for relapse in women experiencing symptoms.
Ketamine
Research suggests that ketamine and oestrogen interact with each other. This is important because menopause and perimenopause are linked to changing, fluctuating and declining levels of oestrogen, which may affect how your body responds to ketamine and how sensitive you are to its effects.
The strongest area of evidence on ketamine use and menopause is its use in treating menopausal depression as an alternative to antidepressants.
Like other drugs, some symptoms of menopause and perimenopause can be similar to the effects of ketamine use. For example, both can cause urinary tract symptoms. Telling the two apart can be difficult, so always seek advice from a medical professional to reduce the risk of longer-term health problems.
Talking about menopause & substance use
Social stigma tends to make it more difficult for women to access support and treatment for harmful use.
If you think menopause or perimenopause may have caused you to begin or increase consumption of alcohol or drugs, it’s important to discuss this with a health professional or a worker at a substance use service such as the WiSE Project. There are options to help manage your symptoms, reduce triggers for harmful use, and improve your overall wellbeing.
Hormone replacement therapy (HRT) is often prescribed to manage menopausal and perimenopausal symptoms. Some women find it reduces the impact of their symptoms and helps them feel healthier, and able to live the life they choose.
Consider keeping a note of the days and times you experience symptoms as well as when you use drugs. This can help to identify themes and patterns.
Just because your symptoms are similar to ones you’ve experienced previously when using alcohol or drugs, please do not ignore them. Symptoms can also be linked to menopause or perimenopause, so always seek medical advice.
You don’t have to go through this alone
Every woman experiences menopause differently, but no-one should have to face it on their own. WiSE offers a safe space to connect with other women who’ve had similar experiences, without shame, stigma or judgement.
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Menstrual cycle & drug use
Across your menstrual cycle, you’re likely to experience cravings, different sensitivities to drug use, withdrawal and relapse, and changes in your mood and emotions. Understanding your cycle is important when thinking about how you use drugs and alcohol.