How your menstrual cycle affects 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.

Drug and alcohol use, and your menstrual cycle, are important aspects of your health. If you notice patterns in how you use drugs during different phases of your cycle, we encourage you to discuss them with a health professional.

Understanding your body is central to reducing harms caused by alcohol and other drugs, but women tell us they’re often not sure how their period affects their drug use.

Every woman experiences her cycle slightly differently, and how it impacts her drug use will change throughout the month. But if you know when you might be more likely to use drugs and alcohol, you can take steps to make sure you’re as safe as you can be.

We’ve prepared a short guide to the different phases of the menstrual cycle, and how natural fluctuations in your hormones might affect your drug use before, during and after your period.

Phases of the menstrual cycle

Menstruation

Your period marks the start of the cycle, and usually lasts around five days. During menstruation, as well as bleeding, your oestrogen and progesterone levels are lower.

You may well experience cramping and other discomfort throughout this stage of your cycle, which can sometimes lead to using drugs or alcohol to self-medicate your pain.

Follicular phase

The follicular phase technically begins on the first day of the menstrual cycle and overlaps with your period. But around the sixth day of your cycle, after bleeding stops, your oestrogen levels rise over the course of a week or so.

You may notice improvements to your mood, energy and activity levels. At the same time, you may experience increased sensitivity to the rewarding effects of drugs, higher motivation to use, and a greater likelihood of developing addictive patterns of use.

Ovulation

Around 14 days into your cycle, your oestrogen levels peak and you'll begin to ovulate.

You may feel more sociable, more sensitive to the rewarding effects of drug use, and more likely to take risks or try sensation-seeking behaviours. You may also be more likely to binge.

Luteal phase

The luteal phase begins around day 15 of your cycle and lasts for about two weeks. Your levels of the hormone progesterone rise and then fall.

You may experience premenstrual symptoms, including lower mood and higher levels of irritability, anxiety and stress. You may find that the impact of drug use is reduced, which can increase the risk of using more or experiencing a relapse.

This stage of the menstrual cycle may also be associated with increased use of drugs or alcohol to cope with negative emotions.

Consider keeping a calendar of drug use throughout your menstrual cycle. Beginning at the start of your period, note down the different moods and emotions you experience during the course of the month to see if they line up with how you use.

Effects of different drugs

Different drugs affect different hormones, so how you feel during your cycle will depend on what you use.

You may experience stronger alcohol cravings before your period, particularly during the luteal phase, which can increase the likelihood of drinking. You may also notice changes in your tolerance to alcohol at different points in the menstrual cycle.

If you ovulate and use heroin or receive methadone treatment, you may experience amenorrhoea (the absence of menstrual periods). This can lead some women to believe they cannot become pregnant, or to mistake early signs of pregnancy for withdrawal symptoms.

Opioids can also change how you experience pain, which may lead you to use more during the more painful stages of your cycle. You may also notice that withdrawal symptoms change throughout the menstrual cycle.

Changes in oestrogen levels can influence how stimulant drugs affect you. You may experience stronger effects during the follicular phase and around ovulation, when oestrogen levels are higher. Some research suggests that women may progress from use to dependence more quickly during these stages of the menstrual cycle.

Knowing how your menstrual cycle might affect your drug use can help you recognise patterns, make informed choices and be kinder to yourself when things feel more difficult. You’re not alone in these experiences, and support is available.

If you’d like to be among women who get what you’re experiencing, in a safe and supportive space, the WiSE Project is here for you.

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