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Women, men and the life cycle: cycle, menopause and differences in response

People ask whether women and men respond differently, and whether the menstrual cycle or menopause matters. This card sets out what pooled laboratory analyses, a preprint, reviews and registered studies report, and what was not located.

Published Information current to 7 November 2026Review due by 5 February 2027

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The short answer

Do healthy women and men differ in the acute response to a classic psychedelic, and what is known about the menstrual cycle, hormonal contraception and menopause?

In laboratory studies of healthy adults recorded as women and men, most measures of the acute response did not differ significantly by sex. Two pooled analyses report some differences. The two do not agree with each other, and one applied no correction for chance findings. Whether the menstrual cycle, hormonal contraception or menopause changes the response has not been measured in people, as far as a documented search found.

What was found

Figures are as reported, not a recommendation. This marking applies to every figure in this section.

  • Pooled psilocybin studies. In 23 pooled placebo-controlled laboratory studies of psilocybin, with 261 healthy volunteers (100 women), the authors found that gender, recorded as male or female, was not significantly associated with any of 15 measures of the response. They note that the studies were not designed to look for predictors. Source 1, level 1
  • A crossover trial. In a double-blind crossover trial, 39 healthy adults were analyzed (19 women). The authors found no significant effect of sex on the acute effects or on the persisting effects measured 28 days later. Psilocybin was dosed by body weight. The authors call the results mostly exploratory and not powered. They write that women were not dosed during the menstrual cycle, so cycle phase was limited by scheduling and was not tested. Source 2, level 1
  • Pooled LSD studies. In nine pooled LSD studies with 213 healthy volunteers (108 women) and 297 sessions, the results text associates female sex, after adjusting for the amount given, with smaller increases on four subjective measures and a smaller temperature change. It does not say which of these remained after correction for 551 tests. The abstract, which reports correction for multiple testing, says sex was not a significant factor. The discussion adds that the slightly less positive experience in women was not significant in a sensitivity analysis with one dose per study. Source 3, level 1
  • A systematic review. A 2021 systematic review of 14 studies (PubMed searched) concluded that sex was not a robust predictor. It names two studies with a sex-related finding, one of self-selected online reports and one retrospective survey, and offers other explanations. Source 4, level 1
  • A preprint. The preprint, which has not been peer reviewed, pooled two laboratory studies of psilocybin, LSD and 2C-B, a synthetic compound, given at fixed amounts, in 72 healthy adults with prior psychedelic experience (40 women, 94 drug sessions). After adjusting for age, women rated five measures higher, with p values from .007 to .048. The authors applied no correction for multiple comparisons, call the findings preliminary, and did not assess cycle phase. Blood levels of the drugs did not differ by sex. On “good drug effect” this points the opposite way from the LSD analysis above (source 3). Source 5, level 3
  • Rodents. In rodents, a 2026 review reported that ovarian cycle phase was the most consistent predictor of whether a sex difference appeared, from a small number of studies, and cautioned against generalizing the direction or size of differences. This was not tested in people. Source 6, level 1, in rodents

What is not known?

“As far as a documented search found” means that searches on 7 November 2026 of PubMed, ClinicalTrials.gov, Europe PMC and the Australian New Zealand trial registry returned no human study with results on cycle phase, hormonal contraception or menopause and the acute response. Google Scholar, PsyArXiv and OSF were not searched. More searching could change this.

  • Whether cycle phase, hormonal contraception or menopause changes the response in people. A 2026 narrative review states that direct human evidence linking cycle phase or hormone levels to altered metabolism of these drugs remains lacking (source 7). A 2025 perspective article states that no study had systematically examined hormonal contraception and psychedelic responses in women (source 8). One registered open-label protocol, of low-dose psilocybin at different cycle phases in 21 healthy women, was listed as not yet recruiting and has no results (source 9). A registered trial in healthy women studies the effect of ayahuasca or esketamine on the cycle, which is a different question (source 10).
  • Whether small differences exist that these samples could not detect, or whether they differ for other substances, settings or longer follow-up.
  • Anything about people not recorded as women or men. The studies used two categories and report nothing for anyone outside them.

What this card does not say

  • It does not say that women and men respond the same way, or differently.
  • It says nothing about timing, amounts or what any person should do.
  • Sex here means the category recorded in each study, not identity.
  • It covers healthy adults and no diagnosed groups. Pregnancy and age are separate topics, not yet written up.
  • It does not rate how risky, safe or worthwhile anything is.

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Where does this come from?

Grade key: 1 = peer-reviewed publication, official document or primary record. 3 = grey source, here a preprint. A grade names the type of source and says nothing about its quality, and the design and limits are given in the text. “Read” means the passages named were read in full on the date given, and any part not read is named. A source read only in part carries no claim on this card.

Review due by 5 February 2027.

  1. Studerus E, Gamma A, Kometer M, Vollenweider FX. Prediction of psilocybin response in healthy volunteers. PLoS One 2012. DOI 10.1371/journal.pone.0030800 PMID 22363492. Grade 1. Pooled analysis. Full text, results, discussion and limitations re-read 7 November 2026 (supplements not read).
  2. Klučková T et al. The phenomenology of psilocybin's experience mediates subsequent persistent psychological effects independently of sex, previous experience, or setting. Pharmacol Rep 2025. DOI 10.1007/s43440-025-00742-5 PMID 40522607. Grade 1. Double-blind crossover trial. Full text read 7 November 2026 (supplement not read).
  3. Vizeli P et al. Pharmacological and non-pharmacological predictors of the LSD experience in healthy participants. Transl Psychiatry 2024. DOI 10.1038/s41398-024-03074-9 PMID 39231959. Grade 1. Pooled analysis. Full text read 7 November 2026 (supplement and figures not read).
  4. Aday JS et al. Predicting reactions to psychedelic drugs: a systematic review of states and traits related to acute drug effects. ACS Pharmacol Transl Sci 2021. DOI 10.1021/acsptsci.1c00014 PMID 33860172. Grade 1. Systematic review. Passages on sex re-read 7 November 2026.
  5. Mason NL et al. Sex differences in acute responses to psychedelics: evidence for greater subjective intensity and impairment in female participants. bioRxiv 2026, version 2. DOI 10.64898/2026.07.08.737179. Grade 3. Preprint, not peer reviewed. Main text and supplementary text of version 2 read 7 November 2026 (tables and figures not read).
  6. Marecki R et al. Sex-dependent effects of psychedelics: review of evidence from rodent models. Front Psychiatry 2026. DOI 10.3389/fpsyt.2026.1824073 PMID 42528876. Grade 1, in rodents. Discussion re-read 7 November 2026.
  7. Kuypers KPC et al. Psychedelics and women's mental health: the effects of female sex hormones on psychedelics' efficacy and tolerability. Mol Psychiatry 2026. DOI 10.1038/s41380-026-03801-2 PMID 42552418. Grade 1. Narrative review. Pharmacokinetics section re-read 7 November 2026. Three authors also wrote source 5.
  8. Cohen ZZ, Blest-Hopley G. Females in psychedelic research: a perspective for advancing research and practice. ACS Pharmacol Transl Sci 2025. DOI 10.1021/acsptsci.5c00255 PMID 40672681. Grade 1. Perspective article, which is opinion. Passages cited re-read 7 November 2026.
  9. Australian New Zealand Clinical Trials Registry, ACTRN12625000991415. Registry record. Grade 1. Registry record, read 7 November 2026.
  10. ClinicalTrials.gov NCT07317232. Registry record. Grade 1. Registry record, read 7 November 2026.