In this episode, Alicia Bigelow, ND joins to discuss the potential of psychedelic medicine to support the menopause transition. Dr. Ali Bigelow is a naturopathic physician, ketamine provider and licensed psilocybin facilitator in Portland, OR. She leads individual and group retreats, enjoys incorporating live music into her sessions when desired, and is passionate about supporting those navigating life transitions, such as end of life and menopause, through her low dose group, Menomorphosis. Dr. Bigelow will be doing retreats in 2026 with Rise Up Journeys at RiseUpJourneys.com

In this conversation, Dr. Bigelow explores the emerging intersection between psychedelics and the menopausal transition, framing perimenopause and menopause as profound neuroendocrine, psychological, and existential shifts rather than merely clinical syndromes. She also discusses how hormonal changes—particularly declining estrogen—interact with serotonin, inflammation, and neuroplasticity, potentially shaping psychedelic experiences and outcomes. Throughout the discussion, Dr. Bigelow emphasizes the unique capacity of psychedelics to support self-actualization, identity reformation, and meaning-making during midlife, especially when combined with hormone therapy, intentional integration practices, and strong community support.

In this episode, you'll hear:

• Why perimenopause and menopause represent a major but under-recognized neurobiological life transition
• How estrogen, serotonin receptors, and psychedelics like psilocybin may interact in midlife
• What we know (and don't yet know) about hormone replacement therapy and psychedelic efficacy
• The potential anti-inflammatory effects of psychedelics and their relevance to menopausal symptoms
• How ketamine may function differently from classic psychedelics during hormonal transitions
• Why psychedelics can support identity reorientation, self-actualization, and "not caring" in generative ways
• The critical role of community, creativity, and nervous system regulation in integration during midlife

Quotes:

"We don't honor and celebrate aging and elderhood overall in our culture. … What I do feel is really vital is that we gather and support each other in all of life's transitions, and [menopause has] not only been underrepresented, but also just under honored." [3:29]

"As [estrogen] levels decrease, there's a decrease in serotonin receptors—which is the 5-HT2A receptor. And so that reduces our sensitivity to, and activity of serotonin. And psilocybin and LSD and other 5-HT2A agonists—they can enhance their receptors and the activity of those receptors." [13:20]

"The understanding is that with [estrogen] hormone replacement therapy you would then, theoretically, see a replenishment of [serotonin] receptors, and then the psilocybin would have more ability to act on those receptors." [15:37]

"Psilocybin—and psychedelics in general—and the menopausal transition are just really beautiful complements to each other and they become even more potent when used together." [19:48]

Links:

Dr. Bigelow on LinkedIn

Dr. Bigelow on Instagram

Dr. Bigelow's website

Synaptic Institute website

Rise Up Journeys website

Psychedelic Medicine Association

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