Is MDMA More Dangerous For Women?

By Victoria Kim 10/13/15

Could a woman's reproductive system be the cause of the difference?

woman mdma tongue.jpg

According to a new study, women are more susceptible than men to the effects of MDMA, which range from feeling anxious and depressed to developing hyponatremia. Though limited, the research points to the chemical differences in the female reproductive system.

The currently available research has demonstrated that women are more susceptible to clinical depression after using MDMA, or ecstasy, because they are more sensitive to the drop in serotonin levels that accompany the comedown from MDMA.

“Women appear to experience the psychoactive effects of MDMA more strongly than men, and they have more negative effects such as feeling anxious, depressed, dizzy, or sedated while under the influence,” said Gillinder Bedi, an assistant professor of clinical psychology at Columbia University.

In addition to higher levels of depression, other studies found that in general, women reported worse sleep quality and lower scores on the mental health scale than men after taking ecstasy.

Of course, factors like body weight or whether an individual is drinking or taking more than one drug could skew one’s reaction to MDMA. But it turns out that the female reproductive system plays a significant role in how a woman reacts to the drug.

A study published in 2015 in which scientists gave MDMA to rats of both genders which had their testicles and ovaries removed found the drug had the strongest effect on female rats with an intact reproductive system. The researchers concluded that “the increased sensitivity of the females can be explained by an increased reactivity of the serotonin system due to the effect of ovarian hormones.”

Research into the apparent difference between male and female reactions to MDMA is limited. Women are often excluded from molecular imaging drug studies because their changing hormone levels present potential complications that can be avoided by studying men, according to medical doctor and post-doctoral researcher from the Imperial College London, David Erritzøe.

But as Broadly. notes, if there are truly gender differences in the way men and women react to drugs, the current advice given about taking substances is based on data that does not necessarily fully apply to women.

This is problematic because according to the 2015 Global Drugs Survey, which collected data from 23,000 ecstasy users from 25 different countries, women were nearly two times more likely than men to be admitted to the hospital after taking MDMA in 2014.

It is also pretty concerning considering that the potentially fatal hyponatremia is more common in female ecstasy users. In fact, almost 90% of cases of ecstasy-induced hyponatremia reported to the California Poison Control System over a five-year span involved women.

Hyponatremia affects MDMA users because the drug both makes one feel excessively thirsty and stimulates the secretion of the antidiuretic hormone AVP, which stops one from urinating.

The difference in effect is “perhaps related to the phase of the menstrual cycle” and could “explain [women’s] individual tendency to develop hyponatremia after doses of MDMA not considered to be excessive,” said researchers who tested the blood concentration of ravers at the Awakenings Festival in the Netherlands and found that 27.3% of the women had mild hyponatremia compared to just 3% of men.

Which is why the common advice to stay hydrated and drink lots of water while on ecstasy was "fatal advice" for women like Leah Betts, whose blood sodium levels had become dangerously diluted and her brain swelled and fatally squeezed against her skull after taking MDMA on her 18th birthday 20 years ago.

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Victoria is interested in anything that has to do with how mind-altering substances impact society. Find Victoria on LinkedIn or Tumblr