Disclosure: Melissa Whippo founded Deva Collective and is running the survey this article recruits for.
Perimenopause is a life cycle transition influenced by hormonal fluctuation with a constellation of symptoms that varies from woman to woman. Despite the significance of this transition occurring for tens of millions of people, it is one of the least understood shifts occurring during a woman’s life. Unfortunately, this pattern extends throughout all women’s health. Beyond reproduction, women’s biology, including their hormonal, immune, neurological, metabolic, and pharmacological differences, was not systematically incorporated into biomedical research until the late twentieth century. In 1993, the Office of Research on Women’s Health (ORWH) created the Revitalization Act, which mandated the inclusion of women and people of color in clinical research and required the analysis of sex differences in clinical trials. Although the advocacy work of the ORWH helped mature science to be more inclusive of the biological differences between the sexes, an enormous gap in our understanding of the female body remains. If psychedelic science follows the same research patterns as conventional medicine, we risk perpetuating this pattern of inequality.
Perimenopause, which brings emotional, physical and oftentimes spiritual change to our population of aging women, remains under-researched, under-treated, and often dismissed rather than honored as a profound biological, psychological, and existential threshold. Characterized by fluctuating hormone levels which gradually decline over time, it begins, for some, as early as the mid-thirties and lasts through a woman’s last menstrual cycle; extending, for some, into their late 50s. Symptoms relating to perimenopause include fatigue, mood changes, joint pain, decreased libido, hot flashes, brain fog, insomnia and memory issues.
Some women are turning to plant medicines to support them as they navigate the many seasons of their lives, from their monthly hormonal cycles to the profound transition of perimenopause. Rather than dismissing these real-world experiences because they occur outside clinical trials, we should study them responsibly. Observational research allows us to learn from women’s experiences and will generate collective-informed hypotheses that can later be tested in controlled trials. Through the identification of patterns and applications worthy of scientific investigation, this creates a bridge between folk medicine and Western science.
Deva Collective, the nonprofit organization I founded in 2023 after several colleagues suggested I do so due to the lack of research on women’s health and psychedelics, created the first observational study to learn from the choices women make during their perimenopause portal. Our inaugural study, a retrospective, observational survey titled “Attitudes, Opinions and Experiences of Perimenopausal Women Who Microdose San Pedro” will discover what women are learning as they microdose this medicine, and hopefully lead to additional research. It’s not an investigational new drug study nor an efficacy study. We want to explore what women in the perimenopause stage of life are learning as they work with this medicine.
San Pedro, also known in Quechua as Huachuma, is a mescaline-containing cactus indigenous to South America, with a 5,700-year history of ritual use (Bruhn, J. G., De Smet, P. A et al., 2002). There are stone carvings at the temple of Chavín de Huántar, in Peru, that feature priests turning into jaguars while holding San Pedro. A retrospective self-report survey of naturalistic mescaline users explored its therapeutic potential for depression, PTSD, and substance use disorders (Agin-Liebes, G., Haas, T. F., et al., 2021). San Pedro also grows abundantly in North America, and is used as a sacrament by some members of the Native American Church. Its long history of ceremonial use and growing scientific interest makes it a compelling candidate for observational research in women’s health. San Pedro has a history of supporting people with transitions, and one of our objectives at Deva Collective is to reimagine the life cycles in women’s health as transformational portals; it made sense to explore the work with this heart-opening medicine in perimenopause.
Mescaline, the psychoactive constituent in San Pedro, is found in both the San Pedro and Peyote cacti. Although opinions about the use of San Pedro vary, it matures more quickly than Peyote, and there are rampant ethical concerns about the endangered status of Peyote. Poaching and overuse of the cacti caused concerns and conflict about who has ethical access to these medicines. We focused on San Pedro as there are fewer ethical issues around sourcing, availability and right relationship with this medicine currently in the United States.
Like MDMA, mescaline is a phenethylamine and is considered an “empathogen,” regarded for its more gentle nature when compared to other psychedelics like LSD or psilocybin (Vamvakopolou et al., 2023). Anecdotally, many women who are microdosing San Pedro during perimenopause report that it feels more gentle than LSD or psilocybin microdoses, and offers sustained energy and focus while helping to stabilize mood.
Since my previous research experience was with breastfeeding populations and I learned how challenging it was to obtain IRB approval for lactating people, I (mistakenly) thought it would be “easier” to work with a non-lactating population, such as women in perimenopause. Having completed a multi-year apprenticeship with Francisca Santibanez in the practice of vegetalismo, which is a South American practice of working with healing plants, I sought her advice. As we mused about our first study, we both wondered about working with San Pedro. Where we live, in northern California, San Pedro grows abundantly, and because women in our network reported positive results when working with San Pedro during perimenopause, we wanted to better understand their experiences. These reports, combined with the medicine’s potential anti-inflammatory properties, were intriguing. While more research is needed to determine the role of anti-inflammatory therapies in mood regulation, a 2020 meta-analysis found that certain anti-inflammatory medications were more effective than placebo in improving depressive symptoms (Bai et al., 2020). With mood shifts and other inflammatory issues notable in perimenopause, we wondered how microdosing San Pedro would be during this transition. My personal experience included night sweats that began the week I turned 47, with increasing brain fog and eczema on my hands, which I had never experienced. When I started a practice of microdosing San Pedro, I noticed I felt more steady in my mood with more capacity to focus and sustain my energy over the course of busy days filled with psychotherapy clients, managing my three kids’ lives, and poring over articles about perimenopause, menopause and medicines. The dearth of literature about perimenopause is astounding. Every time I went to the gynecologist, she offered me an SSRI, which I have never taken and which I didn’t feel I needed as I was not depressed. It felt worthwhile to pursue an observational study of San Pedro, and it took us two years of back and forth with our review board to obtain approval to launch the survey since mescaline is classified as Schedule I medicine.
Deva Collective’s survey, “Attitudes, Opinions and Experiences of Perimenopausal Women Who Microdose San Pedro,” has been open to the public since November, 2025, and will close September, 2026, with an anticipated release of findings scheduled for early 2027. Survey inquiries include both quantitative and qualitative data collections including basic demographics, dosing regimens, perimenopause symptoms before and after microdosing San Pedro as well as attitudes about the role of psychedelic medicine in Women’s Health. Women are invited to share personal reflections about their experience with perimenopause at the closure of the form.
Editors Note: Because mescaline remains a Schedule I substance in the United States, participants must already be microdosing before enrolling in the survey. Deva Collective cannot advise on sourcing or protocols, and all survey responses are collected anonymously under WCG IRB approval. To be eligible for the survey, which is open through the end of September, 2026, participants must be 35-50 years old, experiencing perimenopause, currently microdosing San Pedro, and able to provide informed consent. For more information about the study and how you can participate, please view Deva Collective’s FAQ.
References:
Agin-Liebes, G., Haas, T. F., Lancelotta, R., Uthaug, M. V., Ramaekers, J. G., & Davis, A. K. (2021). Naturalistic Use of Mescaline Is Associated with Self-Reported Psychiatric Improvements and Enduring Positive Life Changes. ACS pharmacology & translational science, 4(2), 543–552. https://doi.org/10.1021/acsptsci.1c00018
Bai, S., Guo, W., Feng, Y., Deng, H., Li, G., Nie, H., Guo, G., Yu, H., Ma, Y., Wang, J., Chen, H., & Wang, G. (2020). Efficacy and safety of anti-inflammatory agents for the treatment of major depressive disorder: A systematic review and meta-analysis of randomised controlled trials. Journal of Neurology, Neurosurgery & Psychiatry, 91(1), 21–32. https://doi.org/10.1136/jnnp-2019-320912
Bruhn, J. G., De Smet, P. A. G. M., El-Seedi, H. R., & Beck, O. (2002). Mescaline use for 5700 years. The Lancet, 359(9320), 1866. https://doi.org/10.1016/S0140-6736(02)08701-9
Calabrese, J. D. (2013). A different medicine: Postcolonial healing in the Native American Church. Oxford University Press. (academic.oup.com)
National Institutes of Health Revitalization Act of 1993, Pub. L. No. 103-43, 107 Stat. 122 (1993).
Vamvakopoulou, I. A., Narine, K. A. D., Campbell, I., Dyck, J. R. B., & Nutt, D. J. (2023). Mescaline: The forgotten psychedelic. Neuropharmacology, 222 (109294). https://doi.org/10.1016/j.neuropharm.2022.109294
