adderall1A new study in the journal Pharmacoepidemiology and Drug Safety examined the use of medications across the menstrual cycle–and it has some intriguing findings about stimulant and antibiotic use that appear to spike at certain times in the menstrual cycle. Here’s a little about the research–and what it could mean for you:

In the study, 259 women between the ages of 18 and 44 who were not taking hormone birth control were monitored across two menstrual cycles. The volunteers kept a diary recording their daily medication intakes, such as painkillers, cough and cold remedies, allergy medicines, stomach treatments and central nervous system (CNS) prescriptions (such as Adderall, which is used for attention deficit hyperactivity disorder, ephedrine, which is a stimulant, and certain migraine medications including Imitrex, Axert and Relpax).

All in all, nearly three-quarters of the women in the study took some kind of medication during the two-month study, giving the researches plenty to examine. And, using the women’s diaries, the researchers were able to pinpoint certain patterns in some medications–specifically, pain medications, antibiotics and CNS drugs–which were used more often at certain points in the volunteers’ menstrual cycles.

Surprising no one, pain medication (such as ibuprofen and acetaminophen) peaked during menstruation. Menstrual cramp pain is no joke and running for an OTC painkiller is usually the first line of defense for many women. (However, there are many natural remedies worth trying since OTC meds like these come with serious health risks, such as stomach bleeding, liver damage and heart attack.)

Migraine medication use also peaked during periods. Menstrual migraines are a common problem affecting up to 51% of cycling females, myself included, so again no shocker there. (There are also natural remedies you can try to both prevent and ease migraine pain.)

But, interestingly, the use of Adderall and ephedrine also peaked during menstruation–and, in fact, Adderall was used more frequently by study participants than migraine medications despite none of the participants claiming to be under the care of a doctor for ADHD.

Another interesting finding was that antibiotic use peaked during the second half of the menstrual cycle–with a sudden steep rise at the end of Week 3 (around Day 22 in a 28-day cycle) when progesterone peaks. In this study, the women who used antibiotics said they did so for cold or flu symptoms, sinus infections, strep throat or sore throat, urinary tract infections, vaginal bacterial infection, upper respiratory infection and mononucleosis (a virus that causes severe flu-like symptoms).

So, what’s this mean for you?

Let’s start with the Adderall and ephedrine. While the study authors didn’t ask the volunteers why they took these drugs, they cast doubt on the notion they were used primarily to treat ADHD because they specifically asked potential study participants if they were taking medications for conditions like this as part of the study’s pre-screening process. The researchers also point to the fact that most of the women enrolled in this study were college students–and the use of these drugs peaked around mid-terms and final exams. So, they speculate that some women may have been using these drugs for their stimulant properties to help study during a time of low pep and/or to boost mood during a stressful time that was exacerbated by menstrual moodiness.

Now, I’m not here to judge. I’m not here to tell you taking stimulants is bad. We didn’t have these kinds of drugs when I was in college. (Heck, we didn’t even have computers or cell phones yet. True story.) So, I don’t know if I would have tried them back then. But, as a health journalist now who’s reported on a multitude of study-proven natural remedies and who prefers to promote a healthy lifestyle, I wouldn’t be doing my job if I didn’t point out that there are drug-free, natural ways to get a push in energy or mood during your period if you need it:

  • Take a multivitamin with iron all cycle long. Iron loss as you bleed during menstruation is one key factor behind period-related fatigue. Taking iron in a supplement (aim for 18 mg. daily) or loading up on iron-rich foods (such as beans, lentils, spinach and lean beef) can help replenish your body’s store of this energizing mineral. Bonus: Women who take a daily multivitamin have better moods and energy, research shows.
  • Go for a brisk walk. Or take a bike ride or jump in a pool or grab a hula hoop. Invigorating exercise sends a surge of oxygen-rich blood to the brain, waking you up. Plus, exercise is a potent stress-buster and mood-booster that prompts the production of feel-good chemicals in the brain.
  • Listen to up-tempo music. Research shows that your body syncs up with the racing beat of fast music, which sends your pep soaring. Plus, your favorite music triggers the release of dopamine in the brain, which is the same rewarding chemical released when you take stimulants. Make this tip even more effective by turning up the volume. But, not while wearing earphones, since that can lead to hearing issues, such as hearing loss and tinnitus (ringing in your ears).
  • Play an action-packed or timed video game. The thrill of these kinds of video games spurs a surge in adrenaline–a natural stimulant that revs alertness and get-up-and-go.

Now let’s talk about the spike in antibiotic use during the end of Week 3. While the study authors say more research is needed to figure out why this steep climb in antibiotic use occurs, they theorize that it could be due to times in your cycle when your immunity is lowered and your risk of infection is greater. Indeed, numerous studies have already pinpointed one spot in your cycle when your immune system weakens–and it just happens to be about a week before this sudden need for anti-b’s: It’s during ovulation, which occurs at the end of your Week 2.

During this phase of your cycle, your immune system weakens slightly, making you more vulnerable to infections from bacteria, viruses and yeast, for instance, you’re more likely to catch a cold, be bothered by a stomach bug, develop an infection in a wound, catch an STD or struggle with a yeast infection. Researchers theorize that high estrogen triggers this drop in immunity to help prevent the body from attacking sperm during ovulation, upping your chance of pregnancy.

I have my own theory about this antibiotic spike and if you don’t mind a little armchair quarterbacking, I’ll share it: During the first half of your cycle–your Week 1 and Week 2–your rising estrogen makes you far more daring and less concerned with safety compared to the second half of your cycle–your Week 3 and Week 4–which is when lower estrogen and rising progesterone push you to be safer and take precautions.

So, my hunch is that we’re taking fewer health and safety measures in the first half of our cycle, for example, we’re not washing our hands as often, we’re getting too close to someone who’s sneezing, we’re not keeping wounds clean and dry, and so on. Then, coupled with our weaker immune system at the end of our Week 2–which is coincidentally when our estrogen peaks, making our carefree attitude about our health peak–we get a double-whammy that sets us up for a higher risk of getting ill or developing an infection.

In addition, because we’re more cautious in our Week 3 as progesterone rises, our worry about our health rises so we head to the doctor to stop whatever ick we got from getting a whole lot worse. And, while we’re there, we’re offered or we ask for antibiotics to make us well again–even in instances when antibiotics don’t work, such as with cold viruses. (As a reminder, frequent antibiotic use during times when they’re ineffective–for instance, for cold viruses–can reduce their effectiveness in the future when you need them–for instance, for bacterial infections.)

So, what can you do with this information? I recommend taking more precautions during the first half of your cycle to improve your chances of staying healthy, for instance, by washing your hands more often, using antibacterial gel, cleaning cuts and steering clear of coughers and sneezers.

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[Photo: Alex Dodd]

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