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MDMA - A greater danger to women than men

The reason behind the difference in MDMA’s biological interactivity for men and women is due to women typically having lower body mass indexes, but not adjusting their dosages appropriately to account for this.

A staple for all-night ravers

Research has found that MDMA (aka ecstasy, molly in the US, or mandy in the UK) could be more harmful to women than men. One of the most popular party drugs since the 80s, it has experienced a recent revival and surge in popularity in the clubbing, festival and dance scenes.

A survey of 27,000 people for the NET pleasure index ranked MDMA as the most pleasurable drug, comparing both its positive and negative effects with a host of other substances including alcohol, cocaine and cigarettes.

The drug works through increasing the activity of three brain chemicals: dopamine, norepinephrine and serotonin. An influx of dopamine causes a surge in euphoria and increases energy, aiding the drug’s status as a staple for all-night ravers. Norepinephrine increases heart rate, blood pressure and heightens sensory arousal and alertness. Greatly increased serotonin uptake boosts mood and suppresses the need for sleep. It also triggers additional hormones that affect sexual arousal and trust, often causing the extraordinary emotional closeness and empathy for others often experienced by MDMA users, and earning it its reputation as the ‘hug drug.’

Women twice as likely to seek treatment than men

But, as with any illicit substance, MDMA has its downsides too. The drug has a multitude of effects on both the bodies and the brains of its users, and can land them, indiscriminate of gender, in A&E. Interestingly, the results of the 2016 Global Drugs Survey revealed that the number of female clubbers in Britain seeking emergency medical treatment is four times higher than it was three years ago, and that women are more than twice as likely to seek that treatment than men.

The survey gravely concluded that now is the worst time to be using MDMA in a generation, due to concerns over the high dosage levels in MDMA pills as well as people intaking greater amounts, leading to increased risk of acute harm, severe damage and death.

Fiona Measham, professor of criminology at Durham University, emphasises the particular dangers for women taking MDMA. “There are concerns with women’s differential metabolising of MDMA combined with low body mass index.” She postulates that the reason behind the difference in MDMA’s biological interactivity for men and women is due to women typically having a lower body mass index, but not adjusting their dosages appropriately to account for this.

Women don't adjust their dosages to account for their lower body mass index

However, a study published in the journal of Psychopharmacology in Berlin found that the psychoactive effects of MDMA were more intense in women than in men, despite male and female participants being matched for body mass. Women especially had higher scores for MDMA-induced perceptual changes, thought disturbances, and fear of loss of body control. This would strongly indicate that MDMA interacts differently in female and male users, but why is this so?

Drowning inside their own bodies

One theory that is proposed to account for MDMA’s particularly pronounced effect on women is increased cellular water retention. A fairly innocuous side effect, it might seem, but in some cases this can lead to hyponatremia and dangerous swelling in the brain. Oestrogen, the female hormone, impairs cells’ ability to release water, meaning that women are particularly at risk of suffering this effect. The side effects of hyponatremia vary dependant on severity of the condition, but in the worst cases it can lead to severe salt imbalances in the cells and cause the user to essentially drown inside their own body.

Other research has also pointed out a number of alternate factors that could cause this pronounced female effect, including a woman’s stage in the menstrual cycle. In a study on MDMA interactivity in rats, when comparing male rats, female rats, and male and female rats that had had their respective reproductive systems removed, they found the drug had the strongest effect on female rats with an intact reproductive system. They concluded that this was due to an increased reactivity of the serotonin system due to the effect of ovarian hormones.

While most MDMA trips are relatively problem free, with the latest European survey data estimating around 2.1 million people aged between 15 and 34 had used it in the last year, its dangers cannot be understated and a bad batch can cause widespread lethalities. While MDMA itself is not biologically addictive, in the same way that cocaine or heroin are, users can find themselves taking it compulsively to keep up with an ultimately damaging lifestyle, and dependency is not unheard of. And, if the trends are to be believed, women should be particularly careful when choosing to indulge.

City Addictions, April 14, 2017

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