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This is my personal experience, not medical advice. Ketamine is a prescription medication and is not right for everyone. Talk to a licensed provider before starting.
There is so much more in the episode. More of my stories from the other side of the lozenge. And two women I want you to know: Meg Randle, NP, my personal ketamine therapist, who prescribes my medicine and walks me through every step. And Sarah Cunningham, MSc, founder of VoyageKit, who takes us deep into integration and how to make the reset last. Pull up a chair with us on Spotify or Apple Podcasts.
Why we are talking about ketamine
I know. Ketamine on a perimenopause site?
Stay with me.
Hormones wake up your body. I will say that until my last breath. But there is another awakening that has to happen, and estrogen cannot do it for you.
There is the trauma you never dealt with. The grief you shoved in a closet. The deep, aching need to reconnect with yourself. With your soul.
Hormones can only do so much.
If you only wake up your body, your soul feels ignored.
If you only wake up your soul, your body feels ignored.
Waking her up means both.
So yes, we talk about patches and progesterone here. And we also talk about how you wake up your soul.
Breathwork helps. Yoga helps. Meditation helps. But there are also real medicines, like ketamine, and in some places psilocybin, that can help you reconnect with yourself and move through trauma. For some women, they reach places years of talk therapy never touched.
That is why we are talking about both.
Imagine this
It is the end of the day.
You turn on soft, meditative lights and watch them pour across your room. You burn a little sage. You open your journal and write down what you want to let go of. You set an intention.
You change into your comfiest clothes. Your person is in the next room, there if you need them.
You lie down in your bed. You place a small lozenge in your mouth. And you stare at the lights.
Slowly, the thoughts that have consumed you for months, maybe years, start to fade. They drift into the lights. Into the air. Into the bed beneath you.
Soon you realize you are not in your body anymore. The idea of arms stops making sense.
And there you are. Nothing.
A smile spreads across your face. You are not sure if you are physically smiling, but the joy fills the room. You are not worrying about today. Not replaying yesterday. Not bracing for tomorrow.
There is only you, being.
And somehow, that makes everything better. You know it is going to be okay. You exist, and the fact that you exist is enough to celebrate.
When you come back, the hard things look different. The sadness and the doubt and the fear sit next to the joy and the excitement, the hot and the cold, the rain and the sun. All of it becomes proof that you get to live a human life. And the most mundane Tuesday feels a little more magical than it did before.
That is my ketamine reset.
My first time was a disaster
I have to tell you how it started, because it was not pretty.
I was at a dance club. A trusted friend handed me something and said, “Put this in your mouth. You’ll love it. It takes the edge off. Keep dancing and don’t stop moving.”
Fifteen minutes later, I was lying on the dance floor thinking, this is horrible. Who would ever do this?
I swore I would never touch it again.
What I did not understand: the same medicine I hated in that club can be a beautiful, effective therapeutic tool. The difference is everything around it. The right guidance. The right preparation. The right intention. The right setting.
A dance floor with strangers is not that.
How it found its way back into my life
Years later, a friend told me how much ketamine therapy was helping with her anxiety and depression. Prescribed. Guided. At home.
I told my husband about it.
He contacted Meg, a nurse practitioner who specializes in at-home ketamine therapy, and started treatment. It has massively changed how he processes the world. His anxiety has dropped. He is more open to learning. The weight of trauma that shaped so much of his life has started to dissolve.
Watching that, I wanted to try it for myself. I am so glad I did.
What a session actually feels like
Here is what nobody tells you, and what I need you to know before your first one.
About 15 to 20 minutes after the lozenge, your brain and body begin to fade into air. You become a kind of nothingness.
If you are not expecting that, it can feel terrifying. That is the medicine doing exactly what it is supposed to do. It is a reset. A full power-down.
Then, about an hour later, you start to feel your toes again. You notice your breath. You come back into your body.
I call it a recess from the human experience.
In some sessions, I have watched my future self give me a pep talk, walk me through my life, and hand me new perspectives. In others, I lay in bed while waves of joy rolled over me and I was completely okay being nothing.
That is where the real lesson landed for me.
I exist without money. I exist without love. I exist without relationships, without things, without a good hair day. I exist even in nothingness.
Once you feel that in your body, you carry yourself differently.
It is the same reason you restart your phone when it glitches. Everything works better after a hard reset. It feels like a deep, deep meditation. And if you have never been able to make meditation stick, this can be your training wheels.
There is a name for that nothingness. Researchers call it ego dissolution: your sense of self softens or disappears for a while. Many people report coming out of it with a shift in perspective, more compassion for others, less fear of death, and more joy in being alive. That matches every session I have had.
What the research says (lightly)
I am not a doctor or a researcher, so I will keep this short.
Why it feels like a reset. Most antidepressants work on serotonin or dopamine. Ketamine works on glutamate, the most common chemical messenger in your brain and a key player in learning and memory. The leading theory is that it helps the brain regrow connections between neurons that stress and depression wear down. In plain words: it may help your brain build new paths instead of running the same exhausted loops. (Third Wave)
Why it feels fast. In a randomized controlled trial of people with treatment-resistant depression, 64% responded to a single ketamine infusion within 24 hours, compared to 28% on the comparison drug. Traditional antidepressants can take weeks to months. The researchers also said more work was needed on how long the effect lasts and on safety. (Source)
What is approved and what is not. A nasal spray made from one form of ketamine, esketamine (Spravato), was FDA-approved in 2019 for treatment-resistant depression and is given in certified clinics. The at-home lozenges many of us use are compounded ketamine, prescribed off-label. In 2023, the FDA warned that home use carries extra risk because no provider is on-site to monitor sedation, dissociation, blood pressure, or breathing. (Source)
It changed my life. It is also a real medicine that deserves real respect.
Why I think this matters in midlife
Perimenopause is not only hot flashes. A 2024 University College London analysis of more than 9,000 women found perimenopausal women had about a 40% higher risk of depression than premenopausal women. (Source)
So many of us are running a brain that never turns off. Caring for kids, parents, partners, businesses. Carrying everyone.
A reset that reminds you that you exist without any of it? That is medicine for a woman who has forgotten she is allowed to stop.
One honest note: if your low mood showed up alongside night sweats, rage, and a cycle that went rogue, get your hormones looked at too. Ketamine is not a substitute for that conversation.
How to do it safely
Work with a licensed provider. Someone who screens you, sets your dose, and follows up. Ketamine can raise blood pressure and pressure inside the head, so it is generally not a fit if you have uncontrolled high blood pressure, heart disease, glaucoma, a history of psychosis, are pregnant, or struggle with substance misuse. Your provider will walk you through the rest.
Do not mix it. No alcohol, benzodiazepines (like Xanax or Ativan), sleep meds like Ambien, or opioids on session days. Those combinations can slow your breathing. Tell your provider everything you take.
Have a sober support person nearby. Better U requires one during sessions. I think everyone should have one.
Prepare your space and your intention. Lighting, music, an eye mask, a journal. Your setting shapes your session.
Integrate afterward. This is where the change sticks. Sarah Cunningham, MSc, a neuropsychology-trained practitioner who supports clients in ketamine clinics, built VoyageKit for exactly this. Her kits include a zero-pressure Bluetooth eye mask, a breathing necklace that slows your exhale, a grounding stone, a journal, a lockable case for safe storage, and a portal full of integration tools. Harm reduction, done with care.
Where to start
My personal ketamine provider: Meg Randle, NP, prescribes in Utah, Colorado, and Oregon. She is the one who guided my husband and me. Reach her at beekindnp@proton.me.
Outside those states: Better U offers clinician-screened, at-home ketamine programs in about 30 states, with a prep session, integration coaching, and the medication delivered to your door. It is cash-pay and not covered by insurance.
The part I need you to hear
You are allowed to put it all down.
Not forever. For an hour. Long enough to remember that you were whole before the to-do list, and you will be whole after it.
You exist. That is enough to celebrate.
And if the heaviness arrived with the night sweats and the 3 a.m. wake-ups: you are not crazy. It is your hormones. Find an HRT provider near you in the WakeHerUp directory.
Wake up. She’s worth it.
