Trans Masc & Ketamine Efficacy During Menopause?

Please note that throughout this blog, we may refer to ketamine, esketamine, and Spravato relatively interchangeably. This is due to the inherent similarities in chemical makeup between ketamine and esketamine, and their similar effects on mental health conditions. In the event that this creates confusion, don't hesitate to reach out to Lumin Health staff to ask any questions about treatment at hello@lumin.health or by scheduling a free consultation.

Dr. Ben Yudkoff, Co-Founder and Chief Medical Officer at Lumin Health, hosted a Reddit AMA on r/TherapeuticKetamine community on March 6th, 2026\. The below blog post is a recap of one of the questions presented on that AMA, syndicated to the Lumin Health blog in the event that it answers any questions about ketamine therapy, Spravato treatment, or general concerns you may have about treatment.

[https://www.reddit.com/r/TherapeuticKetamine/comments/1rj2blv/ama\_im\_dr\_ben\_yudkoff\_psychiatrist\_cofounder/](https://www.reddit.com/r/TherapeuticKetamine/comments/1rj2blv/ama_im_dr_ben_yudkoff_psychiatrist_cofounder/)

Don’t hesitate to get in touch with us if you’re interested in learning more about ketamine for depression at Lumin Health. Thank you once again to the moderators and community members for facilitating such an engaging discussion.


MstrCrimsonSpade asks:

I'm curious if you have any trans masc patients? If you do, have they noticed increased anxiety (menopausal anxiety) paired with decreased ketamine efficacy in early months of testosterone induced menopause? If they have, did that decreased efficacy eventually even out post menopause or did it indicate a permanent dosage increase? I am asking specifically about drug induced menopause.

Answer from Dr. Ben Yudkoff, Co-Founder and Chief Medical Officer of Lumin Health:

MCS, thanks for a good and thought-provoking question. We do have trans masc patients at Lumin Health and your question is inspiring me to think more deeply about the variables we consider when assessing treatment efficacy. Testosterone and changes to levels of estrogen/progesterone can absolutely have an impact on mood but I can’t say for sure whether this decreased ketamine's efficacy. I wish I had a better sense of this or thought to recognize it as a sufficient factor in a person’s recovery story that I would have directly asked about it.

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In a slightly different circumstance – specifically non-iatrogenically induced menopause or perimenopause – some of the mood fluctuations seen can manifest through treatment. It does render a certain unpredictability to the durability or duration of a ketamine response. In this circumstance I’ve generally regarded the treatment as effective but not completely so.

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