Hormones Drive What We’re Interested In, from Sex to Kids to Wo

Hormones Drive What We’re Interested In, from Sex to Kids to Work At the risk of being overly reductionistic, I have noticed that hormones drive what our minds are attracted to, and thereby drive mind-body connection. Louann Brizendine, MD, a fellow UCSF faculty member in Psychiatry, has written a book about this recently called The Female Brain. I’m more familiar with women vs. men but I’ll comment on both. In our 20s and 30s, most of us are focused on education/career, and finding a life partner. For women the monthly cycle of estrogen, progesterone and testosterone, at different yet usually predicable levels each day of the cycle, drive us to be sexual around ovulation, as well as more creative and energetic. We slow down around our time of menstruation and even seek solitude or quiet in the 7-10 days before our periods start. The daily change in hormones makes us overall almost endlessly flexible and accommodating. For those of us who choose to have kids, pregnancy is a time of sky-high levels of estrogen (mostly the anti-cancer estrogen, estriol) and progesterone. For some of us, pregnancy feels incredibly good. There’s high GABA, which has a valium-like effect. The hormones tend to make us focus on embodiment and nesting, preparing to bring new life into the world. Other women don’t feel as good in pregnancy and find that the “insulin resistance” in particular leads to significant weight gain even in the absence of not eating much more than usual. Post-partum the hormones crash to near zero, which is a preview of menopause. Some women adjust just fine; others suffer from post-partum depression or other similar conditions. Estrogen deficiency cause many of us to have drenching night sweats and hot flashes. Mood can be variable. Libido is completely hijacked by infants and babies. You release oxytocin, the “love and connection” hormone, and nothing feels better than connecting with your new baby. This is a time when partners often feel left out, and it requires care and insight to navigate the hormonal drive along with maintaining connection with your partner. For most women, starting sometime between 35 and 50, the regular monthly cycle shifts to erratic patterns. Welcome to premenopause. Unpredictable estrogen levels cause symptoms such as irritability, depression, headaches (particularly migraines), anxiety among others. Often women find their periods arrive earlier (up to every 21 days in a normal woman) and then space out. Ovaries are sputtering, and often you do not produce an egg which leads to an irregular shedding of the uterine lining. Many women find they have “flooding” or intensely increased menstrual flow, like a hemorrhage. The chaotic hormonal pattern of premenopause (sometimes also called perimenopause) tends to make us focused on surviving day-to-day especially when sleep becomes poor, which contributes to poor mood, irritability, and fluctuating to no interest in sexual connection. We become obsessed with getting a good night of sleep. We don’t manage stress as well as we used to. We try to connect with our partners and/or family while coping with the edginess that our hormones create. Menopause is your one-year anniversary from your final menstrual period. After that you are in postmenopause. The hard-wiring of the brain changes. The regular cycle of our 20s to 30s ceases, the erratic swings of premenopause stop. We go from an alternating current to a direct current, almost a flat line. We stop being so accommodating. We stop being endlessly flexible. Self-care becomes a top priority. We’re not sure we really love our partners anymore, or we invigorate and redefine our relationship. While women stop producing their hormones more abruptly over a 2 year period leading to menopause, men have a more gradual decline in hormones. For men, andropause is a common experience. Sometime in their 40s, men start to notice a decrease in vitality, less energy, sometimes depression, enlarged prostate, los in height or osteoporosis, anxiety, less frequent or strong erections and impotence. While each individual is very nuanced and complex, these general comments about hormones are a useful springboard for discussions of hormones and how they drive what our minds are most interested in. Obviously, women and men are more complicated than just a bowl of hormones. I think the most helpful way to approach hormones is to find a good doctor if you think yours are out-of-balance or if you are experiencing significant symptoms you feel may be attributable to hormonal change. I favor a very careful history (much longer than than the US average of 8 minutes per patient for a history and physical) combined with examination and a 24-hour urine analysis. I also favor bioidentical hormone replacement because I think it is safer than synthetic. Wishing you hormonal balance and health!