‘Hormones and mood: from menarche to menopause and beyond’. That’s the title of the first article (by Meir Steiner, Edward Dunn, and Leslie Born) that came up in my Google Scholar search for “hormones and mood”. That article came out in 2003, has been referred to by more than 800 other researchers, and gives me the first lesson of the day. Specifically, medical researchers have known what to expect with perimenopause much longer than women discovering it on TikTok.
I’m not trying to be facetious here; I think there really is a gap between what “experts” know and what people actually experiencing the slings and arrows of outrageous hormones know.
I’ve vicariously experienced the TikTok perimenopause crusade, and it is full of people either asking the not-unreasonable question why nobody ever told them about this “fresh hell” (to steal some of author Heather Corinna’s book title), and survivors (women who’ve been through it) telling women what they need to know.
Why this hidden, not-talked-about thing is not talked about is a story for another column. One refrain from the TikTok crew is “if this happened to men we’d never hear the end of it. And there’d be free, never-ending HRT patches in every men’s loo.” I don’t think I disagree.
No, I’m interested in how the ebb and flow of the hormones are implicated in the “change of life”. You probably already know that the two key players here are oestrogen and progesterone, the female sex hormones. Oestrogen levels, in particular, go on a crazy roller coaster during this time, but progesterone and testosterone also play a role in what women experience.
Yes, testosterone, the so-called male sex hormone. Women also produce testosterone, most of which is manufactured in the ovaries and, over the lifespan, the rate of manufacture decreases. There’s a debate going on about whether testosterone replacement should also be a staple part of perimenopause response.
Why do I think oestrogen and progesterone are important for mood? Well, Steiner and friends, the authors of the first article I looked at, told me so. They start with a pretty straightforward observation – women are notably more likely than men to experience low mood. Though we call persistent low mood “depression”, women experience much more dramatic fluctuations in mood than men. When does this tend to start? Hmm, around puberty, when the influx of sex hormones appears to supercharge the sensitivity of neurotransmitter production and use. Remember, neurotransmitters are the chemical posties in the brain, running messages from one place to another to make things happen. Too much of one, or too little, and you get low mood, or unusually elevated mood.
Are other times characterised by mood shifts ? Yes – in women’s fertility cycle (the infamous PMS). And, of course, during and after pregnancy. That’s circumstantial evidence right there.
But men also experience hormonal fluctuation. Testosterone levels are higher in the morning than the evening, and testosterone production also decreases as men age.
It’s not clear, however, whether men experience other regular shifts. Years ago, Anne Pedersen, an Australian social psychologist, told me she’d tracked the moods of her male students, and this showed that, regardless of whether the cause was hormonal, men also reported a cycle of mood changes.
At the other end, we have polycystic ovary syndrome in which, for about 10% of adult premenopausal women, the ovaries produce a little too much testosterone. Women who experience this condition are also more likely to experience depressed mood, often tied to their menstrual cycle, and it can often be diagnosed alongside bipolar mood disorder. Which is not to say they’re the same thing, and each can occur without the other.
This stuff is more important than people realise – including the half of the population who are most likely to experience it.
