Mood swings, irritability, crankiness - these behaviors in women are culturally attributed to hormones or PMS. We understand that hormones have an impact on our behavior and can make us more emotional - but what is the link? How is our emotional wellbeing connected to the hormones in our bodies?
What are hormones?
Hormones are chemicals that carry messages from the brain to the organs, controlling the function and health of these organs. They are the body’s system of ensuring that the cells of the different organs are working as they should. Hormones control basic human functions (such as eating, sleeping), complex functions (sexual desire and reproduction), and also our emotions and mood.
Where do hormones come from?
Hormones are manufactured by glands in the endocrine system. The endocrine system consists of several types of glands, each of which has a specific focus. For example, the pituitary gland releases hormones for growth; the pancreas glands produce insulin to control blood sugar levels; the ovaries and the testes are glands that release female and male sex hormones respectively. Each gland produces hormones which are then conveyed through the body through the blood.
But what do hormones have to do with my emotions?
Women have two major reproductive hormones that control their fertility and their menstrual cycles: estrogen and progesterone. Apart from this, there are several other hormones that regulate different chemical functions in our bodies. When one or more of the hormones are working overtime (as they do during certain reproductive life stages), the brain may compensate by producing fewer of some other hormones - such as serotonin and endorphins, which are hormones that regulate our emotions.
These reproductive life stages are also those where new stressors enter our lives. During puberty, it is the challenges of peer pressure and confusion about one’s own sexuality; during motherhood, it could be concern about the baby, and worries about balancing work and responsibilities. A combination of the hormonal changes and the stressors in one’s environment can make her feel emotionally unwell, less in control of her own emotions, and even make her vulnerable to a mental illness.
Why are teenagers sulky, moody and impulsive?
During puberty, the pituitary gland begins to secrete estrogen hormones. The changes in hormone level during puberty may make a girl feel anxious or have low mood. During puberty, the brain is still developing; this means that adolescents don’t have strong control over their impulses. This, coupled with the hormonal changes that occur during puberty, can be stressful to a teen.
At this stage, the hormones, in combination with other factors, may exacerbate existing stresses for the young woman. These could include:
Difficulty coming to terms to the idea of menstruation
Fluctuations in menstrual cycle: young women with dysmenorrhoea may find their periods more stressful
Body image issues due to development of breasts, acne, growth of body hair, possible weight gain or loss
Increased awareness of their sexuality, and attraction to the opposite sex (or the same sex); this can conflict with messages they hear about relationships being taboo, or their parents not allowing them to have romantic relationships.
Why do I feel cranky just before my period? Is it PMS?
From puberty to menopause, a woman’s hormones regulate her menstrual cycle. During a single cycle, there are three hormones- estrogen, progesterone and testosterone - that rise and fall in a specific pattern. In the first two weeks, the levels of estrogens go up, boosting your mood and your energy. In the second week, testosterone levels begin to rise. This combination of high estrogen and testosterone levels can lead to good mood and an active libido. During the third week, progesterone rises (while estrogen drops) and may lead to a sluggish mood; some women may also feel emotionally low during this period. During the fourth week, the levels of estrogen drop; this can lead to irritability, body pain and moodiness. Meanwhile, progesterone levels are dropping too, so some women feel energetic.
Premenstrual Syndrome (PMS) is a combination of symptoms that women experience in the days leading up to their period. Many women feel tired, irritable or restless during this time. They may be less tolerant to stress, or have a stronger reaction to stress than they would otherwise. This discomfort subsides once their period begins. Most women develop their own coping mechanisms - whether through rest, diet or food - that help them manage their PMS.
A very small percentage of women experience Premenstrual Dysphoric Disorder (PMDD). A woman with PMDD may experience symptoms of depression in the days before her period:
Distress arising from the discomfort is very high
Feeling very low or very anxious, crying spells
Not being able to cope with emotions; or feeling debilitated by them
Intense body aches
Some women may also have thoughts of suicide
PMDD affects only a small percentage of women. If you think you’re trying to cope with your pre-menstrual distress by choosing not to do things you would do otherwise (going to work, attending meetings, taking up specific tasks, etc.), speak to your gynecologist about your condition. They may recommend that you keep a mood chart for a few months, and record your daily moods along with the days of your menstrual cycle. This will help you track whether your mood swings are connected to your periods, and seek help.
Why is it that some women glow, but some others are moody or anxious during pregnancy?
During pregnancy, there is an increase in the production of estrogen and progesterone. This could be the one time in her life when there are more hormonal changes happening than at any other period in a woman’s life. Estrogen helps the uterus and the placenta in transferring nutrients to the fetus, and ensuring the health of the unborn baby. During the last trimester, estrogen helps in the development of milk ducts. However, the quantity of estrogen produced during pregnancy is a lot more than the body produces when a woman isn’t pregnant. This can lead to nausea.
There’s also an increased quantity of progesterone - this hormone loosens the limbs and ligaments, and prepares the uterus to expand to hold the baby as it develops over the three trimesters.
There are also other hormones at play. Prolactin helps prepare the body for breastfeeding, and oxytocin stimulates labor contractions.
During this time, most of the hormones are protective; they are working to ensure the wellbeing of the mother and the baby. But internal and external stressors can cause emotional distress:
The mother’s anxiety about the health of the baby
Body image issues
Fear about labor
Existing issues in the relationship or family
Worry about balancing career and motherhood
Worry about finances
Pressure from family to have a boy child
Due to the hormonal changes, a woman may be more irritable or moody. This is not uncommon or abnormal. Due to the sleep disturbances, she may be more forgetful than usual or emotional.
Why are new mums always tired and sleepless?
During the late stages of pregnancy, the body has a large quantity of estrogen and progesterone. After the birth of the baby, the levels of these hormones drop drastically. The hormones that begin rising at this time (oxytocin, to promote bonding between mother and baby) are geared towards the baby’s care. The woman is also likely to be struggling with her adjustment to motherhood; and also find it hard to get adequate sleep and food. This makes it an extremely vulnerable period for the mother; and this is also why baby blues are so common. Some women may even develop postpartum depression.
There are also some unique stressors present during this period:
The mother’s anxiety around whether she will be able to care well for the baby
Conflict in the family or criticism of the mother due to the gender, size, colour of the baby
Lack of family support in caring for the baby - especially in nuclear families
Lack of emotional support
The pressure to be glowing with the happiness of motherhood even when she is tired or emotionally low
She’s so moody. It must be menopause…
For most women, menopause occurs somewhere in their mid to late forties. During menopause, the estrogen levels in the body begin to drop, and ovaries stop working. Some research suggests that estrogen may affect memory levels. The hormonal changes that occur during menopause may cause reactions in women: sleep disturbances, irritability, mood swings, memory loss and difficulty concentrating.
Menopause is also the time when women face multiple stressors. A woman who is experiencing menopause may also be going through significant life changes such as the loss of parents or a spouse; and their children getting ready to leave home. Losing fertility can also be distressing to a woman, even if she has had children already. Women with severe hormone depletion may be vulnerable to depression or anxiety.
Are there any other hormones I should know about?
This hormone ensures that all the organs are working well, and converts the body’s food into energy. An underactive thyroid gland means that the body’s processes are working slower than they should; this can cause a person to be lazy, lethargic, sluggish and emotionally low. Persons with low thyroid levels (hypothyroidism) may be vulnerable to low moods and depression.
When the thyroid is hyperactive, a person may feel nervous, irritable and restless, have a high heartbeat rate, and may lose weight easily. Such persons may be vulnerable to anxiety disorder.
This hormone is also known as the stress hormone. Cortisol has several functions: it regulates metabolism and helps control blood pressure. During pregnancy, it aids in the growth of the fetus. High cortisol levels may cause drastic weight gain, and increased blood pressure. Emotionally, it is linked to anxiety and depression. A person with low cortisol levels may experience mood swings.
It’s also known as the love hormone or the cuddle hormone. Apart from stimulating labor and promoting lactation, oxytocin is also known to help the mother and child bond. It also drives social interaction and sexual arousal. Low oxytocin is believed to be linked to depressive symptoms.
This piece has been written with inputs from Dr Aruna Muralidhar, senior consultant obstetrician and gynecologist, Fortis La Femme, Bangalore; and Dr Ashlesha Bagadia, perinatal psychiatrist, Bangalore.