The War Inside Women: How Hormones Influence Psychology - Dr Sarah Hill

Two books on the vagina. Congratulations.

(laughs) I think it's a little bit more complex than that. I think it's a little more complex than that, but thank you.

Why this one?

Well, you know, actually, you know, it, it was the biologist in me that kind of led me to this one. Um, so the first book was really more about my, uh, I ended up in a rabbit hole because of my personal experiences with the pill. And this one, I ended up in a rabbit hole because I couldn't understand why women feel so terrible during the last two weeks of their cycle. Um, you know, and from an evolutionary perspective, like, it doesn't make a lot of sense for women, like, to all have a disorder. Right? It just doesn't make any sense because generally if there's some sort of a trait and it's causing problems, it'll get selected out of the population, and there's been all this really wonderful work that's been done in our field looking at, you know, the impact of estrogen and how when estrogen is high and rising across the cycle, that it does all of these really amazing functional things within the human, you know, within the, within women's brains and then with their behavior and everything else. But, like, n- n- there's nothing like that about what goes on in the second half of the cycle. Instead, it just seems like women feel terrible. And so I was trying to understand why that is. So, like, what is the deep evolutionary wisdom behind self-loathing, (laughs) you know-

(laughs)

... that tends to go on during the second half of the cycle? And, you know, so, like, why does it happen and i- is it supposed to, and is there some way that we can all feel better? So it was really sort of an evolutionary puzzle for me that I wanted to solve.

Like, crazy to think that that's, for some, maybe even most women, 50% of their life.

Yeah, it is. It's, like, 50% of your life, and it seems kinda crazy that, you know, that we would be designed in a way that we're supposed to be intentionally feeling bad. And so I thought there had to be something else going on, right? That it probably didn't make sense that we're just supposed to feel terrible.

What actually happens in the brain across the month?

Well, so to introduce you to the cycle, we just have to understand that, you know, the whole purpose of having a cycle in the first place is reproduction. And for a male to reproduce, all you have to do is one thing, right? And that one thing is have sex. Uh, and for a female, it's a little bit more complicated tha- than that because we're mammals, and that means that we need to do two things in order to successfully reproduce, right? One is have sex, and that means doing things like attracting partners, being able to tell the difference between high-quality and low-quality partners, wanting to have sex, looking sexy, you know, smelling sexy, finding men sexy, et cetera, et cetera, et cetera. And there's a whole bunch of research that finds that, in fact, that that's true, right? And that all of those things tend to, um, correlate to times in the cycle when estrogen is high and rising, an egg is about to be released, and sex can lead to conception, right? So that's job one for reproduction if you're a human female. Job two is implantation and pregnancy, right? And so this is where a female body has to allow this, you know, foreign genetic material, you know, half foreign genetic material, um, this, this embryo implant, um, and then, of course, um, be able to carry it to term for nine months. And this is the set of activities that's coordinated by our other sex hormone, progesterone. And this is the sex hormone nobody talks about, right? It's like we think, like, estrogen, and then with guys, we think testosterone, and there's really not a whole lot of talk about progesterone. And so I was kinda curious about, like, what actually goes on during the point in the cycle when progesterone is the dominant hormone, right? Are these things actually trying to guide our, our brain and behavior in a way that will help to facilitate pregnancy, right? Because we find that, you know, human, b- like, women are, become very much oriented toward men and toward sex, um, in the first half of the cycle when estrogen is high and rising. And so I was really trying to figure out, like, is there some method to our madness, right, during the second half of the cycle, um, when progesterone is dominant, and might it be, um, creating shifts in the way that we feel and experience the world that might be functional? And might they feel a little bit dysfunctional just simply because we don't really give voice to them? And, and by giving voice to them, I don't mean that we all need to sit around and talk about how we feel during the second half (laughs) of the cycle. But instead, it's this idea that, you know, the, the way that women have been handled by science and by medicine is that we're just like small, less hairy versions of men, and so nobody's really given too much, paid too much attention to the fact that our hormones cycle and that what our bodies need and, and the way that we experience the world and even the way that we experience symptoms of chronic diseases or chronic conditions like ADHD and, um, and things like, uh, diabetes and autoimmune disease, and that all of this might actually shift across the cycle with our shifting hormones. Um, and as it turns out and as I talk a lot about in the new book, The Period Brain, is these things do change across the cycle, right? And it turns out that women are a somewhat different version of themselves during the last two weeks of the cycle than they are during the first two weeks of the cycle and that a lot of the misery that we experience is a result of the fact that we've totally ignored that, right? It's just like nobody wants to acknowledge that biological sex matters when it does, and the result of this is that women have been absolutely mishandled by science and by medicine, and one of the results of that is PMS.