In early October, we had an online meeting with Sarah Hill, author of You and Your Hormones. Sarah is a leading researcher in the field of evolutionary psychology with over 50 scientific publications and numerous research grants. In her book, she talks about the effect of hormones on the female and male body and suggests taking a fresh look at the issue of hormonal contraception. We publish the most interesting excerpts from the interview.
Good evening Sarah! I would like to immediately ask you about sex, because in your book we are talking about sex hormones. I have come across studies that have argued that oral contraceptive pills can negatively affect a woman’s libido. On the other hand, only 2% of women surveyed say that their sex life has become worse after they started taking hormonal contraceptives. Please tell me if what I am saying matches what your research shows?
Indeed, many women complain of a decrease in libido under the influence of hormonal contraceptives, in particular, pills. What is the reason for this? When you use hormonal contraception, your body begins to produce more sex hormone-binding globulins. This traps the testosterone it produces and becomes inaccessible to your body. If your libido is sensitive to testosterone levels (and women can vary greatly in this parameter), then it will decrease.
The second reason is related to the basic principle of contraceptives. They suppress the pre-ovulatory rise in estrogen levels. And we know that women have more sex precisely during the growth stage of estrogen. It is logical that its absence can lead to a decrease in libido.
However, it is difficult to make any generalizations on this issue, because a lot depends on a particular woman, on what type of hormonal contraception she uses. For example, a fourth-generation progestin like Yasmin has fewer side effects compared to second- and third-generation progestins.
What would you recommend to women who have used second or third generation pills and are now generally afraid to use hormonal contraception, implants, spirals?
Before completely abandoning such an opportunity, I would recommend that you still conduct various experiments, because there are about a hundred types of hormonal contraception. Progestins of different generations are used, the method of their delivery is different.
The same active ingredient supplied by the coil may not act at all in the same way as the same substance from a tablet.
Therefore, please, consult your doctor, conduct experiments under his supervision. It is also very important to keep a diary to accurately track changes in your well-being and libido. Then it will be possible to react to specific deviations.
Hormone pills were created with a specific purpose – to prevent ovulation and prevent a woman from getting pregnant – but their effect on the body is much more extensive. A source
Since we are talking about libido, there is an opinion that it does not exist at all. For example, Emily Nagoski in her book writes about the gas pedal and the brake pedal – this is her metaphor, with which she explains how female arousal and female desire appear. She says that contextual factors are very influential here: for example, stress hits the brake pedal, while a high level of intimacy, on the contrary, acts as a gas pedal. How could you explain these two processes from a neurobiological point of view?
A very interesting question. What is the neurobiological pattern of stress? The physiological processes that trigger the stress response essentially shut down the part of the brain that is responsible for sexual desire and sexual response.
We can say that stress and sexual desire are antagonists.
A woman’s sexual desire, as you rightly put it, is very, very contextual. In men, this mechanism is more primitive: there is a beautiful person nearby – great, we turn on all sexual processes and mechanisms, we start the reproduction program. A large number of correct contextual signals must develop for a woman, and this is easy to explain from an evolutionary point of view: after all, a woman bears both the burden of pregnancy and additional risks.
Evolution has provided that our brains turn on only in the right situations, so that a potential partner is tested for the right to continue to be in the role of a father. Of course, all of these things happen on a subconscious level.
How can you hack this program? For example, if a woman is experiencing a low level of arousal and wants to raise it?
You can work directly with the relationship, do something that will give you more intimacy with your partner, because there is a certain linear connection between the deepening of the spiritual connection between partners and the growth of female libido. Basically, Emily Nagoski is talking about this.
Moreover, a woman’s body, even in spite of a state of stress, can turn on in conditions of sufficient sexual context, if, of course, it is intimacy by mutual consent. That is, you can go through physiology, if initially the brain is not very well tuned.
I would also like to talk about attraction and attraction. In your book, you talk about how hormone pills affect the kind of people we find attractive. For example, heterosexual women who start taking hormonal pills often find less masculine men more attractive than those who do not use pills. What other interesting observations do you have?
This is indeed a very interesting area of research, and let’s emphasize right away that if everything is true and so works, then the consequences for your relationship can be very, very significant. For several decades, studies have been conducted that show that during the high estrogen, that is, the follicular phase, women who do not use hormonal contraceptives find attractive men who are more masculine, who have a lower voice, a more square jaw, and so on.
When choosing a mate, the female brain is unconsciously directed to improve the chances of survival of the offspring. A source
While women who take hormonal pills find less masculine men more attractive. The foreground is the ability of a man to financially support his family and his ability to maintain a stable relationship. That is, such women want to find in a man, first of all, a good father, in a sense, a safe partner.
So what happens?
It turns out that pills can affect which partners you choose for yourself, and this, in turn, can affect the frequency of divorces.
There are already studies showing that women who choose partners while taking hormonal pills are less likely to get divorced, that is, they choose not so much males as their fathers.
There is also research that if you choose a partner using pills, and then stop taking them, then you are more likely to start having difficulties in the relationship. The opposite transition – did not take pills and began to take – can also lead to difficulties in the relationship.
Interestingly, everywhere we see a decrease in desire, regardless of which direction changes the status of taking hormonal pills.
It turns out that if you have difficulties in a relationship, instead of immediately getting a divorce, you can try to seek advice from a family therapist?
This is a very subtle area. There are many studies, and the result is difficult to interpret unambiguously. Much depends on what kind of hormone is taken, by what method it is delivered to the body, and what happens to a woman in general, what is her status in a relationship.
It can be safely argued that if you have a generally good relationship with your partner, then other factors will matter less. Therefore, do not despair, please remember that you are not a hostage of contraceptives, and by investing in the quality of relationships, you can achieve a lot.
Let’s discuss hormones in our daily life. It is believed that women are characterized by moodiness, variability of behavior, and all this, of course, is explained by the menstrual cycle. In your TED lecture, you said that it is not true that a woman knows her cycle and in this sense her behavior and psychological state are easy to predict. While in men, the opposite is true – they have a spontaneous change in testosterone levels, and if anyone is changeable in character, it is they. So who should we consider the more capricious and more fickle?
Of course, men. Women are often accused of all sins, referring to the fact that their cycle phase is constantly changing and it is impossible to predict their behavior at a particular moment.
In fact, the behavior of the female hormonal system is very predictable.
In the same TED talk, I said that if you tell me the age of a particular woman and the date when her last menstrual cycle started, I can determine her sex hormone levels with frightening accuracy. We cannot give such a forecast for men.
The main sex hormone of men is testosterone, and it does not change in a cyclical way, there are a huge number of factors at work: age, time of day, presence of a permanent partner, whether he has children or not, he sees a beautiful woman next to him or does not see, his favorite sports team won or not, how his favorite political candidate stands, and so on. By the way, if a man sees a weapon, it also affects testosterone levels.
When testosterone levels change, so does a man’s behavior. The same thing, of course, happens in women, but for men this change in hormonal levels is much more difficult to predict.
What about testosterone levels in women? It also affects social life and our sex drive. How and when does testosterone levels change in women?
Yes, of course, in women, testosterone levels also change, it’s just that these changes are much more modest. Testosterone levels are linearly related to cravings and to winning some competitive sports, even board games.
That is, if a guy wants a girl to want him more, he can play a board game with her and succumb to her to win?
Cool idea! Yes, such non-standard foreplay should definitely work.
My last question will be about PMS. I have heard the hypothesis that PMS is partially due to social factors. That a woman knows that she should experience PMS, and when hormonal changes begin, she begins to “replay” the effects of these hormones and becomes more vulnerable. And if a woman at this moment feels contented and happy, then PMS does not flow so brightly. Does your research support this hypothesis?
PMS is the result of an unregulated response to changes in progesterone levels. When progesterone is metabolized, allopregnanolone is injected into the metabolic system, which is essentially a metabolite of progesterone. For those women who are experiencing severe PMS, allopregnanolone for some reason does not work, because, in fact, it should have a calming function. Instead, women often experience irritation or depression, due to a combination of neurochemical and social factors.
Premenstrual syndrome in women is primarily the result of an unregulated hormonal response to changes in progesterone levels. A source
I can assume that if everything is great in your life, then PMS is likely to go smoothly and easily. But 80% of the time, we are upset about something: boys, girls, dogs, family members, and so on. And this, of course, leads to the fact that the PMS becomes sharper.
But, I emphasize, first of all, this is the result of an unregulated hormonal response to changes in progesterone levels. Such women are often advised to change something in their lifestyle, to try to find a way to reduce stress levels at least on certain days of the cycle.
By the way, pills often have a therapeutic effect – they stabilize hormones and thus “cut off” mood peaks. Therefore, many women, switching to hormonal pills, tell doctors that they are feeling better.
You have read excerpts from an interview with Sarah Hill, author of You and Your Hormones. Want to get the full version of the conversation? Leave your mail here.
Cover photo from here