Dossier: Sexuality

How hormones affect us

There are phases in life where we hardly recognise ourselves any more. Suddenly we are irritated at the slightest thing, down in the dumps or close to tears. The simplest explanation is often to blame our hormones. But how much influence do they really have?

Text: Julie Freudiger; photo: Sanitas

Going jogging or singing a song makes us happy. And not just because it “does us good”, but because it releases the happy hormones serotonin and dopamine. How we react, feel and think is not just dependent on our genes or what’s happening around us. Our hormones also influence our daily life and personality. This is particularly noticeable in phases of hormonal change. Some people suddenly react impulsively or are downcast or listless. For those affected, their reactions and feelings are often just as stressful, sometimes even puzzling, as for the people around them.

“Why are you so grouchy?”: young people and puberty

Expert: Professor Urs Zumsteg, Head of Endocrinology/Diabetology at Basel University Hospital

If your son or daughter’s moods seem to change by the minute and it’s hard to get a word out of them, this is a sign that puberty may have started. This stormy phase is kicked off by the adrenal gland: spots start to grow on their skin, their breasts develop and their voices deepen. The hormones stimulated by the adrenal gland cause skin changes in both sexes, among other things. The stress hormone cortisol is also released in greater quantities. And the ovaries and testicles start to produce more of the sex hormones oestrogen and testosterone. “Going through puberty, young people’s bodies change almost daily – and it’s not easy for them,” says Urs Zumsteg. “However, I believe that we overestimate the direct influence of hormones on our personality, because young people who are particularly aggressive or big risk-takers don’t have more testosterone than others.” The higher levels of stress during puberty aren’t directly attributable to hormones either.

Zumsteg believes that this – and the moodiness of pubescents – is mainly due to the social and psychological challenges that they face. It is a challenging time in which teenagers not only feel strange in their own skin but they also start to break away from their close-knit family circle. The unreasonable and impulsive behaviour that can drive parents to despair is due to maturation processes in the brain. “The brain matures from the back to the front, with the areas that control our emotions and impulses being the first to develop, and reason the last.” But thankfully this process doesn’t last forever. 

“Oh, she’s just on her period”: PMS and the female cycle

Expert: Professor Brigitte Leeners, Director of the Clinic for Reproductive Endocrinology at the Zurich University Hospital

Women are often irritable, moody and listless shortly before and during menstruation. Are hormones to blame? Brigitte Leeners doesn’t think so: “Research results indicate that women are mentally and physically capable at any point in their cycle. Except for those who suffer from PMS.” PMS stands for premenstrual syndrome and is the name of an illness that includes around 150 symptoms and occurs in the second half of a woman’s cycle, i.e. after ovulation. Typical symptoms include exhaustion, bloating, irritability, poor impulse control and depressive moods.

The symptoms stop once menstruation starts. This is indirectly related to hormones. In the first 13 days or so of the menstrual cycle, the female feel-good hormone oestrogen increases. If the egg is not fertilised, oestrogen levels fall again and the hormone progesterone increases, causing a tightening in the breasts. But it is not the fluctuating hormones themselves that trigger PMS symptoms, but how the brain reacts to them – and this varies from woman to woman. Studies show that 20% to 30% of women suffer from PMS. Leeners estimates that the number of women who suffer from one symptom – by definition this does not equate to PMS – is more than 70%.

“However, it may be,” adds Brigitte Leeners, “that patients experience pain and mood swings before their period because they expect to. It’s like a self-fulfilling prophecy.” A lot of myths still abound about periods today. It is often forgotten that complaints during menstruation are actually the exception rather than the rule.

“It’s like I’m being controlled by someone else”: menopause and mid-life crises in men and women

Expert: Dr Anna Raggi, Vice President of the Swiss Society for Gynaecological Endocrinology and Menopause / Dr Roger Schneiter, specialist in endocrinology at the Zurich University Hospital

Sex hormones begin to decline from around our mid-40s. During menopause women are most affected by the lack of oestrogen, suffering hot flushes, problems sleeping, joint pain, lack of sex drive and vaginal dryness. “Some patients say that they feel like they’re being controlled by someone else,” says Anna Raggi. Women are two-and-a-half times more likely to develop depression during the menopause, because oestrogen has a positive impact on our central nervous system. When levels fall it can cause irritability, depressive moods and even depression.

However, the menopause specialist says: “The symptoms experienced during menopause are not due to hormones alone. Sociocultural factors also play a role.” For example, when women struggle against getting older and worry about negative changes before they happen. If the symptoms are severe, Anna Raggi recommends prescribing hormone replacement therapy tailored to the patient’s requirements. Menopause can last several years – and the earlier the symptoms start, the longer they last.

“Men’s testosterone levels fall on average by around 1% a year from the age of 30 to 35, but it varies considerably,” says Roger Schneiter. So men don’t experience menopause like women. But this doesn’t mean that men breeze through this phase of life without any problems. “Declining testosterone levels can reduce desire and cause erectile dysfunction.” Some men, but by no means all, also experience tiredness, lack of energy and weight gain. So, mid-life crises tend to be less the result of hormones and more about a fundamental unease when it comes to change. And men and women of any age can be affected.

What do hormones actually do?

Hormones are messenger substances that send information in the body from A to B where they trigger reactions. They are produced in various glands. For example, the sex hormones oestrogen and testosterone are produced in the ovaries and testicles. Insulin, which regulates blood pressure, is produced in the pancreas. 

Endocrinology is the medical speciality that deals with diseases related to hormonal disorders. There is still a lot that we don’t know about hormones. Each year several new messenger substances are discovered, and we are learning more about them all the time.