Hormones, meaning a woman can feel angry and irrational

At what point in the cycle are you? How are you feeling?

I’m on my period right now and I’m going through it terribly. This year I was diagnosed with endometriosis. I’ve felt it for a long time. I had a terrible, painful night, I felt sick. In the morning I took some painkillers, but although I feel okay mentally, physically I’m still not doing well. Is this question asked among your girlfriends?

I guess not. If any comment is made about periods, it is only when it exceptionally keeps us from living. I was once at a workshop for women entitled “Free Your Pelvis”. Each meeting began in a circle. And the women freely said what phase of the cycle they were in, how they were doing. It was like a revelation to me.

My friends and I still do it. We have a group on WhatsApp. One writes: I feel lousy today, I am furious or worried. In the last five years, we have begun to ask ourselves this very question: where are you in the cycle? What a relief! What a sense of community and understanding. How old are you?

This year I will turn 34.

And I will be 36, so we grew up in similar times. Even when I was well in my twenties, I didn’t follow my period. Nobody did it back then. It’s always been a surprise that I feel irritable or scared because of it. It doesn’t surprise me any more.

I wrote the first book on anxiety. I did a lot of research on what it results from and how we can live with it, but it was also personal. I have noticed that when we are able to push aside all this shame and talk about how difficult our period is or anything related to this area (Eleanor makes a circular motion on the lower abdomen), there is a great feeling of relief.

Before writing this book, I had a feeling that I was an intelligent, educated woman, but not so much when it comes to my body, my cycle. While I have always suffered from PMS, I have never tried to understand what was actually going on.

You went through a nervous breakdown, you started looking for ways to deal with it and understand it. Along the way, you’ve noticed that menstrual health is part of your mental health.

Yes, I have. I was also encouraged by my agent, once we were struck by how many points of view you have to use to look at this issue: biology, psychology, social conditioning, the history of women’s health in medicine – there are so many of them! The whole history that had happened before us affects the potential troubles we may have and the shame we may feel. I embarked on a personal journey to understand and so that we, as women, could gather together and see why it is so difficult for some of us, both physically and mentally. What it’s like to live in a body that suffers. It was personal and political at the same time.

To look at medicine through this prism is shocking. We want to trust it, and we should because it is based on scientific research. Most of the studies were conducted in trials made up entirely of men. Therefore, the diagnosis of female ailments, such as the fairly common endometriosis, takes an average of 7 years. When you wrote “Hormonal” you had a feeling of that too, but no one gave you that diagnosis. Only just this year. So should we trust doctors or not?

When we are sick, we want to lean on someone who knows. However, the gaps in research into women’s health, especially reproductive health, and especially women’s hormones and their relationship to other parts of the body, are huge. Research on female pain is also very limited. Many of us are not taken seriously when we say we are in pain. I was at the death’s door because of this.

Tell me about it please.

I was a teenager, I got my period, but I felt an explosion of pain unknown to me. And since I always felt terrible during my period, there was a clear explanation for my pain – my mum exempted me from school exceptionally, but told me to just lie down on the couch. I would lie for three days. No appetite or life, with a vomiting bucket at hand, in streams of sweat. Painful contractions pierced my stomach every now and then. I complained to my mother, but she only thoughtfully assured me: you will be fine. On the fourth day, I passed out for a moment. My stomach was bloated. My mum took me to the clinic. The GP put a hand to my burning forehead, found that my menstrual period was clearly accompanied by a viral infection. Fortunately, my mother did not trust this diagnosis and asked for a consultation with another specialist. I could barely move from the pain. It turned out I was septic and not hours away from dying on that couch. It appeared as a result of appendicitis. I still have various intestinal problems, a consequence of adhesions after surgery.

I trust medicine, but also after a lot of research and conversations with so many women, I learned to be my own advocate in this field. I wrote this book with the intention of giving women something like a bible of knowledge so that if they find themselves in a similar situation, they would know more about themselves, and at the same time be aware that they can say: this seems wrong to me, I would like to talk to another specialist or: I would like to have either an X or a Y test. We learn to quash our pain, we feel that we must remain stoic towards it or even downplay it in order to be taken seriously. We don’t want to be considered difficult, embarrassing, hysterical. Equipped with knowledge, we can have these conversations differently, and not give up.

Reading your book, I remembered a nurse silencing me during childbirth because she thought I was screaming too loudly, and two years earlier, just before the curettage treatment (my first pregnancy was not developing properly), which was at 9 a.m., the doctor was singing merrily between my legs: “I made an appointment with her at nine.” At the time, I was mentally shattered, depressed, and terrified. Then I was lucky enough to sail away.

That’s so bad! Many such stories reappear after reading the book – see how much we have buried in us. We have the right to question what makes us angry, that when we are vulnerable, we are not treated with care and respect. After putting on the Mirena IUD, the nurse rushed me to leave the room. I said: if I get up, I’ll pass out or vomit, give me 10 minutes. But she knew better. I left sad, irritable and defenceless. If you are lying on the bed with your legs open and waiting for a procedure like curettage, you are in an extremely vulnerable position, then you should be treated with care and gently. I have heard of miscarriages and abortions in which women are looked after very well. Usually, other women took care of them. However, there are still many stories like yours.

You notice an interesting thing: the wellness industry, while it certainly brings a lot of good, sometimes deceives us with one simple trick: the very fact that we feel heard by someone for the first time. I was also struck by what you experienced during your internships in the bariatric clinic.

I did student internships in a clinic dealing with the treatment of chronic pain and mental assessment of people qualified for the surgical treatment of obesity. I had a bias when it came to obesity. My supervisor opened my eyes and those months changed me completely. Nobody wants to be that big. No one! 80 percent of the patients were women. Each of them had a traumatic experience – often at this meeting, it was the first time that they had revealed that they suffered sexual, physical or emotional abuse in the past. Before, it had never occurred to me that there could be such a clear link between past trauma and disturbed eating patterns. I am not saying that this is the case with every obese person. But this link to the psychological wound in our body is clear, it’s like the dots connect. Mind and body are one.

We’ve been rediscovering this recently in the Western world. We have been convinced for a long time that the body is a machine and the mind is an independent entity. In the case of women, there is also an additional reason why we don’t know all these important things about ourselves. That’s the p word (period). Aristotle claimed we had “bad biology”. In Victorian times, women with uncomfortable states or personalities were labelled as hysterical. In our culture, menstruation has always been the reason why women were excluded from making decisions and meetings. It all shaped the society in which we live and heal.

We both know that we have a long, long road ahead of us, but slowly women in the world are starting to unite in an important, meaningful way. My book and many other books on periods and pain have been published. Women are taking over.

In your book, we can learn about how our body works, what Mittelschmerz or ovulatory pain in the middle of the cycle are, what the role of the GABA neurotransmitter or aminobutyric acid are or what PMDD and premenstrual dysphoric disorder are. But also about three cases of women who have had their sentences reduced for crimes committed, including the murder of their own child, due to aggravated PMS symptoms. When I read about it, I thought: it’s fantastic that our experience is taken seriously. And then immediately: this is how we perpetuate myths about women as irrational beings. Is it good or bad that there are such justifications in the courts?

I agree, it’s hard to be dogmatic in this regard. Recognising that a woman can feel angry, mad, irrational is good. On the other hand, I feel a strong opposition to pathologising women’s experience. We do not want to perpetuate the belief that women are naturally predisposed to losing their self-control. It makes me wonder: what led this woman to such a loss of control? This area is incredibly underdeveloped. Biology is only a small part of the picture. Because what does it actually mean: to lose your temper? As a therapist, I would ask: what else has happened in your life? What was your home life like? Have you experienced a loss recently? Are you in a difficult relationship? What is your work situation? What is your overall health, anyway? There are so many factors that we can never claim: it’s just hormones. That’s not fair.

You write about the concept of hormones as a truth serum – when their levels fluctuate. I have hypothyroidism and Hashimoto’s disease, so this sentence caught my imagination again. I realised that something was wrong with my hormones after weeks of sudden changes in mood, explosiveness and tearfulness. When I got the diagnosis, I decided that one pill was not enough, because there must be more to it, and I went to psychotherapy.

Did it help you?

Yes, it did.

This approach seems right to me. The idea that you only need to take a tiny pill that will fix everything is tempting.

If you have Hashimoto’s disease, you have to take levothyroxine because you’re lacking it. But all my friends suffering from Hashimoto say what you say. Emotions are never just biological. They cannot be. They are much more complex. They are memory, patterns of behaviour present in the subconscious mind, memories of pain. It all suddenly gets thrown outside. My friend with Hashimoto’s says: Sometimes I feel like there’s a gremlin in me just waiting to come out. Biology is of course very important, but it always has emotional implications.

Do you think that we should learn to live with our discomfort, which is not a popular idea today, instead of immediately chasing it away, e.g., by eating chocolate?

We spend so much time thinking about what we should and shouldn’t eat. My opinion is that if we use it wisely most of the time, then eat that fucking chocolate once in a while! Because sometimes you feel sad, sore and need some consolation here and now, life is too short to say ‘no’ to yourself. But at the same time, it’s worth knowing what can happen. There is good research that has shown that pre-period hormone levels affect how we feel when our blood sugar drops. If we eat a lot of cookies and biscuits, we will feel this decline a lot more than usual. With this, it is of course different for different women. I feel this decline a lot, but I eat chocolate anyway when I feel like it.

In the last two months, I ate it every day because I was finishing my book and needed superpowers and comfort every afternoon.

And here I am vaping. There’s not much tobacco in it, but I shouldn’t, because I have asthma. I exercise a lot, eat well, sleep well. Sometimes we have to take it easy.

Another ambiguous topic: diagnosis. Sometimes it brings relief because it puts our suffering in context and reduces the burden. Sometimes it is a source of oppression because it becomes a stigma. This is especially true in the case of borderline disorders. You write that this is the new hysteria.

Like many other psychologists, I am convinced that this diagnosis is unfounded. There is absolutely no evidence that there is any biological basis for it. The very fact that the overwhelming majority of women receive the diagnosis (3 out of 4 people) means that you need to think about it. Another thing that should give us pause is that the diagnosis is clearly linked to the experience of trauma. Many obese women I met during my internship were diagnosed with a personality disorder at some point in their lives. On a very basic human level, I don’t think anyone has the right to tell anyone that their personality is disturbed. When the overwhelming majority concerns women who have experienced sexual or family trauma in the vast majority of cases, or have been let down by the system: they were neglected. Telling them: your personality is disturbed is an act of violence. Another trauma. This is very controversial in our environment. It is more often referred to as PTSD syndrome, PTSD complex. Because that’s what it is.

It can also be confusing – when you come back from a war you know what to attribute your PTSD to. Otherwise – to your life?

War is a good analogy. If you are a female survivor of some type of sexual abuse, for example, a personal battle is going on in your brain. We learn to survive, to deal with it in ways that don’t actually help at all. We fight in a relationship, we fight at work, we constantly want to make sure that we are safe: running away, getting into conflict because it’s a way to feel some kind of bond. I met women who were chronically afraid of being abandoned and who were able to do anything to keep their partner.

Now the wind of change in psychology and psychiatry is blowing and we are starting to analyse whether the diagnostic system really works because so far there has been no scientific evidence of it. For example, there is no such thing as a disturbed chemical equilibrium, although we have been seduced by the idea. Claims that depression is merely the result of lowered serotonin levels should be rigorously challenged. Scientific evidence does not show this at all.

You managed to find the answer to the question that bothers you: who are we when we don’t feel like ourselves? Because we often say this: it wasn’t me, I wasn’t myself, it’s the hormones.

This results from the belief that we should be steady and stable. This concept covers both women and men, but is especially important for women. Because we have to face the message that we cannot be relied on because we are changeable. Yet being human means not being able to feel the same way all the time.

 

Eleanor Morgan - a British journalist specialising in psychology and women’s health, she cooperates among others with “The Guardian”, “The Observer” and “The Times”. Author of three books, incl. “Hormonal: A Conversation About Women’s Bodies, Mental Health and Why We Need to Be Heard.” She is currently working on the fourth book, “Maps of Desire”

Author: Maria Hawranek

Illustration: Marta Frej

The text was published in „Wolna Sobota” a magazine of „Gazeta Wyborcza” on 17 July 2021