‘Are You Due On Darling?’ A Double Take on Male and Female Hormones by Rowena J Ronson and Nigel Summerley

RJR: Women from young teens through the menopause regularly come to talk to me about their PMS (pre-menstrual syndrome) They say that they are more emotional on the days leading up to their periods – and they describe themselves as ‘hormonal’. In truth, our whole entirety is run and regulated by many different hormones each and every day – and it is the same, and different, for women and men. As a man and as a health writer, are you aware of how hormones affect men daily and throughout life?

NS: The short answer is yes! There’s an old joke that asks why men give their penis a name… the answer is because they wouldn’t want a stranger making all the most important decisions in their life. I’m sure men are ruled by hormones as much as women are – but as you say, in different ways. Sex seems never to be far from men’s thoughts and desires – but I’ve heard older men say how glad they are to be rid of this powerful driving force since its disappearance allows them to feel they haven’t got something compelling them to act in certain ways. Of course, young men have the opposite experience. Somewhere in the middle – in the male menopause – there may be the beginnings of a happier medium. But do we – both men and women – use hormones as an excuse for how we are? Are we really at their mercy?

RJR: Surely if a man gives his penis a name, he creates a degree of separation – and consequently, he can blame his choices on Mr Whatever, rather than owning them himself? But I get your point. And it is also interesting that you answer in response about sex hormones. We have numerous hormones rocketing through our bloodstream, looking for target cells, each and every moment. But if we start with what you call the male menopause, can you tell me more about that? And in answer to your question, I think men might use the term ‘hormonal’ as a derogatory way to describe some women’s emotions when they become more raw and less controlled before their periods. We are not actually at the mercy of our hormones – we are our hormones. There is no degree of separation.

NS: You’re right that I did jump from hormones straight to sex – which is perhaps indicative of the fact that we generally tend to equate hormones with sexual/reproductive functions, both in women and men. But of course you are also right in that there are many other hormones involved in running our bodies, other notable ones being those involved in our reactions to stress. When any of our hormones become out of balance, we have health problems. The male menopause is controversial but it is posited that it is a transitional period between the peak time of youth and the deterioration of old age when hormonal levels can start to fluctuate. Seven different hormones appear to be involved in the male menopause: testosterone, oestrone, oestradiol, progesterone, androstenedione, dihydrotestosterone and DHEA. And when levels of some or all of these start to change, men’s symptoms can include loss of libido, impotence, depression, sweats, hot flushes and lack of energy. Most men over 40 will probably be aware of some of these symptoms, albeit at a fairly low level – although likely to increase with age. You are also absolutely right in that we ARE our hormones – just as we are all the chemical processes going on in our bodies; and as we are the actions and appetites of the microbes in our gastrointestinal systems.

RJR: But what about my original question. Are you aware of hormones affecting you as a man in your daily life?

NS: I don’t think I am as aware of hormonal changes as you would be as a woman. There don’t seem to be any comparable cycles for men. If the sex drive is purely hormonal, that seems a constant with men – until they get to the other side of the ‘male menopause’ when it dwindles. Moodiness and reaction to stress also seem to be on a constant “line” rather than being subject to cycles. Is it interesting that women have “male hormones” in the mix and men have “female” hormones? And are you aware of hormonal changes in that you wake up and know that this day is going to be very different to the previous day?

RJR: But the sex drive for men isn’t purely hormonal is it? It will be influenced by who might be inspiring them at the time, and whether they are being satisfied or frustrated, maybe in the same or different way as it is for a woman. Cortisol is the hormone that influences how much energy we will have during any day. If we are under stress, particularly for a long time, we can wake with a low level of cortisol, and getting up can be a real struggle.

NS: Sexual desire seems to have a large psychological element, but, as I said, from what older men have told me, that seems to disappear in later years… so the hormonal element must be considerable too. And as you said, we are our hormones – so maybe even the psychological desire is hormone-driven? I understand what you say about stress, but I was wondering whether, as a woman, you are acutely aware of hormonal cyclical changes on a day-to-day basis – or do hormonal changes sweep you along so that you are not fully aware of them?

RJR: I hear that from older men too. I know that if I am in a healthy place in myself and all is good in my internal and external worlds, my hormones feel balanced as a result – which of course makes sense.  I write this having pushed myself too much this week with a very heavy load of patients. And I am feeling the consequences today, chemically. I am totally exhausted and need to rest. Lucky it is Sunday! But I am the kind of person who really listens to my body and follows her callings. I will feel energised tomorrow having rested today. With awareness, we are more likely to have some control over how we feel chemically.

NS: But it seems as if “we” can’t have complete control over what we really are – these complex creatures with all sorts of processes going on that constitute “us” but which go on whether we want them to or not. Do you feel sometimes, some days, that you aren’t in control at all?

RJR: When I said control, I meant that if we aware we can look after ourselves to the best of our ability and therefore our bodies will not get depleted or exhausted. ‘Control over what we really are’ is a whole other matter. This goes back to what we were saying earlier, we are our hormones and are hormones are us. I would say that when we are in a relationship with an addictive substance – that can have control over us – and our chemicals. And in answer to your question – no, I don’t have days when I am not in control at all. As I see patents most days, that is certainly a good thing! At least I can say, I walk my talk! What about you?

NS: I am not aware of any predictable cycles related to hormones. Mood seems to be dependent on good sleep and lack of stress, as far as I can figure. Sexual desires/needs driven by a mixture of psychological and hormonal factors seem to continue on a straight line, regardless of what is happening. Real balance seems to come from involvement in creativity and being attentive to other people’s needs – this awareness, rather than a ‘control’, seems to make everything function better. Maybe we should accept that our hormones and chemical changes in our bodies ‘know’ what they are doing and leave them to get on with it, paying much more attention to living and creating? It would be interesting to hear from your readers (female or male) what they think of the role of hormones in their lives.