Weill Cornell Medicine, in conjunction with the 92Y, presented a full-day summit about mental health for the public. Throughout the day, experts from Weill Cornell Medicine shared insights about mental health and wellness, as well as answered attendants’ questions.
During one session, Weill Cornell Medicine physicians Dr. Alison Hermann and Dr. Melissa Katz joined Jacqueline Andriakos, the health director at Women’s Health Magazine to discuss hormones and the role they play in our lives and health.
Dr. Hermann is a psychiatrist who specializes in psychotherapy and mood disorders, as well as the psychiatric conditions related to different life stages, such as pregnancy and postpartum. Dr. Katz is an endocrinologist who specializes in treating patients with reproductive disorders and endocrine problems during pregnancy.
Hormones are chemicals produced within and sent throughout your body to help regulate and control your body’s development. They play a large part in many of our daily functions as well as critical life milestones.
Hormones affect everything from blood sugar to blood pressure, growth and fertility, sex drive, metabolism, and even sleep. Their influence goes as far as changing the way we think and act day to day. There is no doubt that hormones are powerful.
There are quite a few major life events driven by hormonal changes in the female body—including puberty, pregnancy, and menopause. While men have the same hormones as women, they do not experience high levels or intense fluctuations (except at puberty).
Women experience more sudden and frequent hormonal changes. For some, these changes can cause difficult symptoms.
There are a number of symptoms and conditions that we tend to blame on hormones. “Any time we are writing any health story, or talking about any health symptom,” commented Ms. Andriakos. “I get on the phone with experts and you always get, ‘Hormones, hormones. That's it. Let's chalk it up to hormones.’”
Ovulation and premenstrual syndrome might bring about tender breasts, bloating, or skin breakouts. Periods come with cramping and fatigue. Pregnancy certainly has a whole host of physical changes. Menopause can cause hot flashes, night sweats, and vaginal dryness.
There are psychological effects as well. Women often complain of mood swings, anxiety, irritability, insomnia, and other changes in behavior as they experience these hormonal events.
“Hormones have a vast impact on mood and anxiety. And it's all sorts of hormones that do.” Dr. Hermann explains, “Estrogen is actually an antidepressant chemical in your brain. If the thyroid is too low or too high, you can have depression or anxiety. Cortisol, the stress hormone, affects mood. So it's across the board kind of major effects on the brain.”
“The brain can adjust and be okay with either high hormones or low hormones,” states Dr. Hermann. “Where it gets into trouble is when the hormones are changing all the time. Some women are more sensitive to that than others.”
Often patients will come in to see their physician and simply say that they feel “off” or not themselves. Lab work can be done to monitor hormone levels, but both Dr. Katz and Dr. Hermann agree that the level of hormones are not necessarily as important as whether it is affecting quality of life.
Dr. Hermann illustrated how to determine if you should seek help, “Is it getting to the point where you're having significant trouble sleeping or eating? Is it impairing your concentration, your memory, your ability to work or get things done in your day? Is it having significant effects on your relationships? Is it interfering with your work?”
She also stressed that any suicidal thoughts or feelings should certainly be discussed with a medical professional.
One of the most common misperceptions about hormones is that there is nothing we can do to improve the symptoms and quality of life. In fact, there are many different treatment options. For the treatment to be successful, however, it needs to be tailored to the individual’s unique condition.
The first step is to figure out where the disruptions are coming from. Our mood may be most affected, but the root cause may be from easily managed physical symptoms. “Many people are not responding well psychologically because of these base motor symptoms,” Dr. Katz explained.
By beginning a conversation with your physician about your concerns, you can begin the path to finding a treatment plan that works for you. “It's really an individual discussion. I would never randomly say, ‘take this, take that’ I don't know you,” Dr. Katz emphasized. “It's an individual discussion for each and every woman.”
There are many different possibilities and combinations for treatment. For example, there are many different types of hormonal medications. And it is not a simple matter of deciding what you prefer, an amount of trial and error is usually necessary to find the right fit.
“The key is that it's individualized,” Dr. Katz underscored. “There's no right prescription for everybody. Somebody would need to really talk to you about what's going on in your day and your night and what can we do to help you.”
Beyond medication, many experts promote healthy diet and exercise to mitigate both physical and mental effects of hormonal changes.
“Exercise is number one. Exercise, exercise, exercise,” urged Dr. Hermann. “Any sort of mood or anxiety symptom that comes from hormonal changes is extremely stress-dependent. So when your levels of stress are low, you do a whole lot better. When your levels of stress are high, you do a whole lot worse.”
Dr. Katz agreed, “I don't care whether you go to a gym, if you can afford to go to a gym or if you buy $3 ankle weights and walk around the block 10 times. Or you just sit in a chair and you lift your legs up against gravity. You really need to be doing something to benefit your bones, and it'll also help your mood.”
Diet can be equally important in terms of maintaining health and mood. A variety of fruits and vegetables, essential proteins, and minimizing alcohol can all have numerous benefits such as keeping up energy levels, promoting better sleep routines, maintaining a healthy weight, and providing necessary levels of vitamins and minerals.
If the brain’s response to changing hormones is one of the biggest factors in how an individual is affected, a healthy diet will help the brain to function as efficiently and effectively as possible. “You have to get the building blocks from your diet. Things like folate and B12, the brain sucks those up super fast,” Dr. Hermann highlighted. “It's important that you have as much input as possible so that the brain can be as efficient as possible.”
While we know quite a bit about how hormones work, the extent to which they affect our lives is often underestimated. Dr. Katz stated frankly, “I think in many respects, hormones control everything.”
Knowing this, it is vital that we pay attention to our bodies and take care of ourselves. If you ever feel that your quality of life is diminishing due to a hormonal imbalance, know that you don’t have to live with the negative effects or symptoms. With personalized care, a physician can help you find the balance you need.