‘Aroused’: an exciting look at the hormones affecting hunger, sex and everything

NEW YORK — Randi Hutter Epstein says that there’s a lot of confusion about hormones. So much so, in fact, that she decided to write a new book explaining the history of hormones and how these powerful chemicals govern everything from hunger to growth, from sleep to mood swings, from libido to metabolism.

“You think of hormones as boobs and puberty and sex. Within the history of hormones it’s been this century of amazing advances but also of outrageous claims,” says Epstein, a medical writer with an MD/MPH who weaves science and storytelling in her new book, “Aroused: The History of Hormones and How They Control Just About Everything.”

“People think of hormones as if it’s some nebulous thing. It’s not a nebulous thing. I wrote the book so people could have a really good handle on what’s real, what’s fake and what are some of the really wonderful stories,” Epstein says.

The book’s title, which is written across the cover in hot pink, may suggest sexual desire but is in fact a nod to history. Back in 1905 two scientists asked their friend, a University of Cambridge literary scholar, for a Greek word meaning to “arouse or to excite” — as in cells in the body. He suggested “hormao,” and thus was born the word “hormones.”

An adjunct at Columbia University School of Journalism and a lecturer at Yale, the 55-year-old Epstein takes readers on the long and strange road of scientific discovery — such as when the German physician Arnold Berthold castrated two of his backyard roosters in 1848 to see what would happen.

They got lazy, fat and lost interest in chasing hens around the yard. Then Berthold implanted another testicle into the belly of one of the castrated birds and watched as the male “turned back into a full-fledged hen chaser.”

There are stories about false “cures” and dangerous missteps, as well as lifesaving discoveries — many made by women.

Rosalyn Yalow received the Nobel Prize for discovering the radioimmunoassay that makes measuring hormones and treating imbalances possible; Barbara Balaban launched a nationwide campaign to collect pituitary glands from cadavers’ brains to extract growth hormone for her short-statured son.

Epstein recently sat down with The Times of Israel to talk about her book.
This interview has been edited for brevity and clarity.

Nobel Laureate Rosalyn Yalow had a sign in her lab: “To be considered half as good as a man, a woman must work twice as hard and be twice as good… Fortunately, that is not difficult.” Talk about what she did and the challenges women in science face today.

Nowadays we take measuring for granted. We forget that we went from not measuring at all, to after Rosalyn Yalow, when we can now measure down to the billionth of a gram. A billionth of a gram! Today that same technique is used not just for measuring hormone levels, it is used for anything we used to consider immeasurable. We would not be able to measure HIV had it not been for this technique. People who get cancer markers traced for treatment would not have been able to do it had it not been for this technique.

She’s a phenomenal story of a woman who had so many barriers in front of her. She also helped promote younger female scientists. I don’t think Yalow was thinking, “I want to revolutionize medicine. I want to become a leader.” She was someone simply fascinated with learning and science. Her parents were Jewish immigrants and they wanted her to have an education.

When you talk to women in science today they’re going to say it’s still tough, but it’s a hell of a lot easier. You’re not going to graduate top [of your class] in physics and have someone say you should be secretary for a physicist. Hopefully you’re not going to graduate from your PhD program with straight As and have a tough time getting hired because you are a woman. But I think female scientists still complain that they’re not getting some of the breaks men get. It’s still hard in academic medicine if you’re on the tenure track trying to figure out how to have a baby and publish at the same rate as those who aren’t involved with children.

I don’t care how important your work is, you’re still going to get that text message, ‘We ran out of milk’

I think women are still trying to figure out how to make homemade meals, be the perfect mom and be the perfect career person. We’re trying to figure out how to have two intertwined lives. I don’t care how important your work is, you’re still going to get that text message, “We ran out of milk.”

In the book you talk about how women’s health activists pushed for safer birth control pills. Do men require the same activism when it comes to their health?

Oh, God no! Absolutely not. Let me put it this way. A lot of what happened with birth control is of course because of scientists. But a lot of why they did what they did was because of women pushing them to do so. Even today we could have better treatments for menopause if anyone seriously cared what women go through starting in their 40s when the first hints of menopause come.

But let’s go back to birth control. The first pills were dangerous. The first women who took them were saying, “Oh my God, I feel pregnant when I’m on this pill. I feel fat, I have headaches, and I’m moody.” The response was “Well, better than getting pregnant when you don’t want to.”

I listened to an old interview with a male doctor during the time they were developing the pill. He was talking about how wonderful this birth control is and how the side effects really were not that terrible. Then he was asked about birth control for men. And he said, “We tried a hormone pill for men. We did a small study but these men felt like they had just taken a shot of bourbon. It made them feel off. So we had to stop the study.”

Women were saying, ‘We don’t feel good,’ and ‘Oh, this pill may cause a stroke or death,’ and the men were saying don’t worry about it

Women were saying, “We don’t feel good,” and “Oh, this pill may cause a stroke or death,” and the men were saying don’t worry about it. Then a few men said, “We feel a little off,” and it’s, “You better cancel that trial.”

History shows there has always been a search for the quick fix when it comes to hormones and feeling good.

There’s a new thing going around called adrenal fatigue. It doesn’t exist. It’s not real. One can Google it and find all sorts of cures. Hopefully you’re just wasting money if you take one, but you shouldn’t because you don’t know what it will do and because it’s not real.

If you think you have something wrong with your hormones you should never go to a health coach or to someone who claims to be an anti-aging specialist. You want to go to someone who seriously understands how hormones are connected to your health, like an endocrinologist. You don’t want to go to someone who has a 9-5 shop connected to a supplement making company.

After spending several years with this subject, what’s your reaction when you hear the word “hormonal” to describe a woman?

No one ever says, “He was so hormonal. He was being such a hormonal jerk.” When we think of men and hormones, we think, “Wow! Someone with the perfect muscular physique and an astounding libido!”

The word hormonal has come to mean a woman going off the rails. I mean, my dog has hormones. My husband has hormones. My son has hormones.

That’s not to discount that some women really do feel out of sorts before they get their period. Or that in perimenopause women can feel out of sorts. But that said, hormonal has come to mean a woman’s hormones have taken over and she’s saying crazy and stupid things. Maybe we get a little bitchy at times because we are provoked by hormonal men to become bitchier. But we’re not stupider. Anyway, men have issues too. There are men that can have very low testosterone and they can feel tired and that can be very depressing.

Seriously, there are so many other things related to hormones than the menstrual cycle. For instance, we know that people with Parkinson’s disease have an issue with dopamine. Dopamine we know is linked to happiness and to addiction issues. It’s also linked to movement — that’s the Parkinson’s link. When you are depleted of dopamine the sadness may not just be due to, “Oh my God, I have Parkinson’s.” It could be chemically due to the fact that people are lower in this hormone.

It’s all such a chemical stew it’s very hard to say, “I’ve been down in the dumps lately because of X.”

Should we get a hormone panel done the way we do genetic testing?

I don’t think so. Hormone levels change so much throughout the day. There is such an ebb and flow of hormones that you’d only be getting a snap shot of a wave in the ocean. Maybe your cortisol just went up because you’re stressed or you had a fever. Your insulin went up or down? Maybe you hadn’t eaten or you had eaten.

We have to remember there’s a person behind the numbers. I sometimes wonder what we do with all this data. I think you’d see your hormones going up and down and it would freak you out.

The study of hormones as it relates to our understanding of gender and transgender is getting a lot of attention recently. What are the ethical questions for scientists and society as this research develops?

We think that starting at about six weeks in utero there’s a hormone that kicks in and you go toward what is either conventionally girl looking or conventionally boy looking. We have a hunch that at that time, when those hormones are altering your anatomy, they are also altering your brain wiring. Normally the brain wiring matches the anatomy but sometimes it doesn’t. We don’t know why.

As opposed to the early days when we put people with hormone issues in the circus to be gawked at, or the horrific time when we tried to convert homosexuals by giving them hormones, I hope we are becoming a more accepting society. I hope we don’t try to manipulate these things.

That said, we are never going to tell scientists not to try to understand things like what makes someone transgender. There is fascinating research about what makes someone identify as transgender. We’re not going to stop that research and I think it will help us understand the human body.

What frightens people in the transgender community — rightly so — is they would never want their decision to be based on a blood test. So there’s a fear that if some study comes out and says people who identify as transgender have this level of hormone in their blood and then you go to the doctor and you “fail” the blood test, the doctor says, “I’m sorry we can’t treat you, you don’t have the right levels.”

What frightens people in the transgender community — rightly so — is they would never want their decision to be based on a blood test

A lot of clinicians who treat those in the transgender community now worry about the high suicide rate among those who identify as transgender – it’s 40 percent, 10 times the national average. So those doctors who know they can make you feel better in your own body do not want to base that decision on one test that could be wrong.

Aside from research into how hormones affect obesity, what are some of the new frontiers in hormone research?

We are learning a lot more about behavior and oxytocin (not to be confused with oxycodone, which is an opioid), but we’re not there yet to use it for any treatment. We’ve known for years that oxytocin squeezes the uterus and gets the baby out. It gets the breast milk flowing. Recent research shows it also has some social stuff going on, some behavioral stuff.

But we’re not yet where we’d say spray it on you and the guy next to you is going to love you. The only time that we know oxytocin has these wonderful hormonal pulls are if you happen to be a female silk worm. They can emit hormones like a pheromone. We don’t have this ability. But if you are a female silk worm, you can release a chemical and if a male silk worm gets it and travels far away, he will come back to you like a sex slave.