Sunday, November 23, 2008

Actually, Science DOES think about these things.

I don't know much about this field, and of course there is no conclusive discussion (because there hasn't been one of ANY neurological issue so far in science and medicine--we're still working on figuring out how everything about neurochemistry systems work). BUT it is simply not true (as suggested by JLK in a comment about Ambivalent Academic's post in response to mine) that it's all a "myth" that women experience strange and disruptive neurological symptoms as a result of hormonal changes.

Unless there was some major debunking study that I just didn't happen to find in my Pubmed search for 'hormone levels pms,' it looks to me as if plenty of people are trying to understand this and clinicians take it pretty seriously.

I haven't read Fausto-Sterling's book so I cannot comment on what evidence she provided for her apparent assertion that "PMS does not exist." But if she thinks it doesn't, she must be as fucking lucky a lady as JLK, to never have experienced these feelings of someone else inhabiting her body dictating her response to the world around her. I'd like some of what she smokes, please.


Ambivalent Academic said...

Yeah, whoops!

There's all kinds of science on this subject. There's no official science party-line dogma as to whether or not PMS is an official "syndrome" in this country (others have already decided that they can treat it as such). that said, I don't think that there is any self-respecting scientist out there who can assert with a straight face that hormones do not affect your neurological state. And for the non-scientists out there - remember when you were a teenager.

It's tricky to study because a) hormones are slippery little buggers and it is hard to measure them in real time especially while manipulating the experimental system but we're getting better at it, b) since "baselines" vary greatly between individuals (and over the course of even a few hours) it makes it had to establish real differences within an experimental group.

I am somewhat sympathetic to JLK's ignorance on this matter. Before I was on the pill I didn't cycle regularly and I didn't have any PMS symptoms to speak of. At the time, I thought all those other girls who did have symptoms were being big whiny crybabies and making it all up (it probably didn't help that the worst "offenders" were the drama-queen type to begin with). Yes, I was one of those lucky fucking ladies. I know better now that I've had my own experiences with it, and I know just how-hormone dependent it is after having been through all the different "drugs" and doses and feeling all those fluctuations. I wonder if we could convince Dr. Jekyll to blog about her mental state as she goes through the super-ovulation regimen for her IVF cycle.

JLK said...

Just to let you ladies know a little something about me.

I had an irregular period for most of my life.

I was on depo-provera for 6 years in which I experienced both a period that lasted for 4 months straight and then a 4.5 year time frame in which I had no period at all.

I have now been on birth control pills of two different kinds - the 30 day kind and the 120 day kind.

I was also an egg donor, during which time I was on Lupron, Gonal-F, and some other shit that made me completely fucking miserable physically because I was carrying the volume equivalent of a 15wk pregnancy in my abdomen.

I have experienced all the same shit that you have. I have probably experienced WORSE than you have because of the egg donor cycle.

But until pregnancy is listed in the DSM-IV as a possible mental disorder because of the hormonal changes that affect the brain, I will continue to rage against anyone who categorizes women's behavior as being determined by the biology of being female.

Arlenna said...

JLK, rage all you want. The biology of being female still controls our behavior just as the biology of being human controls our behavior.

If that doesn't, what does? Magic fairy dust? God(s)? Chemicals are chemicals and they DO affect our behavior, all the time every day. Just because it makes you mad doesn't make it not true. It makes me mad too. I hate it. But it is there, and despite my best efforts to control it sometimes I still doubt myself--that's why I opened up to talk about this taboo subject.

The taboo says that we aren't supposed to talk about it precisely for the reasons you bring up: because it isn't helpful to our case. Well, fuck it--it's still there whether we want it to be helpful or not and I am morally against hiding data that might contribute to the interpretation of what is going on simply because I don't LIKE the data or what it might mean. There is both subjective, internal data that plenty of us recognize and there is the objective data about hormone levels and behavior. It's there. What we do about it is a different question.

JLK said...

"The biology of being female still controls our behavior just as the biology of being human controls our behavior.

If that doesn't, what does? Magic fairy dust? God(s)? Chemicals are chemicals and they DO affect our behavior, all the time every day."

Really, Arlenna?

Explain to me the placebo effect in terms of your biological basis without adding the variable of expectations.

Arlenna said...

Bodies are made up of huge, incredibly complex sets and coordinations of molecules. The only place 'expectations' have in that system is in creating a molecular response that we haven't explicitly identified yet. Most biological signaling and communication happens using the same sets of chemicals, just used in different combinations and ratios. If expectations can affect those, then the placebo effect can work.

JLK said...

Okay. So we are in agreement that environment, the person, the situation, etc can affect biology and chemistry.

In my field, we study psychophysics - the relationship between psychological and physical events, and this includes everything from vision to pain.

One thing we know for certain based on research is that pain perception is subject to the effects of expectations, mood, and myriad other factors that we can't explain in terms of physiology, at least not yet. If you really believe something is going to hurt, it's really gonna hurt, and vice versa.

Another thing we know is that there are a substantial number of men out there who report similar symptoms as the women in their lives who are experiencing menstrual cycles and/or pregnancy. Again, we can't explain that in terms of physiology yet.

I am a complete and total agnostic, if you will, in the nature versus nurture contraversy because of the things that I have seen demonstrated in the labs of my field.

Because of the complexity that you're talking about, as well as my personal feelings about the stigma attached to this issue, I hesitate to ascribe any human behavior or experience as solely stemming from biology or chemistry, especially when it is so politically charged.

As an example, testosterone was long believed to cause high levels of aggression. A genetic syndrome causing males to be born with an XYY genotype is the best way to illustrate. They tend to be taller, more "masculine" in appearance, and have higher testosterone levels. Some early studies showed that XYY males were overrepresented in the criminal population, and people began to believe that there was a "criminal gene" and that the testosterone led to their criminal behavior.

Turns out that in a controlled study that compared these guys to the general population and males with XXY chromosomes, these men did not tend toward criminal behavior any more than their "normal" counterparts with lower levels of testosterone. What did predict criminality was lower intelligence, something that the XYY genotype has been demonstrated to cause.

There are so many interactions among chemicals in the body as well as our situational and dispositional factors. I'm not saying that the premenstrual experiences are not caused by hormonal changes. What I am saying is that we just don't know enough to be able to say that definitively considering everything that we know about psychophysics.

The only things that I am confident in defining as female problems are breast, ovarian, and uterine cancers.

I really, really want someone to experiment with men's testosterone levels as well as women's estrogen levels. Unfortunately, I'm pretty sure that these studies would be unethical in every setting that isn't a clinical trial for an experimental drug, and then you're adding in that drug and its components as a confounding variable.

Arlenna said...

Testosterone is another part of the story, too, that affects women as well as men.

There was an awesome This American Life program about it:

I wish they'd had everyone including the men in the group also get tested for estrogen and progesterone, and repeated their tests every day over the course of a couple of weeks.

But still, when I started this discussion it was from an internal recognition of what is going on around here. My baseline is the same as Ambivalent Academic's: my own feeling of how I feel most of the time. I am notoriously bad about scheduling and calendar and perception of time, and my cycles are not evenly distributed, as in, they don't occur with clockwork regularity so they always come up at me as a surprise. I never know it's coming, and yet it always manifests the same way: body snatchers come and put someone else in my body.

I am sure it is possible I could be affected by some placebo effect of expecting myself to change brought on by cultural indoctrination, but given that I don't even realize it's going on until it hits me that seems unlikely. I too have experienced something like what AA and Neuropostdoc talk about, with a version of the pill that completely and royally fucked me up. That's why I can't be on birth control anymore, it whacks me out to the point of mental illness. Yes, brain dysfunction. And the whole point is: I change with these same feelings a little bit about once a month or so for a few days. And it affects the way I feel about my abilities.

Whether it affects my ACTUAL abilities is the real point, and what we all seem to agree on is that it should not.

JLK said...

"Whether it affects my ACTUAL abilities is the real point, and what we all seem to agree on is that it should not."

Yes! I've spent like all afternoon and all evening trying to articulate that exact point, and you managed to do it in a single sentence.

I'm incredibly jealous right now that you were able to do that and, try as I might, I just freaking couldn't get the words out.

I was getting to the point where I was so lost in all the details of my argument that I was forgetting exactly what it was I was trying to say. So thank you for saying it.

Apparently, my brain is ALWAYS dysfunctional. LOL

Ambivalent Academic said...

Ah! There it is! Hooray for Arlenna! Good grief we've all been running ourselves in circles and foaming at the mouth trying to say just that - Thanks!

Arlenna said...

Haha, thanks. I love realizing that we all actually agree on the point we're arguing about.

That's the story of faculty meetings!

Ambivalent Academic said...

I didn't mean to steal your thunder Arlenna - It's weird how that happens sometimes. My post regarding Dr. Grand Poobahs harassing young PIs in public inspired another at Blue Lab Coats, which got a few particularly interesting comments and then that's where all the good conversation happened (in part, because an entirely different group of people read her blog than do mine).

Anyway, it's a conversation I'm glad we had and it wouldn't have happened were it not for your original post. So cheers to you, and your blog should get just as much credit for those 39 comments (whoops, YOU made it 40!). Have a nice Thanksgiving.

Arlenna said...

Oh I certainly don't actually mind, I was just sticking my tongue out at you! I am just happy to have inspired some discussion since that's why we all blog! It ended up spanning over three different blogs, which is a record for Chemical BiLOLogy so far--pretty heated topic that I almost didn't talk about!

Silver Fox said...

And you have two posts, so the comments now add up to 21. Not a bad #, really. Keep up the good posting work!