Q&A with Eleanor Morgan, author of Hormonal: A Conversation About Women’s Bodies, Mental Health and Why We Need to Be Heard
Published on 4 July, HORMONAL explores everything from contraception to PMS, in relation to anxiety, depression and taboos about hysteria and the ‘hormonal’ woman. Combining her own experiences with extensive research and expert contributions, Eleanor Morgan explores the relationship between the female body, the female mind and the ways in which women’s bodies are being medicalised.
We spoke to Eleanor about her own journey through PMS and period pain, the gender pain gap, and how women can be empowered by understanding their bodies and brains.
How much did your own experience inspire and shape the book?
Massively. I wanted to write the book I’ve always wanted to read. A book that connects the private experience of a woman with the world we inhabit, and how we aren’t just biological bodies; we are bodies within a very masculine orientated society.
My own experience was integral, it informed everything. I’ve had a really, really, really hard time with my periods since they started when I was 13, and I’m now just about to turn 35. So it’s been a long time of physical and mental distress, and the ‘journey’ I went on was about trying all sorts of medical interventions for PMS, and I’m now being investigated for endometriosis, finally, after 10 or 12 years.
On the psychological side of things, my anxiety would become absolutely intolerable at certain times of the month, and I’ve tried to medicalise and treat that for a really long time. It was running out of options that really took me on a different and ultimately more therapeutic journey.
Did you always feel it was written off as normal or ‘just what women go through’?
Yes and no. My GP, who I’ve had for years, has always been incredibly sympathetic and she has real compassion, but I guess she is limited in her options. But when I’ve seen male gynaecologists there has been a sense of disconnect, for sure.
There is definitely a societal idea that as women we have this unlimited font of tolerance, and that because we’re women we’re supposed to experience pain. I think that can create tension between women themselves as well – if one woman doesn’t know what it’s like to suffer in that way, it’s quite hard for them to really get it.
What surprised you the most in your research for the book?
The thing that I found most shocking was when I really started to dig into how female pain is heard, treated and perceived in the medical world. When women present to hospital emergency departments, for example, they are consistently, systematically not given as much pain relief as men. You have to think about all of the factors that contribute to that, and ultimately I think it comes down to this historical stigma about being a woman who makes too much noise and is perceived to be asking for too much.
The other thing I found weirdly validating, but also a bit scary, was realising just how imprecise the scientific line is on what our sex hormones do to our mood, and the interaction between our sex hormones and our neurobiology. I’m training as a psychologist, so I’m acutely aware that no mental distress is ever just in the mind or in the biology. There’s always lots and lots of factors, and that goes for PMS as well.
I looked at so much literature and interviewed so many people, that I realised that actually the phrase ‘it’s just my hormones’ – which I’ve said thousands of times in my life – is not quite valid. Obviously our fluctuating hormones do have an impact on our mood, but we always have to think about what else is impacting us and why it’s so hard to sit with how we feel in those moments.
The imprecision of the science is a bit disorientating – and it’s chronically under-researched of course, because it’s women’s health – but I think it’s also quite empowering because, knowing these things are not completely rooted in our biology, it actually gives us something to work with.
In terms of the intersection between ‘hormonal’ and ‘hysterical’, how do you feel the notion of hysteria lives on and continues to influence women’s healthcare today?
In the days before mental health was really properly understood, hysteria was a catch-all, really nebulous diagnosis and a means by which to keep women who were too loud, too troublesome, too disrupting out of view so they didn’t cause trouble.
But it is still used all the time, and I think there’s a general idea that if a woman isn’t suffering quietly enough, or isn’t suffering in a way that’s comfortable for other people, it’s very, very, very easy to just diminish her experience by saying: “You’re being hysterical.” And it’s such a horrible thing to hear as women, because we all know the connotations – it’s the ultimate “shut up”, isn’t it?
Massive improvements have been made in the medical establishment, and there are some really progressive, brilliant clinicians out there who are helping women live much more peaceful lives. But of course there are still echoes of all of that old stuff about hysteria and women, and I don’t know whether we’ll see a real, genuine shift until there’s proper parity in medical research looking at women’s health.
From a feminist perspective then, how do we find a balance between taking women seriously when they’re suffering, without pathologising these natural hormone fluctuations or reinforcing that idea that being hormonal makes us inherently unstable?
We are more than a label so I think balance is key, but it’s very individual. If a woman wants to understand and conceptualise her distress, and finds a diagnosis empowering, then fantastic. And if it gets her the treatment she needs, and she’s able to live more peacefully and with less pain, then I don’t know how anyone can argue with that. But I think there is a wider thing to be said about pathologising distress that is actually quite reasonable.
What I hope is that this book starts conversations. I was careful to not take a very strong stance either way, but I think we have to present different views and ask difficult questions because we live in these systems that want to label us, and want to medicalise and pathologise distress, which actually sometimes is very valid. We also have to think about why, as women, if we become angry or start questioning people around us in these pre-menstrual phases, we have to ask, why is that not valid? Why is it so difficult for us to sit with being angry? On the flip side of course, if you feel completely hijacked and like you can’t really function, then it’s a different story.
It is a tricky balance, but I do think there’s some sense of empowerment in thinking, well what is the root of our discomfort about saying that period pain can be debilitating? I’ve had it so bad I’ve vomited, I’ve fainted, not been able to get off the loo – how is that less valid or less worthy of compassion than having a vomiting bug or a migraine? If we start being more open and pushing through the squeamishness, maybe there will be a wider change.
Finally, who do you hope reads the book and what would you like their main take-aways from it to be?
I hope this book is for any woman who has questioned why things feel so hard sometimes. It’s not just for women who have had bad periods or mental health issues; it’s for any woman who’s sat at some point and thought, “Fucking hell, why does it feel so hard sometimes to just be?”
The take-away message, I hope, is that we can be empowered with knowledge of ourselves, by removing the separation of body and mind – because our minds are our bodies, our bodies are our minds – and also by acknowledging that our private experiences as women are affected by our environment and society around us; they aren’t just a product of our hormones. I hope it can generate more self-acceptance.