Recommended Reading

Hormones are the body’s messengers, influencing nearly every system—our energy, mood, metabolism, reproductive cycles, and even how we sleep. In Aroused: The History of Hormones and How They Control Just About Everything, Randi Hutter Epstein traces the fascinating story of how medicine has tried to understand and harness these chemical signals. From the groundbreaking discoveries of Harvey Cushing, who mapped the pituitary gland, to Rosalyn Yalow’s Nobel-winning work on hormone assays, to the myths and marketing around “rejuvenation” cures, the book shows just how much our knowledge of hormones has shaped modern medicine—and how much mystery still remains.

Aroused: How Hormones Shape Our Bodies, Health, and Pelvic Floor

Hormones and the Pelvic Floor

The pelvic floor is directly influenced by hormones, especially estrogen, progesterone, and testosterone. These hormones affect muscle tone, connective tissue strength, lubrication, and even pain perception. During times of hormonal change—such as puberty, pregnancy, postpartum, perimenopause, and menopause—people often notice new or worsening pelvic floor symptoms. Incontinence, pain with intercourse, or pelvic organ prolapse may be tied not only to muscle strength but also to hormonal shifts that alter tissue resilience. Pelvic floor physical therapy can be a powerful way to address these changes. By focusing on muscle coordination, breath work, mobility, and relaxation techniques, therapy supports the body through transitions where hormones alone don’t provide the full solution.

PCOS and Hormonal Imbalance

Ovarian Hormones and Menstrual Regulation: Although PCOS isn’t named, Epstein’s book does delve into female reproductive hormones and ovarian function, which are relevant to understanding PCOS. For example, Epstein describes how the brain’s hypothalamus and the pituitary gland orchestrate ovarian hormone release (estrogen/progesterone) to regulate menstruation and reproduction. She notes that while this brain-ovary feedback loop controls puberty and menopause, scientists still don’t fully understand what triggers key transitions – a reminder of the complexities that underlie conditions like PCOS. The book also recounts some historical attempts to manage or manipulate women’s hormones. Epstein writes about early 20th-century “anti-aging” and fertility tonics made from animal ovary extracts – a money-making fad predicated on the notion that consuming glandular extracts could boost women’s vitality or cure hormonal woes. (One such dubious remedy involved desiccated rabbit ovaries used to “treat” menopause and menstrual symptoms.) These anecdotes illustrate the longstanding medical interest in ovarian hormones and the sometimes questionable methods tried – indirectly setting the stage for understanding modern ovarian disorders. Polycystic Ovary Syndrome (PCOS) is one example of how hormones directly affect the pelvic floor and overall health. PCOS is a common condition where higher androgen levels and insulin resistance disrupt ovulation and menstrual cycles. While its symptoms are often linked to reproduction, the ripple effects can include pelvic pain, urinary issues, or challenges with sexual function—areas that pelvic floor therapy may help improve. By connecting the science of hormones with the lived experience of patients, both Aroused and pelvic floor physical therapy highlight an important truth: our hormones influence nearly everything, but support and healing often require a whole-body approach.

Main points from the book:

• Explores the history and science of hormones as powerful chemical messengers that regulate metabolism, mood, behavior, sleep, and immune function.
• Traces the evolution of endocrinology from early discoveries to modern hormone clinics.
• Highlights pioneering scientists, such as Harvey Cushing (pituitary research) and Rosalyn Yalow (Nobel laureate for radioimmunoassays).
• Includes stories of individuals who promoted questionable or unproven hormone-based remedies.
• Weaves together real-life stories, rejuvenation surgeries, and myths around hormones.
• Shows how medical thinking has been shaped by both scientific progress and eccentric or tragic experiments.
• Demonstrates how our understanding of hormones has evolved and how these molecules continue to shape health in powerful, often unexpected ways.

Aroused reminds us that while hormones are tiny, their influence is vast—shaping not just our health, but also the way medicine has developed over the past century. For those navigating pelvic floor concerns or conditions like PCOS, understanding the role of hormones is empowering. Pelvic floor physical therapy bridges the gap between these unseen chemical messengers and the very real physical symptoms they can trigger, offering tools for strength, resilience, and healing. By appreciating both the science and the lived experience, we can see that caring for the pelvic floor is never just about muscles—it’s about the whole body, hormones included.