How hormones influence student wellbeing

The Professor of Psychology, Dennis Schutter, would very much like to know exactly what influence hormones such as testosterone and cortisol have on student wellbeing. Students' mental health is a subject close to his heart, not least because he is a lecturer himself.

Even though he conducts extensive research in experimental and biological psychology on emotion and motivation, he believes that very little is known about the relationship between hormonal balance and student well-being.

His colleague, the Associate Professor of Clinical Psychology, Lotte Gerritsen, combines research into sex hormones and stress hormones with neuroimaging and behavioural data to understand individual differences in emotion regulation and stress sensitivity. According to her, there is still a great deal of knowledge to be gained, particularly about female sex hormones and their influence on mental wellbeing. Both have been calling for more attention to be paid to the relationship between hormones and students' mental health.

"We conduct much of our research among student populations. So, you could say that we already know a lot about students' mental health and the role hormones play in it," explains Gerritsen. "But there are no studies specifically on the relationship between hormones and student wellbeing," adds Schutter. "Therefore, the influence of hormones on student wellbeing cannot be made explicit. Besides, mental health cannot simply be reduced to a set of molecules."

Dennis Schutter. Photo: Ed van Rijswijk, UU

Schutter spoke with fellow lecturers this spring at the Student Wellbeing Staff Symposium, organised by the UU Student Wellbeing Team, as well as during a workshop on student wellbeing organised by the Faculty of Science. "We aimed to exchange ideas about student wellbeing, raise awareness, and brainstorm possible causes of mental health problems and how student wellbeing could be improved. After all, lecturers and students are barely aware of what hormones do to their brains."

Lotte Gerritsen. Screenshot from a Studium Generale lecture titled "How hormones influence our emotions"

You are less afraid of failure when your testosterone levels are higher

"Take the sex hormone testosterone, for example," says Schutter. "Testosterone influences our emotions, such as feelings of dominance, competitiveness, and self-confidence. In addition, testosterone inhibits cortisol, the stress hormone that stimulates anxiety. The more testosterone in your body, the less stress and anxiety you experience in mildly stressful situations and the less you worry about the consequences of your behaviour and what others think of it."

Not all men have the same testosterone levels, and women also have testosterone in their bodies. The amount is much smaller in women, however, and part of that testosterone is converted into the female sex hormone oestradiol, which, according to Gerritsen, has different effects than testosterone. Schutter explains that the effect of higher testosterone levels is not only reflected in physical characteristics such as a deeper voice, more muscle mass, or facial and body hair, but also in the brain and, therefore, in our behaviour.

"High testosterone levels contribute to a lower sensitivity to punishment, which in turn is positively related to risk-taking behaviour. You are actually less afraid of failure. This effect leads to greater self-confidence. In the context of competition and the drive to perform, this can be to your advantage. In some other situations, however, it is a disadvantage and it would be better to be more cautious."

Whereas testosterone mainly plays a role in increasing self-confidence, dominance and a go-getter attitude, Gerritsen believes that estradiol plays a role in women's memory, attention, mood regulation and stress sensitivity.

Schutter also sees this hormonal effect in his lecture hall. "Testosterone is a possible reason why men are more likely than women to think: 'Oh, I'll just give this a try.' Or why men are more likely to skim through a book before an exam and think: 'I'll just bluff my way through', while women memorise an entire book, so to speak."

Testosterone is also associated with drive, or a desire, for power, reward, and competition. "In that sense, high testosterone levels could have a negative impact on the wellbeing of male students, such as when education does not challenge them enough or in the right way," says Schutter.

Most women feel more attractive and have more self-confidence in the second week of their cycles

Female sex hormones also influence mental health. "Last year, a study was published showing that we need to take the menstrual cycle into account in psychology and psychiatry," says Gerritsen. "Certain psychological symptoms worsen during the cycle. For certain disorders, medication needs to be adjusted as the cycle progresses. These are insights that we are only gaining now."

According to Gerritsen, it is worthwhile for women to learn more about their cycle and how it affects their mental health. "Every woman has her own cycle, which can also vary from month to month. Some women are very sensitive to progesterone, while others are sensitive to the effects of oestrogen."

"For example, a drop in progesterone in the premenstrual phase can make you more agitated. Some women may become gloomy and even anxious, although progesterone should have an anxiety-reducing effect.  We also see that appetite often increases. But poor sleep and, consequently, poor concentration are also common."

"The sex hormone oestrogen, on the other hand, often has a positive effect on a person's wellbeing. In the second week of the cycle, towards ovulation, women experience a huge spike in oestrogen. Most women feel more attractive, have more self-confidence, and need less sleep. They are full of energy, feel strong, take more risks and are more impulsive."

"These are significant differences per cycle. If you are sensitive to this, it would help to take these fluctuations in your cycle into account. When planning an important presentation, for example. In practice, however, this is not always feasible."

‘One night of partying and your testosterone levels will be significantly lower the next day.’

In addition to individual hormone balance, numerous external factors can affect how someone feels. Synthetic hormones can cause the body to stop producing certain hormones itself. "Take the contraceptive pill, for example. The natural cycle is suppressed. The effects vary from woman to woman and can also affect their wellbeing," explains Gerritsen.

"Stress also affects the menstrual cycle. Stress is driven by cortisol, and cortisol interacts directly with progesterone and oestrogen. We suspect that when someone experiences a lot of stress, they will get more severe symptoms in the premenstrual phase," says Gerritsen. "We are currently researching this. Another study has shown that the impact of exam stress on female students varies depending on the phase of their cycle."

Nutrition is also an important factor. For example, sugar affects insulin levels. Insulin is a hormone that regulates blood sugar levels. Sex hormones, such as oestrogen and progesterone, affect insulin sensitivity and can cause fluctuations in blood sugar, especially during the menstrual cycle or menopause. "A sudden drop in blood sugar levels, caused by a sugar dip, for example, can make you feel less comfortable and energetic," says Gerritsen.

As for men, "alcohol and drugs have a particularly adverse effect on testosterone in men. Just one night of partying and your testosterone levels will be much lower the next day."

However, the interaction between hormones and external factors such as nutrition and exercise means you can positively influence your wellbeing. "Men have their testosterone peak in the morning and are full of energy. In the evening, this weakens again. Testosterone levels fluctuate and can be temporarily boosted by intensive exercise, making you feel more energetic."

‘Simply accepting it should not be an option.’

According to Schutter and Gerritsen, it would be beneficial if educational institutions took students' hormonal differences into account more often. For example, institutions could consider medical exemptions for women who suffer greatly from menstrual symptoms, allowing them to take sick leave or receive an additional opportunity to take an exam.

Currently, it is up to teachers and students themselves to raise awareness of this issue. Schutter: "As a teacher, you can see that a sensitive person in a highly competitive environment may not benefit from more pressure, or that creating experiences of success contributes to students' wellbeing. An experience of success sends a reward signal to your brain. You get a short boost of testosterone and a decrease in cortisol, which makes you feel euphoric and competent. For example, when you finally pass that exam or understand something in the book."

"This is a simplified representation because a million things happen at once at such a moment, but this effect of testosterone is self-reinforcing. Such an experience makes you more confident the next time, which can only benefit your mental health. The reward signal also works for women, but the scientific research is not conclusive. Perhaps because of a bias in research on men. There is a study that provides evidence that women in teams show an increase in testosterone when they win, but not in individual contexts."

According to Gerritsen, female students should be more comfortable in their own skin. "Knowing your own cycle and understanding menstrual and premenstrual symptoms can help you feel more confident. During the vulnerable phases of your cycle, you may be more prone to feelings of anxiety that you may already have. It is important to understand where these feelings come from. After all, let's be honest, anyone who suffers from stomach aches and sleepless nights will be grumpy the next day and unable to function optimally."

"It's also important to schedule more time to recover from a stressful performance. Or take time to do something fun and seek support when you notice that your hormones are throwing you off balance. Build in buffers. Simply accepting it shouldn't be an option anymore."

UU's Wellbeing Week takes place this week, November 17-28. The programme includes several different activities. Click here for more information.