Episode 449: Dr. Sarah Hill: How Birth Control Changes Your Brain, Dating Choices, and Evolutionary Psychology

26:28So if you smell my estrogen levels, then we call that a pheromone if that influences your behavior. And so with a naturally cycling woman, you do get these kinds of pheromonal effects, as I've noted, since men, when they smell the scent of ovulating women, it tends to increase their testosterone levels. So men actually get a little increase in testosterone in response to the scent of ovulation. And without knowing what it is, right, they'll like smell t-shirts worn by women who are ovulating. And they prefer the scent of the ovulating women compared to t-shirts worn by the same women at different phases in the cycle when estrogen is low.

27:05And so, yes. So having like taking the pill, for example, can disrupt this, right? It can prevent because women aren't in this nice estrogenic state at any point in their cycle. that's going to decrease some of these attraction-related molecules that women might already release otherwise. And it also seems to decrease women's ability to pick up on male pheromonal cues, right? So we know from research that especially at high fertility, when estrogen is high, women are really good at being able to detect metabolites of testosterone. So when men's bodies are breaking down testosterone, it releases different types of compounds that shed in the skin.

27:46And women are really good at being able to pick up on it when estrogen is high. Their brain is like, you know, like I smell a man, right? Really? Yes. And yes, and like are really, it's like, it's attracting to them, right? They're drawn to it. They like that. And for women who are using the pill, no. It's like everything is shut off. It's just blunted. Yeah, it's just blunted. It's that blindfold from like we've been talking about from that show, Love is Blind. Love is Blind. Yeah.

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29:28so then women though who are not on on birth control they typically like what what what is attractive to a woman naturally and what is attractive what is attractive to a man naturally okay yeah and obviously when i when i answer this question it's going to have huge error bars around it because there's so much idiosyncrasy in everybody's partner choice. But just, you know, like there are some things that men and women tend to desire sort of in equal measures. And so like men and women both want a partner who's, you know, kind and understanding and a partner who's in good health. And these are things that men and women are both looking for in ways that men and women on average tend to differ in terms of their partner choice.

30:11women, a naturally cycling woman likes to strike a balance between what in the evolutionary sciences we would call direct and indirect benefits. Direct benefits are all of those things that you get yourself from your partner. So for example, if they are a good provider, that would be a good direct benefit. And that's one that we know that women desire in their partners. We also know that women are interested in a long-term meeting context with partners who exhibit cues related to being a good dad, right? So somebody who's going to be caring and be able to help care for children. And so those are direct benefits.

30:47Anything a woman gets herself, indirect benefits are essentially good genes, right? So this is where we're looking for qualities that are related to genetic quality in a partner that we want for our children. And obviously, this usually goes on unconsciously, right? These tend to be the qualities that our brain just happens to find really sexy, right? So something like having testosterone related cues. So we like men who have a nice chiseled jaw, right? Broad shoulders, deep voice, you know, a dominant sort of personality. These are cues related to testosterone. And testosterone is what we call a good genes marker, simply because men who were able to release high levels of testosterone during development, that indicates that they probably had a high quality immune system, because men's immune systems get traded off with testosterone in a way that men's bodies will not produce high levels of testosterone if they have an immune emergency to deal with.

31:42And so the idea here is that only men who are in good health during development are able to release really high levels of testosterone during development because there is this trade-off between immune system functioning and testosterone levels, right? And so one of the reasons that our brain finds testosterone-related cues sexy in men is because only men who had relatively high functioning immune systems during development were able to release that and form those types of features. And so, yeah, so that's like one type of a cue. The scent of genetic compatibility, that's another set of sort of genes that we're looking for.

32:16And we tend to pick this up by way of scent, right? Sort of picking up on some of those cues that somebody might have different immune genes than your own, which are generally the ones that we find most attractive. And for most naturally cycling women, what you see is that when we're choosing a partner, it's generally brokering that tradeoff. It's like sort of understanding you want the sexy qualities that are going to just really attract you and make you physically drawn to somebody. but then also as a long-term partner, somebody who's going to be, you know, sort of a good provider and, and, you know, be a good parent and so on and so forth.

32:52And, you know, so for naturally cycling woman, what you generally see is that there is some sort of trade-off, right? Where they're making decisions about, you know, this person has to be somebody I'm attracted to, but also has to have these other qualities. And then you find the person who best, you know, matches that set of criteria. For women who are using the pill, it seems like all of that, you know, what we call indirect benefits, that genetic compatibility and cues of, you know, immune system quality because of testosterone and all that, it seems like all that just gets shut down. It's just like the light switch goes off.

33:22And it's just, it's focusing exclusively on these other partnership qualities, which again, isn't necessarily bad, right? It's just different. It's going to get you a different partner probably than what you would get if you were striking that balance between what, you know, who you're most physically attracted to, and then, you know, who's going to be a good partner and, you know, good at provisioning. And so that's, you know, women, men tend to be, you know, in a sort of natural state of things. Men are also brokering that same balance, you know, but for men, there's a whole lot of emphasis placed on cues related to fertility and what we call reproductive value.

33:58And fertility, of course, refers to the probability that a woman will be able to have a child with an active sex. And we know that for women, fertility peaks at the very young age of about 25, and then starts to decline. And of course, it declines pretty rapidly after a woman's in her late 30s, mid to late 30s. And men, of course, are dialed into cues that have historically been related to fertility. Because again, you know, over the course of evolutionary time, those men who just so happened to find women most beautiful, when they were able to reproduce, they would have passed down that preference to a lot of sons.

34:35Whereas if you have a man whose preference tended to focus on qualities related to older age, they wouldn't have passed down that preference to anybody. But that doesn't seem to be like, I think, are there very specific things that you can point to that men find attractive beyond just cues of estrogen cycles? Right, right. No. No, I'm just kidding. I'm just kidding. Absolutely not. That's the only thing that matters. No, no, absolutely not. No. Yeah. There are so many things. I mean, men's partner choices are just as complex as ours in a lot of ways. And what you tend to see is that if men are just choosing like a short-term sexual partner, you know, then it's like, you know, looks and all the superficial stuff.

35:20Men are choosing a long-term partner in addition to the cues related to fertility. But let me just make sure that I, that really is important to men's attraction. I mean, whether we like it or not, it's like, you know, it's huge. Yeah, youth and, because youth is related to fertility. Yeah, exactly. It's confounded. Yeah, and so those things tend to play a really important role. But men are also, like, some of the things that they find most important, like when you ask men to rank, order, like how important are all these qualities, loyalty, kindness, right? So some of these, you know, other types of qualities.

35:57That's a load of shit, to be honest. I think if they're not attracted to you. Oh, yeah. No, 100%. I think after that, then it's loyalty. Because I have a lot of guy friends who are in their mid, let's say in their midlife, like 40s, let's say. Even some of them are 50s, never been married, never have a serious girlfriend. And I try to set them up all the time. And I say to them, oh, I have the best girl. She's this. She's pretty. She's successful. She's got a great personality, at the end of the day, they're not interested. Why? Unless they find her hot physically. All those other qualities, her success doesn't matter, her confidence doesn't matter, her sense of humor doesn't matter.

36:40I think that with men, I'm no evolutionary psychologist, but I would say physical attractiveness is pretty much paramount. I would completely agree with that. No, I think that it is. But in a lot of ways, I mean, is for us, for women. Not for women, no. Well, no. So yes and no. So no, I don't think that looks are paramount for women. But I will say that for women, for us, what attraction is, is a lot more complex than for men. Attraction for men is generally physical attraction, right, based on physical cues. Women's attraction is a lot more complicated, right? Just meaning that it's like, for us, physical attraction, in addition to just being based on somebody's physical appearance, is also based on all kinds of things.

37:26Like, does this person have, you know, a take charge personality? Does this person, you know, say the, like the right things? Is this person going to be a good provider? And some of these other cues, I mean, it's like women are the ones who get the ick for a reason. You know, it's like the ick is essentially like somebody just violated something that impacts our very complex and nuanced version of attraction, which is about more than just physical appearance. But for us, attraction is just as important as it is for men. It's just that what feeds into attraction for women is more complicated than just physical appearance.

37:58Okay. That's, that makes sense to me. That makes sense to me. But then why is there such a mating crisis? Like people are not dating anymore. They're not having relationships anymore. Right. Yeah. And you know, that's such an important question because it's like, what is going to happen societally? Yeah. I mean, honestly. And you know, I think that the, I think the answer is very complicated. I don't, I don't know that I know all the answers. I think that one of the answers is just simply that, you know, we have the ability to regulate our fertility now with birth control. And for most of history, we did not have that ability.

38:31And the fact is, there are a lot of people who now are saying, I don't want to have kids, and I don't have to have kids, right? And it used to be the case that that was never a possibility, right? It's like, if you liked sex, you were going to be a mother, like whether you wanted them or not. Like the idea of like whether you want kids used to not be a question people could ask. It was about whether or not you want to have sex. And so I think that's one thing, but why are people not wanting to have sex? I think that there's a few things happening. One is that I think hormone or endocrine disruptors have lowered testosterone to an extent that it's making people just less sexually motivated.

39:11We know that testosterone is one of the big sexually motivating hormones and that higher levels are related to more sexual desire. Lower levels are linked with less sexual desire. So that's one thing is that we have these endocrine disrupting compounds that are lowering testosterone. And I think that's part of the puzzle. Another part of the puzzle is hormonal birth control. And we know that hormonal birth control is something that's associated with lower libido, right? So it can really kill women's sexual desire and in a pretty significant way. And so women are feeling less sexually motivated, and they're feeling less sexually motivated in part because of the endocrine disruptors because their testosterone also is being lowered.

39:50And then birth control can lower sexual desire further. So I think that's also part of the picture. I think another part of the picture is that now, you know, we have internet porn available everywhere. And I think that men are like, why should I bother to do all of this work and have to jump through all of these hoops for somebody who's less hot than the person that I see on the computer screen. And so I think that men are like not feeling as motivated to do the types of things that they used to have to do in order to get access to sex by, you know, just by sort of using a cheap alternative. And so I think that's also part of the picture.

40:27Another part of the picture is that birth control has allowed women to achieve more than they've ever achieved in their entire lives, right? In our entire history as a species, I mean, women are dominating. I mean, it's like we're getting more college degrees, we're getting more advanced degrees, we're going to law school and medical school at a greater extent than men. And women are hypergamous, meaning that they like to mate up. So they like to be involved in relationships with men who have at least as much education as they have themselves. So women are now in this position where they're looking up to find partners who have the same levels, at least of education and career success that they have themselves.

41:06And there's just not a lot of men there. Because, you know, women are doing really well. Men are kind of like, I don't really, you know, I can just look at porn. And then I don't have to do all this work and get all these degrees and jump through all these hoops in order to get sexual access, because I my brain is being tricked into believing I'm getting sexual access by looking at by looking at pornography. And then the last one, I think is online dating. And I think that what that has created is made it really easy to find partners. And for men who are doing well. So men in this climate, like who have those really good jobs and have the types of qualities that women are looking for partners, they are now entering the marriage market from the dating market a lot later than they used to.

41:47And so what happens is because men are able to get access to dates, just like it's so easy, you know, it's so easy to find a date when you have a dating app. And so they're not settling down until they're like 40, you know, or like 50. You're 50. 50 is now the new 40. Yeah, that's what they say. That's what they say. That's what they say. That's what the men are trying to tell us. And so you'll have men who are hanging out in the dating market for a really long time. And then you have women who go into the marriage market from the dating market earlier, where they're like ready to settle down because their fertility is going to decline.

42:20And so women then are up here in the marriage market, right? There's not a lot of men around because they're mostly hanging out in the dating market. And then the women are also looking for people who are at least as educated as themselves. And I mean, it's really causing problems. Well, yeah. And also from the way you described it, what that would tell me is if men are getting married later, right? Because they don't have to get married as early. They have this dating app so they can date. And what they're attracted to is more youthful estrogen cycles. They're going to end up dating younger girls.

42:55So the young girls are going to get married to these older men. because for girls, men who are older can come across as sexy, not old. Right. Yeah, yeah, yeah. But for girls, you know, older women look like older women. Right. Yeah. It's like our brain, it's so interesting. Yeah. Go ahead. Oh, no. I was going to say, and then what happens is it's leaving these women who have now been, who've had a lot of success, you know, financially, in business, professionally, they're leaving them in the lurch because now there's nowhere for them to go further, right? Right. And what my question is then is why don't those women just go out with a younger guy who's just hot and just do what men used to do for all these years, right?

43:43Like just do what men do. Right. They're successful men. They want a younger girl. So then they end up with these girls. Why don't women do that? Right. Well, and I think that there are some women doing that. And starting more. Right. Yeah, so I've got two answers to that. So one is that I think that women are starting to do that more, right? So we see like, you know. But they're not having kids with them. No, they're not having kids with them, right? They're not having families with them. We're sort of seeing like the rise of the cougar, right? Where you'll see older women dating. And they're just, you know, they're not serious boyfriends.

44:15They're just like. Play things. Yeah, play things. Because the women are like, I have my own money. Yeah, exactly. Yeah, it's like, I've got my own money. I don't need a man for that. I just want to have fun on my own terms. And so then they just like take a hot guy that they can parade around and, you know, and have a good time with. And, you know, Godspeed, men have been doing this forever. It's about time. A hundred percent. But it's disrupting the natural flow of evolution and Darwinism, I would say. Well, isn't it survival of the fittest is all about? So it's just really about whatever traits get passed down or the traits that you're going to see, right?

44:48And so all that that means is that, like, yeah, the tendency for older women to date younger men, they're not passing that preference down to anybody, you know, because they're not having any more offspring. But the men aren't passing that tendency to want to mate with older women on to anybody either because there's no reproduction going on in that context. And so, like, I don't think that it's really disrupting anything, you know, just because nothing is really changing. Yeah, exactly. Nothing's really changing. But I think that there's not as much of that as there is for men because, you know, we spend most of our evolutionary history in a context, you know, living as hunter-gatherers.

45:24And women were very dependent on men for access to resources. And so, like, you know, getting access to food and protection, particularly during pregnancy. And because of that, we have inherited the psychology that tends to be more coy, right? So we tend to be more sexually cautious relative to men, and we tend to be more oriented toward long-term mating relative to men, just simply because throughout most of our evolutionary history, there was no short-term. I mean, if you're a woman engaged in short-term mating, you could end up with a baby. And so even if you're choosing somebody as just a casual fling, there's this tendency for women to get emotionally enmeshed in those relationships because we're wired that way.

46:07Right, we're wired differently. Yeah, we're just wired differently. It's like we faced different adaptive problems throughout our history due to the fact that we're the ones who get pregnant, right? And because of that, the costs of short-term sex and just being sort of casual willy-nilly are much greater than what they are for men. And so that's led to a divergence within our sexual psychology that tends to make men more oriented toward, you know, casual encounters without really, you know, developing any sort of strings attached. Whereas for women, it tends to be a little bit more complicated.

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47:55Are men attracted to successful women, confident women, established women? Yes, but in as much as they're attracted to them first, right? Like as you're talking about, like, I don't think that any level of professional success or success can make up for if a man doesn't feel that a woman is physically attractive. And what that can mean, though, is very broad, you know, because that doesn't mean obviously, there's a lot of people that I think objectively, we could say like, this person is not the most attractive person we've ever seen in their life. And somebody's in love with them and thinks that they're beautiful, you know, so it's like, we have to, you know, sort of also take that with a grain of salt, sort of understanding the fact that they're attractive.

48:31that there's, for the most part, there can be somebody for everyone. Right. My mother would always say there's a lid to every pot. I love that. That's beautiful. That's perfect. That's right. I heard you say somewhere, I don't remember where, that looks is the number one predictor for women's upward mobility. Yeah. How's that for a depressing statistic? Right? Yeah. They did a study where they were looking at different types of predictors for being able to transcend the social class in which you were born. And, you know, in this great meritocratic society that we live in, we would like to think that it would be something like your educational attainment or, you know, where you went to school or what you majored in, right?

49:11It might be something like this. But instead, what the research found is that the strongest predictor for women for upward social mobility was their physical attractiveness and that this played a greater role in their ability to transcend their social class of origin than their family's existing socioeconomic status, their education level, and their career choice. Yeah, it's pretty depressing. Isn't that depressing? It is. What's a man's number one predictor for upward mobility? Oh, that's a really great question. I don't know, but I am willing to bet that it is probably either education. I think it is some combination of like education that they get and then like their career choice is my guess.

49:54Right. Totally different, right? Totally different set of, yeah, no, it's not his physical attractiveness. It's definitely not. Exactly. Do you know the other saying, like if a man wants to be attractive, he stands on his wallet. Yeah, yeah, yeah. I've heard that. But the truth is, I hate to say it, but there's a reason why some of these things, there's a lot of truth in these things, right? That's why you see a lot of women I see with men who are like, you wouldn't call them attractive by looking at them. They're four foot three, bald, and not that physically attractive. But I tell you, when they have like$100 million in their bank account, they're very attractive dating the supermodel.

50:32Yeah. It's really funny because we did this really cool study where we had men who were kind of average looking. We had them photographed like looking like they were in a couple with women of varying levels of attractiveness. And what do you think as soon as women see kind of an average, you know, kind of kind of guy with a really beautiful woman, what do they think? He's rich. Yeah, exactly. And so what we did is we asked people about like different qualities, you know, that these men had. And just based on the virtue of the attractiveness of the women that men are pictured with, women infer all of these different things about like what they're like, and including the fact that as we see a man with a beautiful woman, it was like far more beautiful than he is handsome.

51:13There's this general assumption that we tend to assume that he is like financially very well off and, you know, probably kind of, you know, got some other positive qualities as well. But it's really funny. And it's funny because the second you think of that, you think about the female and you think if the girl's really beautiful, you think, oh, well, she's a gold digger or all the other connotations. Which then like because of the survival of the fittest and all that, is there a lot of jealousy with women? Because it's only a certain amount of that stuff we're talking about. There is a limited amount of great guys that we all want.

51:48Like I've done a few podcasts on this where just in terms of just on the dating apps, right? Yeah. It's like 1 % of the men get 99 % of the action, right? Yeah. Because women who are 6 foot make over 100 ,000, all these things, let's just say, where it doesn't leave a very big amount of, a lot of men. But there's a lot of women out there. Yes. Right? Yes. And women are naturally catty. Yes. Right? I think that there's an element of that that's very true, yes. Yes. Yes. An element or more than one element? Yes. Multiple elements. Yeah. So, you know, with any resource that's desirable, there's only so many, right?

52:32Or else it wouldn't be desirable. Supply. Right. You know, supply and demand. It's like there's only so many houses on the water. You know, there's only so many attractive mates. There's only so many top positions in the job. Yeah. And so there's always going to be an element of competition. And for women, especially when we're talking about mate related things, one of the primary areas in which they compete is attractiveness. And so here you have women who kind of size each other up, right? And then they can be really terrible to one another when they're trying to compete in the same pool. And I mean, I've found, I remember when I was in my 20s, and how much of that there would be, this rivalry and that sort of thing.

53:12And then once I was married and had children, Like it allowed me to have friendships with women in ways that I hadn't been able to have. Right. You know, when I was in my 20s, because I think that like that people were paired off, kind of took the pressure off of all of that. They didn't find you to be a threat. Right. Exactly. Right. Exactly. Because you were taken, you were already like, you were dormant in their way. Like you were kind of like, your things were suppressed. Right. Right. Yeah. Well, no, it's really interesting because I've also, I've been divorced and now I'm married again. And during that period when I was divorced, I mean, talk about a polarizing event in people's lives.

53:48Well, I mean, you know, when you are a person who is with a bunch of married people, right, you live in a community of married people who you spend a lot of time with. And then all of a sudden, you know, you're not a married person. You become very much a threat to everybody. Did they ostracize you? Yeah, there was a lot of that that happened. I kind of got shoved out. I got a little bit of the exit stage left. So then what happened then? Well, so what happened, I found my new community. I mean, you know. Was your new community all single women? Yeah, it was mostly single women. And yeah, and it was a totally, you know, and it was a really freeing, you know, experience to go through that.

54:31It was terrible to lose. I lost some people that I thought were really good friends. But I think that, you know, it was like, on the one hand, I understood it. Yeah. Yeah. If anyone would, it would be you. Yeah, well, exactly. And so it's like, you know, I didn't, at first I was hurt and angry. And then afterwards I was, I had a little bit of reflection on it. And it's like, you know, I mean, there's two things going on there. It's like, one, you know, you don't want to have this single person that that's a threat. But it's also a threat to, I mean, marriage is kind of held together by bubble gum and shoelaces.

55:03You know what I mean? It's like, it's like, it's a hard thing to do, You know, it's like really hard to do. And so the idea that somebody can just like walk away from it and be okay, because I was. I like walked away and, you know, and my ex-husband and I, in some ways it's even more threatening, he and I are great. And like we're great co-parents and we do Thanksgivings together. I love that. We call it the web of love. How long were you married for? Like 17 years. So I was married a long time. And how old were the kids when you got the divorce? Uh, two, I want to say 12 and nine. Wow. Yeah. So, yeah.

55:44And yeah, so, so to have somebody who we, you know, I walk away from a marriage and I'm okay. And financially I'm fine because I've, you know, I'm taking care of my business. And then to be able to get along well with my ex-husband. And I feel like that also feels threatening to marriage. Do you know what I mean? Really? Why? Because marriage is hard and horrible sometimes. Yes. And being somebody who's married again, it's like, and we talk about this. My husband was also formerly married. And it's like really hard to be married. I mean, it's like sometimes you're just like, this is terrible. Like, this is a really terrible thing.

56:18But you persevere. And the idea of like, you know, when you're having one of those moments of marriage being terrible, to see people walking away from it and being just fine. I mean, that feels really threatening. Like, oh my gosh, should I be like, like, that might be the end. And that is like, you don't want to go down that rabbit hole. Nobody wants to have to sit and think about whether their marriage is a good idea or a bad idea. I mean, it's like, it's a really scary thing. It was a hard thing. I think also it makes people like think to themselves like, like they're jealous a little bit. Like, I wish I could do that.

56:47Why can't I do that? Like, will I be okay? Or they feel trapped because financially they're trapped. Right. Like there's all these other them issues. Yes. That you are basically, you're basically making them have to, you're forcing them to look at. Well, right. And I think that that is, I think that that was like, I think that's the biggest. I think you just hit the nail on the head. I mean, honestly, it's like how many people are in, in my ex-husband and I had a pretty lovely relationship for the most part. We just kind of grew in different directions. Yeah. And so like there's a lot of people who are in marriages a lot worse than ours was.

57:22Yeah. And then, you know, and then to. And you're the one who got the divorce. Yes. And so I think that there was a lot of that too. So I, like I said, studying what I study, I have a lot of compassion for how everybody responded to me. And it was really hurtful at first, but I do feel compassion and I understand why that happened. Right. And then I was able to find my new community. And so when you're now in the new community and you guys are all single, like you were saying, was there cattiness and jealousy? Because you're all in the same boat and look like, oh, she's going on a date. Why can't I go on a date?

57:57Was there any of that? No, what's really interesting is no. And so with my really tight group of girlfriends, no. And we actually would trade no. It's like we had a spreadsheet when we were dating. Really? Yes, where it was like to make sure like, did you go out? And it's like, oh, wait, I know I went out with him. No, he's great for you. And so like, we would even like set people up on the side, like on side chat with people that we would go out with and then, but they didn't match up on the app or whatever with the other person. I love that because you know what you're meeting these people as like, yeah, maybe they're not right for you, but you have Sally out there who you'd be great for.

58:33Yes. And in fact, one of our pictures that we had was all three of us together. Like, cause there was three of us that spent most of it. There was five of us, but there's three of us that were actively dating. And so we had a picture of all three of us. And then it was like, if it doesn't work out with one of us, you can have the other two. I love that. It's like a three-pur. Yeah. And I think that there's something about, you know, because we were all in our, you know, we were all in our early 40s or late 30s, early 40s when we met. And I think that there's also something where as you get older, in addition to, you know, just like whether you're partnered or not, it's like I think there's really a time that you can appreciate just how amazing female friendship is that I don't think you get when you're in your 20s.

59:16Yeah, I think you're right. Because I think there's a different, like, your priorities change, you soften up a little bit, you know, there's other things that happen. How have you been married to this new husband? Oh, my God. Well, we've been together for three years. We're just recently, recently married. Yeah. Oh, congratulations. Thanks. You're welcome. And so he's got kids too? Yes, he does. Yeah. So we've got a blended family of five kids. Oh, wow. Yeah. And I say thankfully, but no, really, they're all wonderful. They're older. I mean, so like, you know, the oldest is, you know, about to graduate college.

59:47The second oldest is a freshman in college. And then, you know, our youngest are both freshmen in high school. So it's not like we have all of these, you know, like so much chaos going on in our lives. Right, right, right. But it's interesting because you've like lived all these different stages of life that you can talk on. So then you were on the apps. Yeah, I was. So how did you find the apps? So I found the app. So it's funny, because my first exposure to the apps was when I was in graduate school at UT Austin way back in the day, I was like 2001. I mean, I was actually writing a research paper on mate preferences.

1:00:22And it was before there were apps, but it was like when like match.com was a thing, it was like a website. And so I remember going there and like, you know, I was doing a project looking at what are some of the qualities that men compared to women say that they're looking for in partners. and, you know, and then like did a quantification and lo and behold, you know, men were more likely to say they were looking for looks and women were more likely to say they were looking for financial stability or some version of that. And, uh, and so that was like my very first exposure. And then, you know, and I was dating my, that my, what ended up being my husband during that.

1:00:57So I wasn't like on the app, you know, on that, but then, you know, I had, because of the work that I do. I mean, I'm very familiar with what everybody is doing with the apps forever and sort of monitoring that because it's like something that I've been really interested in, you know, understanding relationships and sex and dating dynamics. And so looking at the apps, I mean, I wasn't like looking at the apps when I was married, but just having awareness of them and like what they were and what people were doing was something that I'd always had. It was research. Yeah. I mean, totally. It was like I had my finger on the pulse of it.

1:01:31And then when when I got divorced and then when it was like, you know, I, I don't even, I'm trying to remember how I found out like what all the kids were using, you know what I mean? And I think, I think that I had, I feel like I read something like how wonky is this? I think I read it in like the Wall Street journal, like what people were using. And I think that that's how I found like Bumble. Is that what you used? That's what I was on. And then Hinge for a little bit, but then, yeah. And then I ended up dating the person. I mean, I dated a few different guys, but then I ended up in the relationship with my now husband.

1:02:08And so then it's all she wrote. The rest is history. Are you happy now? Yes, I'm very happy. Okay. Are you happy you went through the divorce? Yeah. You know, I don't, it's hard to say that, right? So yes, it was the right decision. Do I hate it for my kids? Would I prefer for them not to have to visit both of us? Yeah, I would prefer that. I do, I will say that I think that of anybody that I know who's in a divorce relationship, I think mine is incredibly healthy. And like I said, my ex and I, he came over for Christmas to my husband's in-house. And it's just like, this is the way that we do things.

1:02:43And everybody's cool with it. And I feel like my kids get the experience of being able to see that their parents still love and care for each other, even though they're not married. And so that's, I guess, on the positive side. And I can also tell myself, I think it's better for my kids to see me flourishing and not feeling like I'm in a bad spot. And like I said, we didn't fight or anything. I just wasn't happy. And I think it showed. And I was working all the time, so I didn't want to, you know, that was not good. And so, yeah, I guess the answer is that, yes, it was the right decision. But it's hard to say like, yes, about something because of course it hurt my kids.

1:03:22And that was hard. Yeah. I mean, even if the most amicable divorce is still a divorce for the kids, right? Exactly. They're going to have to go back and forth at the homes. Yes, exactly. And that's what they do. And would they prefer not to do that? Yes, they would. They would prefer if we were still together. But that being said, they're also learning some resilience with all of this. And like I said, I think that of anybody I know who's got a divorce set up, I think ours is really a nice one. And I think that the kids have been able to learn a lot from it. Good answer. Thanks. You're welcome.

1:03:57I think I got sidetracked there because I was so interested in your life. Yeah, let's talk about life. Well, I know that at the beginning, I asked you a question and I think that we kind of like didn't finish it, which was, well, it's like the five things that birth control can change or how, it's not just this, your partner choice, but there's other things too it does. And that's the part that I didn't finish with. Sorry. No, that's okay. Do you want me to start it off? Yes. Okay. So let's talk about some of the things that birth control does besides just influencing potentially partner choice.

1:04:30We also know from research that it affects sexual desire, which I think I alluded to. It's like it really can put women on sexual lockdown in a lot of cases. It increases the risk of developing depression or anxiety. And this is particularly true for younger women. So they've done studies where they look at the risk of developing major depressive disorder based on whether or not you're using hormonal birth control or not. And what you tend to see is that the risk is increased for everybody of developing one of those types of outcomes from using hormonal birth control, but it's especially great for young women.

1:05:05So women 19 and younger whose brains are still developing the risk of developing a major depressive disorder and the risk of suicide risk attempt and successful suicide attempt are significantly greater for teens who use hormonal birth control compared to those who do not. There's also now research showing that if you're using hormonal birth control during your teen years, so again, 19 and younger, that this is associated with a greater risk of developing major depressive disorder across your lifetime, even after you go off the birth control pill, because it seems that it's probably influencing brain development.

1:05:38And so the important message here with depression and anxiety is one, if you go on hormonal birth control, keep an eye on yourself, have somebody that you love keep an eye on you. Because the fact is, when we're depressed or anxious, our brain doesn't say like, gosh, you know, I'm depressed or anxious, but it's my drugs. Instead, what happens is we think like, God, my life sucks right now. Like my boss hates me. My boyfriend hates me. Like it's like we feel like all of these things are happening and we feel bad. Right. We don't actually think, gosh, I'm depressed, right? And so it's good to have somebody - We don't acknowledge what's really happening.

1:06:11Yeah, no, it's like our brain has no idea. You know, it just makes up stories about what's going on. And so having somebody know that you're going on it so they can keep an eye on you is incredibly important because then they can tell you if you're having a personality change, if you seem low, if you seem off, right? These are things that can tell you that your birth control might not be working for you in that way. And this is particularly true, as I said, for these young girls. And, you know, I think that it's smart to avoid going on hormonal birth control, if at all possible, until you're 20 or older.

1:06:40Just because your brain is going to have most of its development done at that time, which means that it won't have a long term lasting impact on you. But if you are going to go on it when you're younger than 20, really, really take care and make sure that somebody is keeping an eye on you just because the risk of developing a mental health related side effect is so high and pronounced in this group. So that's another thing that hormonal birth control can do. Another thing that surprises people is that it can actually decrease your ability to put on muscle mass from weight training. And this happens because it keeps your testosterone levels low.

1:07:16And testosterone plays an important role in terms of prompting the biological cascade that allows you to put on lean muscle mass. And so women who are doing weight training, doing the exact same regimen compared to women who are naturally cycling, they put on significantly less lean muscle mass compared to their naturally cycling counterparts, which is surprising to a lot of people. Well, you know what? It's not that surprising to me because they do say that there's weight gain with being on the pill. And a lot of people don't want to go on the pill. I was one of them at a very young age because I was scared of gaining weight.

1:07:49So that makes sense to me because your testosterone will be suppressed. You won't be, the less lean muscle mass you have, the less calories you're going to burn. Therefore, you know, you won't be burning as much. Yeah, no, for sure. Yeah, no, for sure. That makes sense to me. Yeah, 100%. And then it also can influence your ability to regulate stress. And this is another one that's really surprising to people. And that is that when you go on hormonal birth control, there's research that finds that it decreases your body's ability to respond in a dynamic way. way to stress, potentially leaving you less able to be able to regulate your emotional responses to things and also being less able to cope from and learn from stress.

1:08:31And so there's research that shows, for example, that women who use hormonal birth control, that rather than having a big spike in cortisol that all of us get when we're feeling stressed out, which a lot of people, you know, give a bad rap and cortisol gets kind of a bad rap because it's, you know, if you have that chronic exposure to cortisol is not good. But having big bursts of cortisol when we're stressed out is actually very adaptive. And it's like part of how our body helps to manage stress and cope with stress. And so like when cortisol gets released, it dumps fat and sugar into the bloodstream so we can make a quick getaway.

1:09:03It primes the birth of new neurons in our hippocampus, which is the brain area that helps us learn and remember things. And so it gets us ready to be able to recover from stress, to be able to learn from stress, and to be able to sort of move on with our lives. And research finds that women who are using hormonal birth control, that rather than having this nice big response of cortisol in response to stress, they have a really flat blunted response to cortisol in response to stress. And this is something that we only tend to see in people who've suffered from PTSD or things like exposure to childhood trauma.

1:09:35They have these blunted cortisol types of responses. And you also see this in women who are using hormonal birth control. And it suggests that it has some sort of dysregulatory pattern within the stress response. And, you know, nobody knows exactly what it is. But what researchers think is going on is that the synthetic progesterone in birth control pills, which is called a progestin, it doesn't perfectly match the progesterone receptor, which is the receptor in the cell that picks up the hormone. and it also gets picked up by other things, including sometimes testosterone and including sometimes cortisol.

1:10:13And so what researchers think goes on is that these molecules are stimulating cortisol receptors and making the brain think that it's in a state of chronic stress, like chronic uncontrollable stress, and that that's causing the stress response to shut down, which isn't good. It's not good for anybody. It's bad for emotional regulation. It's bad for mental health. And like I said, it's something that we tend to see in people who have PTSD. And so not something that's positive for women who are using hormonal birth control. Wow. So as an adolescent, if you're listening or parents listening, what is an alternative just besides doing the, what we talked about earlier?

1:10:49Copper IUD. Yeah. Besides doing the copper IUD, that's really, that's the best alternative. I mean, yeah. As far as I'm concerned, you know, doing something, especially with a teenager that's non-hormonal is going to be the way to go. Copper IUD is a good one. I don't recommend the fertility awareness method for teenagers because, you know, just the idea of tracking your cycles and only using condom, like the idea of a teenager trying to do that effectively, it just gives me chills. I can just imagine. So, I mean, we just aren't left with a lot of options. And so one of the big messages from, you know, that I've wanted to really communicate with my book is not like, oh, you know, the birth control pill is evil and all this.

1:11:26Instead, it's we need more options. This is imperfect. Like this is imperfect and we need to have more choices. Because the fact is, especially for young girls whose brains are developing and are very sensitive to hormones, like we don't have a lot of good options. No, I mean, at all. But the thing is that's, and that's probably why also you wanted to write this book I saw, right? Because it's, you had your own, you had your own story, but you got off of birth control. You were a different person. You're making playlists and you were like, I was like, yeah, I felt alive and I felt sexy. And I just, yeah, it was just like, it was like an awakening in a lot of ways.

1:12:00Yeah. I mean, And I find that so like, you don't, that's why I like, I love this conversation with you because I never really, I never really spoke about the correlation between, we talk a lot about HRT on here, right? Like hormone replacement therapy when you're older, right? But we don't talk about the hormones that we are putting in our bodies at a younger age to suppress, right? Or we only talk about the opposite. Right. Yeah. And it's really interesting because, you know, people tend to assume that like, oh, you know, hormone therapy, like you must be anti-hormone therapy because and i'm like no like i think hormones are great like i think the problem you know that with the birth control pill is it is that you're not getting exposure to hormones they're suppressing your hormones suppressing them right hormones are wonderful they're a wonderful thing it's a different thing right you're either at a young age or because of for birth control you're suppressing them but at an older age you're you're trying to increase them to balance yourself out right yeah you don't so you don't really do any work on that right on the studies of like...

1:12:58No, I mean, I definitely have awareness of this space. Like I know about the research in this space and I can say that, you know, there's a lot of women who are being given birth control pills as a way to ease the menopausal transition instead of being given mycronized progesterone and estrogen. Yeah. And which I think is terrible just because the the synthetic progesterone in birth control pills that progestin isn't biologically identical to progesterone the way that micronized progesterone is. And because of that, you don't get many of the really beautiful benefits that progesterone has for the body, including the release of this really nice neurosteroid called allopregnanolone.

1:13:43And it's something that gets released when progesterone is being broken down in the body. And it stimulates these receptors in our brain that are known for making us feel calm and relaxed. And it's really good for us. Like it promotes neuroplasticity, which means that it makes our brain plastic and malleable and able to respond to things and not, you know, freak out. And it's associated with having better mental health and all these other really beautiful things. And women who are using synthetic hormones, you know, this progestin, that because it's made out of testosterone, it's not made out of progesterone, you don't get this beautiful metabolite that has all these wonderful benefits to the brain and benefits to mental health and also benefits to bone health because progesterone and estrogen work together to help to create new osteoblasts in the bone and help to strengthen bones and do all these really nice things.

1:14:34And I think that there's a lot of doctors out there who are just, you know, because they're comfortable with the birth control pill, they're just like giving women that to try to prevent them from not experiencing the symptoms of the menopausal transition, but the women that aren't getting all the benefits you get from actual hormones. I've never even heard that before. Oh, really? Yeah. Oh my gosh. Yeah, no, I hear about this. So, you know, of course, women reach out to me about their questions. And one of the questions I get a lot is about the use of birth control in menopause and like whether or not, you know, that's recommended.

1:15:06And is it the same as using hormone therapy with, you know, biologically identical hormones? And, you know, the answer is no, because you don't get all those great benefits. And it does, you know, tend to have this side effect profile that's really unfavorable to women. Wow. Thanks for telling me that. Yeah. I had no idea. Yeah, yeah, yeah. Wow. Well, Sarah, thank you for being on the podcast. Yeah. Thank you for having me. This is so fun. This is so fun. Did I miss anything? Is there anything else we should talk about? I don't think so. I think we talked about things I didn't even think we were going to talk about.

1:15:36I know. Your personal life. We talked about my personal life. I know. Thank you for sharing. because I think a lot of people can relate to that too. I think it's real life. I'm somebody that is very much someone who's interested in the nitty gritty of someone. Beyond all this other stuff, I wanted to get to know you as a person. So thanks. Yeah, no, thanks for having me. Where do people find you or more information on what you're doing or your book? Yes, of course. You can find me on all social platforms and I'm at Sarah E. Hill PhD and that's Sarah with an H. so Sarah E. Hill PhD and my website is SarahEHill.com and my book This Is Your Brain on Birth Control is sold everywhere that books are sold and you can also find my new book that'll be coming out in September called The Period Brain in September.

1:16:26I didn't know that. Thank you guys. Go follow Sarah. She's awesome. Thanks.

1:16:39Thank you.