The battle of the pregnancy hormones

The word ‘pregnancy’ is almost synonymous with ‘hormones’. Oestrogen, progesterone, hCG – most expectant mothers will have heard these names without understanding their proper meaning for their pregnancy.

For example, hCG (human chorionic gonadotropin) is the hormone detected by pregnancy testing kits. It’s responsible for placental development and widely considered to be (in part at least) the cause of morning sickness because of its impact on the brain.

Production of hCG peaks around week 13 of pregnancy as your baby reaches around 3 inches (roughly 7.5 cm) in length and you wave goodbye to the first trimester. But what do the rest of these pregnancy hormones actually do?

Here, one mum shares her experience of the hormonally challenging thirteenth week of pregnancy.

Me, my hormones and I – One mum’s perspective

There’s no doubt that pregnancy can be a wonderful, emotionally fulfilling, exciting time in a woman’s life as her unborn child strengthens and grows inside her. However, it can also be draining, painful, tiring and mildly scary. I’ve always thought that anyway – and I’ve had three!

Facing the reality of pregnancy for the first time did frighten me. There seemed so much stuff that I should know; almost by osmosis it seemed. The worrying pregnancy signs and symptoms to watch out for, the recommended diet and exercise routine to think about, the pregnancy vitamins to select, foods to be avoided….I could go on. By week 13 I remember feeling quite overwhelmed with it all and tearful a lot of the time. So when my friend Kate confided in me about her pregnancy worries, I could empathise wholeheartedly.

Ever since she got married three years before, Kate and her husband had been trying for a baby. It’s a tough thing to watch a friend struggle to get pregnant, especially being a mother myself, and I was absolutely thrilled when she announced to me that she was six weeks pregnant.

“Everyone else has to wait,” she told me, “but I wanted to tell you straight away.” For the next six weeks I didn’t see an awful lot of her and it was about thirteen weeks into her pregnancy when she next called round. I’d been expecting to see her glowing with health and happiness, so it came as quite a shock to see the drawn, pale Kate who turned up on my doorstep. Immediately, I assumed the worst. “What’s happened?” I asked her, taking her through into the kitchen. “Nothing,” she burst into tears. “That’s just it. Nothing’s wrong and yet I still feel like this.”

“Like what?” I asked gently.

“I feel exhausted, fed up and tired. I can’t sleep properly, I still feel sick, I can’t focus or concentrate properly and I’m snapping at everyone. My work is suffering and it seems like ever since I became pregnant my whole life has fallen apart.”

I knew immediately how to help her. “Wait here,” I told her, and fetched my pregnancy diary, flipping through the pages until I found Week 13. Here’s what I had written – It’s all about the hormones:

• Oestrogen (gives the pregnancy ‘glow’, makes us feel contented)
  
• Progesterone (thickens the lining of the uterus)
  
• Prolactin (responsible for changes in the breasts and milk production system)
  
• Testosterone (yes, really! Slight increases in this essentially male hormone is the reason why many women will experience a raised libido in pregnancy)
  I handed Kate the diary, “Here, keep it,” I told her, “and make sure that you read through it.”

It had been around this stage in my first pregnancy that I really began to feel very low in mood and my diary documented this struggle. I had been easily irritated, tearful and lost interest in many things I had previously enjoyed. And I couldn’t understand it. I was out of the first trimester safely, my risk of miscarriage had dropped substantially so I could have more confidence in my pregnancy, and I had all the nice things to look forward to – my changing shape as my bump appeared, feeling my baby’s first kicks and beginning to choose furniture for the nursery and impossibly tiny babygrows.

But despite what my conscious mind was telling me, I was still experiencing feelings of utter hopelessness and I was completely unable to enjoy life. Eventually, these feelings became overwhelming and I had to talk to my midwife. And I was glad that I did, because, to my shock, it turned out that she thought I had prenatal depression.

Virtually every expectant mother has heard of postnatal depression (crippling feelings of depression after the birth), but a much smaller number are generally aware of prenatal depression. And this condition was making me feel so unhappy just when I thought I should be feeling the opposite.

Those lovely pregnancy hormones, whilst they were doing a sterling job of supporting my pregnancy, had also led to prenatal depression.
Luckily, as I discovered, there’s plenty of support out there. You can talk to your midwife, GP or a psychiatrist – each of them will be able to offer advice depending on your specific situation. For severe mental health problems your midwife can work alongside you to develop a specific care plan and give you access to the perinatal mental health team, or community mental health team.

I opted for talking therapy and a low dose of antidepressants and it wasn’t long at all before I began to feel better. Obviously not everybody with low mood will have prenatal depression, but it’s useful to know that it’s a real condition and you’re not making it up.

Kate looked visibly relieved as she left. “Besides,” I told her, “if your baby is a girl, by week 13 she already has around two million eggs in her ovaries – imagine how many hormonal upsets they’re going to be responsible for!”

I thought I saw her relief slip a little bit…….but it could have been my imagination.