Hormonal Imbalance: The Stress Effect

By Jessica Stull, MD

We all get stressed out sometimes. Maybe we’re facing a tight deadline at work, or our car broke down on the highway. Whenever we feel stressed, our brain’s hypothalamus signals our adrenal glands to release and increase levels of stress hormones, including cortisol and adrenaline (or epinephrine). This triggers a “fight or flight” response, which is our body’s way of alarming us that there’s an immediate threat we need to address. After the threat is gone, our cortisol and adrenaline levels go back to normal.

But prolonged periods of stress can cause cortisol and adrenaline to remain elevated. This can result in a hormonal imbalance and have a profound effect on our health, particularly for women. Chronic stress can be due to an extended event, such as a divorce, the severe illness of a loved one, or simply being so busy your body never has a chance to relax.

A large number of American women are constantly juggling work, parenting, managing the home, and a myriad of other responsibilities. According to a 2019 survey by the American Psychological Association, nearly half of U.S. women aged 30 to 60 have experienced the symptoms of a hormonal imbalance. However, 72% of the study’s participants had no idea their symptoms were related to hormones.

When you add to this everyday pressure the prolonged stress brought on by such events as the COVID-19 pandemic, it’s possible hormonal imbalances may be on the rise.

How a Hormonal Imbalance Affects Health

Excess cortisol alone can contribute to high blood pressure, mood changes, low libido, weight gain, and irregular periods. But a prolonged stress response can also interfere with other hormones, including testosterone, estrogen, and progesterone, further exacerbating these problems and adding others.

High cortisol levels can cause testosterone levels to decrease. Although testosterone is the primary male sex hormone, women have it, too, and it’s just as vital as estrogen or progesterone. In women, testosterone helps develop and maintain muscle mass, stimulates red blood cell production in bone marrow, helps support normal cholesterol levels, keeps metabolism and weight in check, produces better sleep, and supports libido. Low testosterone can contribute to a variety of issues, including obesity, muscle loss, joint pain, insomnia, high cholesterol, reduced sex drive, osteoporosis, infertility, and abnormal periods.

High cortisol also lowers estrogen levels. In women, estrogen maintains the reproductive system and regulates processes like menstruation. Low estrogen can cause irregular periods, weight gain, hot flashes, night sweats, fatigue, moodiness, and other issues.

The biggest inhibitor to progesterone production is chronic stress and elevated cortisol levels. Low progesterone in women can cause abnormal uterine bleeding, irregular periods, headaches or migraines, mood changes, anxiety, depression, weight gain, decreased sex drive, breast tenderness, fibroids, and gallbladder issues.

Chronic stress can also affect:

• Thyroid hormones, leading to hyperthyroidism or hypothyroidism
• Ghrelin and leptin, the hormones that regulate appetite, increasing hunger
• Melatonin, resulting in restlessness and insomnia
• Insulin, contributing to Type 2 diabetes

General Hormonal Imbalance Symptoms

Depending on which hormones are out of balance, women may experience any of the following symptoms:

• Fatigue
• Mood changes
• Gastrointestinal issues
• Unexplained weight gain or loss
• Anxiety or depression
• Irregular menstrual periods
• Hair loss or thinning
• Hot flashes and night sweats
• Skin tags
• Vaginal dryness
• Sleep disturbances
• Decreased libido

Getting Back into Balance

If you’re struggling with stress-induced hormonal issues, there are changes you can make on your own to try and to alleviate stress, lower cortisol levels, and get your hormones back in balance.

• Practice deep breathing techniques
• Get frequent exercise
• Practice yoga, tai chi, or meditation
• Spend time with friends
• Reduce caffeine and sugar intake
• Find ways to laugh more
• Learn to say no and avoid overextending yourself
• Get regular massages
• Talk to a therapist or counselor

If you’ve been experiencing any symptoms of a hormonal imbalance and have been dealing with prolonged periods of stress, you should see a doctor to determine whether testing is needed. Your doctor can also help you find ways to reduce stress in your daily life.