Stress may be inevitable, but the damage from stress doesn’t have to be! Mostly everyone in our fast-paced, technology-driven, multitasking world lives with some level of acute or chronic stress.

Did you know? Every day a million Americans miss work due to stress-related issues. (1)

The adrenal glands sit on top of the kidneys and secrete cortisol, sometimes known as the stress hormone, and DHEA. Even though the adrenals are the size of a sugar cube, and weigh as much as 3-4 paper clips, they can dramatically affect how we feel. (2)

Stress and the stress hormones from the adrenal glands have far-reaching effects on health, but in this blog, we will specifically be discussing how stress affects hormone balance in women. (3)

The three stages of stress

Alarm

In the alarm stage, your cortisol and DHEA levels are high. You identify yourself as being stressed, but you are up, doing too much, you may feel jazzed, even anxious, and have trouble sleeping. If the stress is short lived, you bounce back and recover.

Adaptation

As time goes on, with unrelenting stress, in the adaptation phase the levels of the stress hormones cortisol and DHEA come down and may look normal, but the adrenals start to tire.

Exhaustion

In the exhaustion phase, the adrenals give up and start putting out less and less cortisol. Fatigue sets in. You know you are there when you start thinking you need caffeine and chocolate to get up and get through your day.

High cortisol levels are associated with other signs of risk to health. (4)(5) They lead to increased risk of heart disease and high cholesterol, as well as loss of muscle mass and lowered immunity. Stress researchers have quantified the most stressful events, and have determined that the greater the stress, the greater the chance of illness. (6)

Here’s a list of the highest stressors:

1. Death of a spouse
2. Divorce or marital separation
3. Imprisonment
4. Death of a close family member
5. Personal injury or illness
6. Dismissal from work
7. Retirement
8. Marriage or marital reconciliation
9. Work more than 40 hours/week (7)
10. Financial problems (8)

Other common powerful stressors are times of hormone fluctuations, such as pregnancy, childbirth, and menopause.

Stress affects your hormones

The “vicious cookie cycle” and your hormones

Everyone has their own adaptation to stress, some positive, some less positive. Some people just ignore it altogether! Many of the patients I see try to cope with their stress by comfort eating. Cortisol actually increases the cravings for sweets. The practice of eating sweets or other high glycemic index foods that break down quickly into simple sugars is what I have called the “Vicious Cookie Cycle”.

This is an easy way to see how stress and high cortisol levels affect other hormones. When cortisol levels are high and we eat sugar or other simple carbohydrate foods, it causes insulin to spike. High insulin levels cause the blood sugar to plummet, leading to a further increase in the secretion of cortisol, and also increased hunger, especially for sweets and carbs. So we eat another cookie and go back into the vicious cookie cycle!

How stress impacts your insulin resistance

But if this pattern happens regularly, and insulin spikes over and over, it may lead to insulin resistance or metabolic syndrome. In insulin resistance, the insulin stops doing its job of removing sugar out of the blood — and the result is — chronically high blood sugar. This is often is a precursor to diabetes. High cortisol and chronically high insulin cause the body to deposit fat, mostly in the belly.

To add insult to injury, high cortisol lowers thyroid function, so metabolism is slowed and women often gain weight and feel fatigued.

Other stress-related health risks in women

High cortisol also lowers estrogen levels, which can result in the deposition of fat, also sometimes called that “menopausal middle.” When estrogen is lowered from unrelenting stress and cortisol production, all the female hormone imbalance symptoms such as hot flashes, night sweats, sleep problem, and mood swings can get worse.

High cortisol levels from stress also reduce serotonin levels, so a woman may be even more moody, depressed, and have trouble sleeping. (9)

So stress, which is endemic in our society, if not managed, can cause many other important hormones to become out of balance.

Managing cortisol dysregulation with supplements

Herbs and nutrients that are adaptogens improve the regulation of the HPA axis and regulate the secretion of cortisol. They should be prescribed under the advice of a professional and based on the stage of the stress response the woman is in.

Cortisol is a diurnal hormone and can be measured by a saliva test to determine the cortisol output four times during the day. This helps a practitioner prescribe the right adrenal supplements and the right time of the day.

Vitamin B & magnesium are appropriate for anyone under stress. In addition, we can treat according to which stage of the stress response a patient is in.

Alarm stage

• PS (phosphatidylserine) regulates high cortisol levels
• Amino acids L-theanine and GABA help reduce feelings of stress and anxiety
• Ashwagandha is relaxing and balancing to the adrenal glands

Adaptation stage

• Rhodiola
• Holy Basil
• Eleutherococcus
• Maca
• Ashwagandha

These all are adaptogens and provide resilience and increased stamina to counter stress.

Exhaustion stage

• Combination of the herbs listed above with the addition of glandulars, to increase cortisol
• DHEA to balance cortisol.

Lifestyle tips for women experiencing stress

A woman’s lifestyle can have a large impact on her mood, behaviors, and feelings. Lifestyle can also affect stress levels and it is important to understand what to do and what not to do. For women experiencing stress, some lifestyle choices to manage their stress include:

• Avoiding sugar and refined carbs and other pro-inflammatory foods
• Getting enough sleep (7-9 hours reduces cortisol levels)
• Regular exercise – aerobic exercise reduces cortisol
• Meditating
• Practicing yoga

Women and men respond to stress differently. Researchers at UCLA have termed the woman’s response to stress as “tend and befriend” in contrast to the usual fight or flight response. (10) This means that women, under stress will take care of the children and the home, and look to their girlfriends for help and support.

This healthy response to stress involves the 3C’s: communicate, collaborate, and cooperate. If a woman under stress will tend and befriend, it will cause her body to produce more oxytocin, the bonding hormone that reduces cortisol. Actually, any self-nurturing activity, any activity that brings happiness — besides eating inappropriate comfort foods — can increase oxytocin, and reduce cortisol. (11)

The bottom line

Given how present stress is in our lives, and how much damage it can cause, stress management tools are particularly valuable. Supplements and herbs to support the adrenal glands and regulate cortisol production are one of our most important interventions.

Stress management techniques and adrenal support should be a component in the care of a female patient during times of hormonal transition, and any time a woman has symptoms of hormone imbalance.