Menopause is a physiological process that marks the end of a woman’s reproductive life. It occurs due to the decline in ovarian function, resulting in the cessation of menstruation. Menopause occurs between the ages of 45-55, with an average age of onset at around 51 years. While menopause is a natural process, it can be accompanied by a range of symptoms, including hot flashes, night sweats, mood changes, and changes in libido.
Cortisol is a hormone the adrenal gland produces and uses in the body’s stress response. It also involves other physiological processes, including glucose metabolism, immune function, and blood pressure regulation. Cortisol levels can fluctuate throughout the day in response to stress and other factors, and abnormalities in cortisol regulation can lead to various health problems.
This article will explore the relationship between cortisol and menopause, including how cortisol levels change during menopause and how this can impact women’s health.
Cortisol and Menopause
Cortisol is released into the blood in response to stress or other stimuli. Cortisol levels can fluctuate throughout the day in response to stress and other factors, and abnormalities in cortisol regulation can lead to various health problems.
During menopause, cortisol levels can become dysregulated, leading to various health problems. This can occur partly due to changes in estrogen and progesterone levels, impacting the body’s ability to regulate cortisol production.
Estrogen and Progesterone Balance
Estrogen and progesterone hormones play a crucial role in women’s reproductive health. During menopause, estrogen and progesterone levels decline, leading to a range of changes in the body, including changes in cortisol regulation.
Estrogen has been shown to play a role in cortisol regulation, with studies suggesting that estrogen can enhance the body’s ability to regulate cortisol production. This may be due to estrogen’s impact on the hypothalamus-pituitary-adrenal (HPA) axis, which regulates cortisol production.
Progesterone may also affect cortisol regulation, although the evidence is less clear. Some studies suggest that progesterone may suppress cortisol production, while others have found no significant effect.
Changes in cortisol regulation during menopause may be due to changes in progesterone and estrogen levels. As estrogen and progesterone levels decline, the body’s ability to regulate cortisol production may be impacted, leading to the dysregulation of cortisol levels.
Symptoms of Dysregulated Cortisol Levels
Dysregulated cortisol levels can lead to various symptoms, including fatigue, anxiety, depression, and weight gain. These symptoms can be particularly challenging for women during menopause, as they can exacerbate the other symptoms of menopause.
Fatigue
Fatigue is a common symptom of dysregulated cortisol levels. Cortisol is involved in regulating energy levels, and abnormalities in cortisol regulation can lead to feelings of fatigue and lethargy. This symptom can be particularly challenging for women during menopause, as they may already be experiencing fatigue due to other symptoms, such as sleep disturbances and hot flashes.
Anxiety and Depression
Anxiety and depression are also common symptoms of dysregulated cortisol levels. Cortisol regulates the body’s stress response, and abnormalities in cortisol regulation can lead to heightened anxiety and depression. These symptoms can be particularly challenging for women during menopause, as they may already be experiencing mood changes due to changes in estrogen and progesterone levels.
Weight Gain
Weight gain is another common symptom of dysregulated cortisol levels. Cortisol plays a role in metabolism, and high levels can lead to increased appetite and storage of fat in the abdominal area. This change can be frustrating for women already dealing with other menopause-related symptoms, such as hot flashes and mood swings.
Hot Flashes & Sleep
Research has shown that high cortisol levels during menopause can exacerbate symptoms such as hot flashes and sleep disturbances. A study in Menopause found that women with high cortisol levels reported more frequent and severe hot flashes than those with lower cortisol levels. Additionally, cortisol has been shown to interfere with estrogen production, leading to a further decrease in estrogen levels and worsening of menopausal symptoms.
Bone Health
Cortisol can also affect bone health during menopause. Women face a higher risk of developing osteoporosis during menopause due to the decline in estrogen levels. High cortisol levels can further exacerbate this risk by interfering with the body’s ability to absorb calcium, essential for maintaining strong bones.
Brain Health
Furthermore, cortisol can affect cognitive function during menopause. A scientific study in the Journal of Clinical Endocrinology & Metabolism found that women with high cortisol levels had a decline in cognitive function compared to those with lower cortisol levels. This decline in cognitive function can further exacerbate menopause-related symptoms such as mood swings and irritability.
Reduce Stress
To manage cortisol levels during menopause, reducing stress and engaging in stress-reducing activities such as yoga, meditation, and deep breathing exercises are essential. Maintaining a healthy balanced diet, getting good sleep, and exercising can also help manage cortisol levels and reduce menopause-related symptoms.
Cortisol plays a significant role in menopause and can exacerbate hot flashes, sleep disturbances, bone loss, and cognitive decline. Managing cortisol levels through stress-reducing activities and a healthy lifestyle can help reduce the severity of menopause-related symptoms and improve overall health and well-being during this transitional period.
If you experience these symptoms, speaking with your healthcare provider is essential. Various treatments are available to help manage menopause-related symptoms, including hormone replacement therapy, lifestyle changes, and stress management techniques. By working with your healthcare provider, you can find the right treatment plan to help you manage the symptoms to improve your quality of life during this important transition.
Here, we discuss with Adele Wimsett, a Health Coach who focuses on women’s hormonal health to get her thoughts on Cortisol and Menopause (and Perimenopause).
What is Cortisol?
NourishDoc: I hope everyone had a great Diwali. We had Diwali yesterday. So, happy Diwali. Well, we are back focusing on women’s health forty and above. Today, we want to talk about cortisol, the stress hormone. So, we’re talking about this. We have Adele. Adele is a health coach who focuses on women’s hormonal health. Welcome, Adele, and she’s joining me from the UK.
Health Coach Adele: Thank you for having me here. Are you ready for me to start?
NourishDoc: Yes, please go ahead.
Health Coach Adele: Amazing. So, I’m a women’s health practitioner and part of a collaboration of women who support perimenopause called perimenopause. Today, I will give you a brief whistle-stop tour because this doesn’t even touch the sides. However, I want to honor our time together and look at the fact that the main issue we have with balancing our hormones is how stressed we are.
We’re completely desensitized to our stress level, and this has put us in a state of hyper-arousal which has a massive impact on our hormone balance; in this webinar, I’m just going to introduce you to the concept of the interplay of our hormones where and why addressing stress is a number one way to manage our symptoms. So I hope you can all see this because this slide begins to put this in context.
Cortisol And Perimenopause
After all, quite often, when looking at perimenopause, any hormone imbalance focuses on progesterone and estrogen, but not all hormones are created equal; as you can see in this image, there’s a hierarchy, and I would put cortisol above this now. She is the queen bee of our hormones and has a close relationship with insulin, so the whole thing crumbles when these two go out of whack. When I’m working with women, we balance these two; we focus on cortisol and insulin.
We often see that many symptoms women experience during perimenopause begin to settle down. One of the key things being women start to sleep better, which is a huge issue for us during perimenopause. So let’s look a little bit at cortisol. This is the focus of this very brief lecture and introduction to this. But I lovingly refer to this as the old crack hormone; our cortisol is released from our adrenal glands which sit just above the kidneys, and its job is to save our life.
It makes us fight or flee from a predator or maybe even freeze, but it’s designed to overrule the non-essential functions in our body to help us run away and save our life. So outside of this role, its daily functioning was meant to rise in the morning to wake us up and then gently decline during the day; however, our lifestyles have got us in this constant state where cortisol’s just being released. They did a study that showed that cortisol was pumped out with every phone ping. Every time your phone gets a message, it releases cortisol.
So, you could be sitting happily watching Netflix, and your body is pumping out this cortisol. So, this modern living has created some health issues, particularly for women with our hormone balance. This is how cortisol is released, okay? So, this is our HPA axis which is our stress response. It stands for the hypothalamic pituitary adrenal axis, a way that our brain perceives stress and sends a message down to our adrenals to pump out this cortisol.
Cortisol Impact On Digestive System
So, as I said, it shuts down these non-essential bodily functions, one of which is ovulation so, at a time in our life, we’re trying to maximize our ovulation to have all these beautiful reproductive hormones that protect our long-term health actually, the cortisol is sending a message not to do this. So, as you can see, when this happens all the time, it shuts down our digestive system. It makes that slow down so you can see how digestive issues become linked with stress, and the gut plays a huge role in our hormonal health. Can you hear me, okay?
So it keeps cutting out, and when we’re operating at this level a lot and all in a chronic state where our cortisol is pumping out over time, our adrenals get tired. So this causes something called HPA axis dysfunction, previously termed adrenal fatigue. So really, balancing our cortisol is fundamental to our overall health. As you can see here with, cortisol has a sister hormone called melatonin; they play this beautiful symphony together in our circadian them; this is our twenty-four-hour inner timekeeper that men and women have.
However, of course, we have this beautiful second inner timekeeper, our monthly rhythm, our infrared in rhythm. Suppose our circadian rhythm is out of balance due to imbalances with our cortisol melatonin. In that case, this can significantly affect our monthly cycle. As you can see here in this image, ideally, cortisol rises to pink first thing in the morning to get us up and out of bed, which is the awakening response and steadily declines during the day so that melatonin or sleep hormone can rise to get us ready for bed. However, our non-stop twenty-four-seven lifestyle has messed with this.
So, once we start seeing this dysfunction happen here, it affects our hormonal shifts, which we don’t want as we try to balance things out as much as possible. So, how do you know if this is being affected by you? Many of the symptoms you can see here on this slide are probably what people would put down just to modern living. However, they are significant whispers of your body being dysregulated. So they’re quite simple to notice, but we’re so busy rushing for our lives.
We don’t always feel them, so we can experience this brain fog, struggling to remember things and feel quite tired during the day but then get into the evening. Suddenly have this second wind feeling quite wired to get to sleep. This interplay between cortisol and insulin they have a close working relationship. If cortisol is not working properly, insulin probably isn’t, either. So, we start to get this poor blood sugar regulation where we see cravings; we start relying on caffeine for a boost, and we get this afternoon’s energy slump.
We can; one of the other things is, if you find yourself waking up at about three or 4 a.m., this is quiet and due to this dysregulation, but some of the other things you might experience are like issues with your blood pressure finding yourself picking up lots of colds and struggling to get rid of them, these digestive issues just a consistent mood imbalance maybe gaining some weight around the tummy because this insulin relationship, this fatigue are maybe craving salts. Hence, we start to see these little things that we might not see as a symptom but their ways of your body trying to communicate with you. There are some functional medicine tests available as well.
Cause Of These Stresses
However, the symptoms usually are enough for us to figure out what is happening. So what causes these stresses? I mean, I’m sure you don’t need me to tell you the sources of stress in your life. However, it is worth noting that there may be more hidden ones we’re unaware of, like mold toxicity and parasites and viruses such as Epstein. So if you feel like you’re doing all the things, let’s be honest, we have so much access to information about supporting ourselves during this. You might want to pick out some of these less obvious signs of cortisol dysregulation.
So, feel free to take a screenshot of this and look at it, and just sort of really analyze about, you know, where this stress is coming from into your life? But the good news is that once we start to embody some strategies to start to manage this, we can start to feel better; you know, unfortunately, as much as I love a good bubble bath and going on a retreat, that’s not going to deal with the stresses usually, it can start to take the edge off, but actually, you want to create a life that you don’t need to retreat on. So that you give your beautiful yummy hormones space to balance out. And I promise you it’s worth it.
As women, we struggle to prioritize non-negotiable time to reset ourselves to calm down our nervous system, and this isn’t always easy; you know, sometimes this can be having a difficult conversation to put a well-needed boundary in place for yourself; we have so many demands on us being pulled in lots of different directions we become desensitized that and it becomes our norm. However, we can improve our well-being once we address some of these issues.
Remove The Stressors In Your Life
As I say, this can be things like, you know, letting go of pointless arguments, practicing saying no, avoiding the toxic, stressful people in our lives, so often, as women, we hold onto relationships that we’ve outgrown, due to a feeling of some kind of, that we have some, we owe something to that relationship, but it doesn’t serve us. Where can we begin to delegate things? Where can we ask for help? This is not a sign of failure; it’s a sign of us acknowledging where we are.
I’m a big fan of women’s circles; by joining spaces, particularly Facebook groups, we can access lots of support and information, look at some gratitude practices, and be kind and compassionate. Give yourself a break, full permission to take a rest guilt-free. So often, as women, we take a break and see just one more job that will get done. Just one more thing, we’ll do that, and then we can rest, and then before we know it, the space we had to slow down has gone. So really trying to make self-care which I’m not a fan of that term.
But trying to make that non-negotiable time for you. Particularly during perimenopause because we crash into this season if we don’t. So here are just some of my favorite practices. I’m sure you can think of your own. However, these are fairly easy to incorporate into your life. Yet, they greatly impact this HPA axis and reduce your cortisol. As women, we can struggle to meditate and be still. Now there’s great beauty in that practice, but using our senses in pleasure practices, like just sitting down with a hot drink and using all of your senses within that, can be incredibly calming.
So feel free to take a screenshot of that so you’ve got this to return to and add in your own. Sometimes I find that having a good journal rant to download what’s in my head can avoid a stressful argument or conversation. So here, you know, sleep, okay? We know the last thing a stressed woman wants to know is that her sleep plays a massive role in her health. It can contribute to us feeling more stressed and more uncomfortable.
But we must honor this sleep this season; my family laughs at me because I have a non-negotiable bedtime between 9 and 9:30 every day, which has worked wonders. I used to be a dreadful insomniac, and now I sleep beautifully. One of the reasons is by having this robust sleep hygiene, trying to go to bed at the same time and wake up at the same time each day, avoiding screens in the evening, only using your bed bedroom for sleep, and, like all the loveliness that comes with being intimate with somebody, keeping a room cool and comfortable, lovely natural fabric, cotton, particularly few experienced sweats at night, maybe even a wet weighted blanket.
If you’re somebody who experiences anxiety, a weighted blanket can be useful. Of course, lovely essential oils like vetiver and lavender are great at night. I also suggest avoiding caffeine after noon; if you drink caffeine and have fun in the evening instead of phrasing, how many more emails can I complete? How many more messages can I get? Please turn it off and sit and have some pleasure and some fun in your life. So this has been a whistle-stop tour of being able to introduce this to you and how stress is affecting your hormones.
I want to invite you to go back and list your stresses and consider which ones feel available to you to be able to tackle; you know to remember to start small; this isn’t about going in and going right now. I’ve got to get rid of all these people in my life. I might sit, journal, and reflect on who fills my cup. Who takes from you? You and then consider some of the habits you’d like to gently introduce, you know, doing things quickly and fast, and all of this triggers this HP axis.
We can bring things into our lives that force us to slow down. It can be as simple as just laying in bed and taking five deep breaths before we start our day. So we begin to start our day with intention. So I hope that that was of use to you. I’m very conscious that we had this time framed to introduce this concept to you. Before tackling the progesterone and estrogen in space, perhaps develop that hierarchy and work on your stress response and insulin balancing.
Why Stress Management is Important?
NourishDoc: It was to the point and succinct. For a lot of us, well, all of us, stress is part of our life. Right? No matter where you live, right? Now the important thing is to understand the way you explain why balancing stress and managing stress is so paramount for our bodies and why stress is the queen bee-like; I don’t think we understand that part that the queen bee we have to take care of the queen bee, you know.
Understanding the fundamentals of why stress management is important is what you brought today to the viewers; you can do it. However, you have to understand why you have to do it and if you don’t do it, what it’s going to do to you, right? So then, that’s why you’re doing yoga, journaling, breathing exercises, and other things. So really appreciate that because this is very important for us to understand the fundamental reason.
Health Coach Adele: Absolutely. Thank you so much for having me.
NourishDoc: Thank you. We are developing programs and workshops for women over 40 in January. So give us a couple of months to get organized, but stay tuned, and that’s what we’ll be coming up with really exciting programs. So, thank you so much for your support.