How cortisol, the stress hormone, affects women's hormones
How chronically raised cortisol shifts the balance of oestrogen and progesterone, what it does to ovulation and the cycle, and what the functional approach suggests.
Cortisol is the hormone the body releases under stress. When it stays raised over a long period, though, it can also affect the production of women's reproductive hormones and the regularity of the cycle. Understanding that interaction offers a useful perspective on unexplained cycle irregularities and hormonal complaints.
What is cortisol, and why is its effect so wide?
When the body registers a source of stress, the hypothalamic-pituitary-adrenal (HPA) axis is activated and the adrenal glands release cortisol. Cortisol is a powerful hormone, able to affect the working of many endocrine organs — the ovaries and the thyroid among them.
The link with women's hormones
Steroid hormones such as progesterone, oestrogen, cortisol and DHEA share a common precursor: pregnenolone. Under chronic stress the body can direct that raw material primarily towards making cortisol, in which case progesterone production may fall and a relative imbalance against oestrogen — oestrogen dominance — can appear. High cortisol can also reduce the effect of progesterone at cellular level while increasing the effect of oestrogen, and can suppress hormone synthesis in the ovaries.
The effect on the cycle and on ovulation
Raised cortisol can affect ovulation directly. A stress-related shortfall in progesterone can shorten the luteal phase and lead to irregular periods. Extreme physical or emotional stress can disturb the hormonal coordination between the brain and the ovaries, causing ovulation to stop altogether (anovulation) and even periods to cease (amenorrhoea).
Signs of chronic stress
- worsening premenstrual syndrome (PMS)
- irregular periods
- a tendency towards insulin resistance, and fat gain around the middle
- hair loss
- anxiety, sleep problems, difficulty concentrating
- frequent migraine attacks
What does the functional approach suggest?
The first step in supporting hormonal balance is generally stress management and adjustments to the way you live: regular sleep, regular exercise, a balanced diet (reducing sugar, alcohol and excessive caffeine) and relaxation or breathing techniques form the basis of this approach. In some people, nutritional support or herbal approaches may also come into consideration after assessment by a doctor; support of that kind should be planned individually and under medical supervision.
Frequently asked questions
Can stress on its own cause irregular periods? Stress can be a significant factor, but irregular periods have many different causes; the actual cause is established by medical assessment.
How is cortisol measured? It can be assessed in blood, saliva or urine samples; your doctor decides which method is appropriate.
How long does stress management take to affect hormonal balance? This varies from person to person and with how long the stress has lasted; lasting changes to the way you live generally show their effect over time.
This page is for information. It does not replace an examination or individual medical advice.