Cortisol and Menopause
What are the effects of excess cortisol during menopause?
Cortisol is a hormone that is produced by our bodies and is essential to our health. When it comes to managing stress in menopause, cortisol can be our best friend or worst nightmare, depending on the levels we have in our body.
We need cortisol to kick-start us in the morning, it’s what motivates us, allowing us the energy to get out of bed. Our bodies normally produce cortisol in a cycle – more when we wake, less near bed time. Levels should naturally decline as levels of the hormone melatonin rise to induce sleep.
But when cortisol levels become higher or lower than normal for prolonged periods, our wellbeing can be compromised.
What is cortisol and why does our body need it during menopause?
Cortisol is known as the ‘stress hormone’ and is produced in our adrenal glands, it’s one of the major hormones in our body. You have major and minor hormonal systems.
Major hormones are essential to life
Minor hormones are responsible for fine-tuning and creating a feeling of well-being
Each hormonal system communicates with the other, they need a balanced equilibrium for you to feel well and for our body to function at its best.
What does cortisol do?
Cortisol holds three powerfully essential properties that keep us alive.
It increases blood sugar, therefore energy
It stabilises blood pressure
Importantly, it neutralises inflammation (our body's process of fighting against things that harm it)
Cortisol is a major hormone and if deficient it is important that balance is restored.
Understanding cortisol and how it has an impact in menopause
Our body produces two hormones when under stress, cortisol and adrenaline.
Both are produced in a part of the endocrine system called the adrenal glands (these sit on top of our kidneys). Both tend to work especially hard both during menopause, and when experiencing high stress.
Cortisol and adrenaline are our ‘fight, flight or freeze’ hormones. These are the hormones that give us energy, focus, and increase alertness when something like a sabre tooth tiger leaps out of the bushes or, more realistically, when we experience extreme life changes!
Long term stress could cause further health issues and play havoc with the delicate balance of our hormones.
Why does stress make menopause symptoms worse?
When highly stressed, our bodies maintain excessive levels of cortisol throughout the day. Over a period of months or years, heightened cortisol could cause serious problems across our finely tuned systems.
Heightened cortisol could lead to adrenal fatigue (hypothalamic-pituitary-adrenal or HPA) - when too little cortisol is produced, this induces another set of challenges and may require a variety of therapies to resolve.
Yoyoing hormones during menopause change the way we physically and emotionally respond to stress, heightening feelings of depression, anxiety, or make us feel overwhelmed and isolated.
How stress affects symptoms of menopause
Stress can cause a range of emotional and physical responses. Where these responses are emotional, feelings can be caused by how we think, perceive, and respond to a situation.
We may feel overwhelmed, or anxious. The body can also experience a physical response, such as a raised heart rate, changes in body temperature or changes in our gut health.
Stress, cortisol and how oestrogen and progesterone react in menopause
During menopause the adrenal glands can support our declining ovaries and produce small quantities of progesterone and the precursors for oestrogen and testosterone.
Our bodies are doing their best work adapting through menopause however, our adrenal glands aren’t as efficient at producing progesterone and other hormones when they’re constantly pumping out cortisol; our bodies tend to choose survival over fertility.
Before menopause our bodies are great at buffering stress because we have optimal levels of progesterone. Once those levels start to lower during perimenopause, the cushioning effect of cortisol weakens.
High cortisol levels can also decrease progesterone’s impact on the body. This may lead to adrenal fatigue, or ‘burn out’.
What are the signs and symptoms of high cortisol levels and adrenal fatigue in menopause?
High cortisol can cause the following symptoms, which are also symptoms of perimenopause:
Low energy, even if getting adequate sleep
Frequent colds
Cravings for unhealthy foods
Digestion problems like bloating
Weight gain, especially around the middle
Low mood
Evidence based facts about the impact menopause has on cortisol levels
A Menopause study published in 2009 by the Seattle Midlife Women’s Health Study looked at cortisol levels of 132 participants, who were not on HRT, during perimenopause and early post menopause.
Knowing cortisol levels rose among some women during the late stage of menopause, little evidence was available about changes in cortisol levels in relation to menopause-related factors.
They examined the influence of menopause-related factors, stress-related factors, symptoms, social, and health-related factors on cortisol levels during the menopausal transition.
They looked at different circumstances that might create raised stress:
At what stage in their menopause transition cortisol had most impact by testing: urine, testosterone and follicle-stimulating hormone (FSH) levels
Stress-related factors: adrenaline, norepinephrine (this plays a role in your mood and ability to concentrate), or perceived stress
Menopause symptoms: hot flushes, mood swings , poor sleep and memory loss.
Social factors: income, role burden, social support, employment, parenting, and history of sexual abuse
Health related factors: depressed mood, perceived health, physical health, BMI, and smoking
Methods of observation to test cortisol levels through menopause
Participants submitted menstrual calendars to pinpoint their stage of menopause transition, annual health reports, health diaries, and overnight urine samples.
Study result conclusions
Overnight cortisol levels were associated with women’s physiology including testosterone and follicle-stimulating hormone (FSH) levels.
They were significantly associated with adrenaline, norepinephrine (this plays a role in your mood and ability to concentrate), or perceived stress.
Menopause stages, symptoms, and social, stress-related, and health-related factors had little relationship to overnight cortisol levels. Although they are correlated with other biological indicators of stress response.
The study found cortisol levels increase gradually with age, from late 40’s onward. It does have a psychological impact in menopause and is linked to sleep-wake patterns, eating, physical activity, and challenges in life.
What factors are related to high cortisol levels in menopause?
Low bone density, minor memory loss and perceptions of poor health
Hot flushes, night sweats, sleep symptoms
Post-menopause health - later development of diabetes and heart disease may potentially be associated with changes in cortisol levels
7 Steps to balance cortisol levels in menopause
If you (or your doctor) don’t realise these feelings are hormonal issues relating to menopause, anti-depressants may be prescribed as a solution. Clinical depression and hormonal depression should be approached differently when it comes to menopause. But there are plenty of options to manage symptoms and alleviate some of the feelings of stress you’re experiencing.
If you’re struggling with symptoms of elevated cortisol or experiencing adrenal fatigue due to a stressful lifestyle, the following self-help steps may help balance cortisol levels and recover your equilibrium.
Stabilise your circadian rhythms
Practice healthy sleep habits by sleeping and waking at the same time each day, aim for at least 7 hours of uninterrupted rest, and limiting electronics use before bedtime. Also try to get plenty of sunshine in the morning and at midday to stabilise your body’s circadian rhythms.
Relaxation to relieve stress
Rest and relaxation are two of the most crucial elements we rely on for overall health. Disrupted cortisol levels may make it impossible to relax.
Mindfulness is more than just a fad. Relaxation practices are necessary for reducing cortisol in those who experience chronic stress, so make them your priority.
Try these out to calm your stress levels:
Deep breathing exercise – taking five deep, long breaths can effectively calm down your nervous system.
Relaxation/meditation – sitting for 5 minutes with your eyes closed and focusing on your breathing can work wonders.
Walking – an over-looked activity that’s not only great for your overall wellbeing, it is brilliant for stress management.
Balance blood sugar levels
Raised cortisol causes increased blood sugar, comfort eating and a diet full of sugar and processed foods isn’t helping your problem.
Focus on a diet that keeps blood sugar levels balanced. When you eat a diet that spikes your blood sugar, your body responds by producing more cortisol. When your blood sugar crashes after a cake and coffee, your body uses cortisol to bring your blood sugar back up.
Try an anti-inflammatory diet
Reassess your diet: try to include more meals rich in vegetables, healthy fats, and replace refined white flour, pasta and rice, with whole grain versions.
These anti-inflammatory foods help your body maintain stable blood sugar levels and reduce your risk of developing weight problems, diabetes or obesity.
Supplement your diet
Nutritional changes may partly help balance cortisol. But your body may crave greater proportions of certain nutrients. *Supplements including vitamin C, vitamin B5, Omega-3 fish oil, magnesium, adrenal adaptogenic herbs such as Rhodiola may help reduce cortisol levels.
*It’s vital you consult your doctor before adding any supplements to your diet (even over the counter supplements), to make sure they don’t interfere with your other medications or treatments.
Motivate yourself to move & exercise right.
Research carried out by Obstetrics & Gynecology Clinics of North America in 2011, show that exercise throughout menopause reduces the stress response in the brain which helps improve cortisol levels. Exercise promotes healthy ageing overall in both mind and body.
Our bodies love movement, so move it any way you like: dancing is great for lifting spirits, pilates or yoga for stretching and relaxed breathing, jogging and high intensity interval training HIIT. Even gardening is helpful in lowering stress.
Don’t overdo it, take it slowly and build up fitness levels gradually. Intense exercise without adequate nutrition can also be a source of stress via production of cortisol, so it’s good to balance something like aerobics with gentler activities like yoga and pilates.
Reduce unhealthy habits
Alcohol, the go-to for unwinding at the end of the day has been found to significantly increase cortisol levels. Similarly, with caffeine, creating a temporary but dramatic increase in blood pressure and related symptoms of anxiety.
If you’re struggling with cortisol imbalance steer clear of both, give your body the chance to recalibrate itself. The same goes for smoking!
HRT and cortisol - can it help?
If you’ve tried the self-help steps explored above without any significant change in your symptoms, it may be time to get support from your doctor, or through a menopause specialist clinic.
Estradiol is a form of oestrogen, a female sex hormone that regulates many processes in the body. It’s available as a form of HRT as an oral tablet, a topical gel or patch, vaginal cream, or as an injection.
Studies have shown that Estradiol has a powerful effect on brain function. As shown in a placebo-controlled study conducted by Neurobiol Aging in 2012. They examined 39 postmenopausal women (56-84 yrs) with the effects of estradiol and heightened levels of cortisol on the perception of ageing and cognitive degenerative disease.
They found favourable responses for Estradiol on elevated levels of cortisol in healthy postmenopausal women.
Cortisol imbalance appears to be more prevalent as we struggle to juggle busy professional, family, and social lives. And until we can manage stress in a healthy way, we may continue to struggle with this significant cortisol imbalance.
Menopause can for some, feel stressful but let’s not be too negative. We look at this phase as a positive, transformative experience. As our name suggests, it has a plus side. This transition should be a time to pause, recalibrate and evaluate life: to reflect on stress triggers we have some control over including careers, relationships, health and wellbeing.
April 2020
If you are looking for ideas to improve your menopause diet, then we’ve got plenty of Recipe ideas that will get your taste buds tingling!