The Effects of Chronic Stress on Women 

By  Dr. Luke Martin, D.C.

Chronic stress can have detrimental effects on women's health compared to men's because they are more vulnerable to cortisol dysregulation. Women are nine times more likely than men to have cortisol dysregulation, which is an imbalance of cortisol levels in the body. The hippocampus and follicles in the ovaries are both sensitive to cortisol levels, meaning that cortisol affects ovarian hormones and reproductive function. Acute stress causes cortisol levels to rise, but chronic stress causes cortisol levels to remain high over time preventing women from releasing progesterone key for birth control and pregnancy and regulating other hormones. In this article, we will examine the effects of chronic stress on women's health, specifically how chronic stress can affect cortisol levels, hormones, and reproductive function. We’ll also provide tips on how to manage stress to reduce cortisol.

How Do High Cortisol Levels Affect My Body?

When cortisol is released in response to stress the body experiences a "fight or flight" response. Acute stress elevates cortisol levels by increasing catecholamines – i.e. epinephrine (adrenaline) and norepinephrine – released from the adrenal medulla. Typically cortisol levels peak at approximately 30 minutes after acute stress begins and then return to normal within four days. 

However, chronic stress causes cortisol levels to remain elevated for longer periods of time preventing individuals from returning to homeostasis and causing cortisol dysregulation which hurts women's health more than men's because they are more sensitive to cortisol. Cortisol dysregulation in women can occur because cortisol receptors are expressed on ovarian follicles and the hippocampus of the brain. The hippocampus is a part of the brain responsible for learning, memory, and emotions which means that cortisol impacts behavior, moods, and memories as well as reproductive function. Ovarian follicles have cortisol receptors which means that cortisol levels affect fertility by preventing ovulation. So, chronic stress causes cortisol levels to be elevated resulting in problems with both hormones and reproduction in women compared to men.

What Are The Signs of High Cortisol in Women?

Cortisol and hormones can be the underlying cause of many women's health issues. For example, cortisol is responsible for regulating blood sugar levels, energy and metabolism, immune function, and more. Women are particularly prone to cortisol dysregulation as cortisol receptors are expressed on ovarian follicles and in the hippocampus. These are also two areas that play a key role in female reproductive function. 

So what does chronic stress have to do with these hormones? When cortisol levels are increased due to stress, the body releases less progesterone which may lead to infertility or problems during pregnancy. It also leads to lower estrogen production which increases the risk of osteoporosis. Chronic stress also increases cortisol response to further stressors making it harder for women's bodies to return cortisol levels to normal. 

Chronic stress can affect the quality of women's sleep as cortisol secretion in women is highest at night when cortisol does not have time to dissipate from the body as it does during the day. Studies have shown that cortisol levels are particularly high in women who wake up frequently and cannot get back into a deep sleep, leading to cortisol levels remaining elevated throughout the day. Sleep deprivation triggers cortisol secretion so women who do not get adequate sleep may see cortisol levels rise as they try to catch up on missed sleep.

When cortisol levels are consistently high in response to chronic stress, it can lead to adrenal insufficiency, often found in women in midlife with chronic diseases such as migraines, fibromyalgia, and autoimmune disorders. Some cortisol receptors are located in the smooth muscle of blood vessels which allows cortisol to increase blood pressure therefore women should also be aware that cortisol dysregulation from chronic stress can lead to hypertension.

Higher cortisol levels associated with chronic stress have been linked to depression, PTSD and anxiety due to the fact that when cortisol is too high for too long it causes brain cells to shrink which may affect mood as well as cognitive function. The hippocampus is particularly vulnerable because the cells there produce cortisol receptors; cortisol receptors send signals throughout the body causing hormonal changes in areas such as bone density, immune function, and reproduction when stimulated. Chronic stress can damage the hippocampus because of this constant stimulation causing impaired memory formation, learning, and mood regulation.

The hormones cortisol and progesterone are intricately linked, so if cortisol dysregulation affects cortisol production it can lead to lower concentrations of progesterone in women which may affect metabolism, sleep and mood. Also, cortisol inhibits the release of oxytocin which is associated with bonding and social interaction; cortisol acts as an anti-stress hormone but if there is chronic stress cortisol levels remain elevated for a longer period of time leading to withdrawal effects such as depression. So then cortisol has a negative effect on all the systems controlled by cortisol or stimulated by cortisol including sleep, mood, metabolism, and reproduction causing women's bodies to change negatively when exposed to chronic stress. What else do we know about women affected by chronic stress? We know that women are more likely than men to worry, not only about themselves but also about the people around them. Social support seems to make a difference though; women with social support are less likely to be affected by cortisol dysregulation resulting from chronic stress and depression.

Factors That Contribute to Chronic Stress in Women

There are many factors that contribute to chronic stress, one of the most important being perceived control over stressful situations. Women report feeling like they have less control in their lives than do men and this lack of control can lead to feelings of helplessness, anxiety, and depression which results in cortisol release. One study found that when participants were asked whether or not they had a choice or control over stressful situations and how much control they felt they had over those events cortisol levels increased as did cortisol responses when cortisol was measured at a later time during the study. Personal beliefs are also important as cortisol levels increase when someone is thinking rationally about others but not themselves which shows that cortisol response does not necessarily reflect individual vulnerability to stress or distress, it depends on other factors such as what the person believes they can control and how others influence them.

Women who have experienced sexual abuse in childhood are likely to experience cortisol dysregulation in adulthood; cortisol is overproduced in response to stressful situations due to these women's experiences of trauma which leads them to be hyper-aware of their surroundings and therefore more stressed than those without this history. Women with histories of child abuse tend to be affected by ongoing stress for longer periods of time because cortisol remains elevated so chronic stress has a greater impact on cortisol levels and body systems in these women. In addition, cortisol blockers such as cortisol itself or cortisol-like drugs sometimes prescribed to those with PTSD have the opposite effect in women who were sexually abused suggesting that this group of women may be more sensitive to cortisol normally released during stressful situations than other women.

Psychological factors such as negative mood states are also important; once again, cortisol release is associated with worry about others but not oneself which shows that emotional involvement tends to increase cortisol response regardless of whether it is a positive or negative emotional state depending on what the person believes they can control. It isn't always clear though because cortisol responses vary greatly between individuals even when experiencing similar events; some people respond strongly to stress while others don't but cortisol response is related to mood and cortisol levels tend to be higher when women are in a negative mood state.

Psychological factors that can lead to cortisol dysregulation include depression, anxiety disorders, trauma, and stress; these mental health problems tend to cause cortisol levels to remain elevated longer than they would for someone without these conditions which means the body suffers from long term exposure of cortisol- it becomes resistant to cortisol's effects so that cortisol has less impact on the body systems commonly targeted by its effects. Studies conducted show that people with high cortisol reactivity are more likely than others to have psychological problems such as depression and anxiety because they're susceptible to developing cortisol resistance which causes them chronic stress making it hard for them to cope with events

How Does My Diet Affect My Cortisol Levels?

Certain foods can cause cortisol levels to spike, for example, foods that are high in sugar or refined carbohydrates. These foods cause a sudden increase in blood sugar levels, which triggers the release of cortisol. In addition, fatty and processed foods can also lead to higher cortisol levels. These foods are difficult for the body to digest and can cause inflammation, which can further contribute to cortisol production. Caffeine can also affect cortisol levels; studies have shown that coffee consumption can increase cortisol levels by up to 50%. It's important to remember that everyone reacts differently to caffeine. Some people may be more sensitive to the effects of these substances than others.

Conversely, there are certain foods that can help to lower cortisol levels. Foods that are high in fiber and protein take longer to digest and can help to stabilize blood sugar levels. This, in turn, can help to reduce cortisol production. In addition, omega-3 fatty acids have anti-inflammatory properties, which can also help to reduce cortisol levels. Cortisol lowering foods include:

  • Dark leafy greens: Spinach, kale and collard greens are all excellent sources of magnesium. Magnesium has been shown to help reduce cortisol levels in the body.
  • Fatty fish: Fatty fish like salmon are rich in omega-3 fatty acids. These healthy fats have been shown to decrease cortisol levels and promote a healthy inflammatory response in the body.
  • Probiotic foods: Probiotic foods like sauerkraut and kimchi contain live bacteria that can promote a healthy gut environment. A healthy gut has been linked with lower cortisol levels and a reduction in stress.
  • Herbs and spices: Certain herbs and spices like ashwagandha, cordyceps, rhodiola, ginger and turmeric have been shown to help reduce cortisol levels in the body. 

Does Exercise Affect Cortisol?

Cortisol is a hormone that is released in response to stress. It is sometimes called the "stress hormone" because it helps the body deal with stressful situations. Cortisol can be beneficial in small amounts, but too much cortisol can have negative effects on the body.

Exercise is a type of stress that can cause cortisol levels to increase. However, exercise is generally good for the body and can actually help to reduce cortisol levels in the long run. Intense or strenuous exercise for a long duration, on the other hand, can cause cortisol levels to spike. This is why it's important to find a balance when exercising - too much or too little can both be harmful.

So, does exercise affect cortisol? Yes, exercise can influence cortisol levels, but the effect is usually temporary and depends on the type and intensity of exercise. Exercise is generally beneficial for cortisol levels, while intense exercise for a long duration can cause levels to spike in the short term. As always, it's important to find a balance that works for you and listen to your body to avoid any negative effects.

How to Manage Stress and Keep Your Cortisol Levels Down

When cortisol levels are chronically high, it can lead to weight gain, anxiety, and depression. Fortunately, there are some things you can do to lower your cortisol levels and manage stress.

  1. Most importantly - make healthy lifestyle choices. Eating a healthy diet, getting regular exercise, and getting enough sleep are all important ways to reduce stress. When you take care of your body, you’re better able to manage stress and stay healthy.

    • Getting enough sleep is essential in managing stress and cortisol levels. Most adults need around 7-8 hours of uninterrupted sleep per night. If you're not getting enough sleep, go to bed a little earlier each night until you reach your goal. 10:00 pm to be in bed, and 10:30 pm to be asleep.
    • Avoid all processed foods and eat plenty of lean protein and non-starch vegetables. Omega-3 fatty acids have been shown to help reduce cortisol levels, so be sure to include them in your diet as well.
    • Depending on the state of the patient, exercise can be a great way to relieve stress and lower cortisol levels or a detriment. Your health care professional should guide you through this process. In some cases, a short, brisk walk can help to increase endorphins and reduce cortisol. Meditation and deep breathing exercises can also be helpful in managing stress. If you're feeling overwhelmed, try taking some time out for yourself to relax in a quiet place.
  2. Understand what stress is and how it affects you. Stress is a normal physical and mental reaction to the demands of life. It occurs when your body reacts to a change or a threat, real or imagined. The stress response is the body’s way of protecting you. When working properly, it helps you stay focused, energetic, and alert. In emergency situations, stress can save your life—giving you extra strength to defend yourself, for example. But if you don’t manage stress effectively, it can have harmful effects on your body and your mood.
  3. Identify healthy coping mechanisms and stress management techniques that work for you. Some people find that exercise, journaling, or spending time in nature helps them cope with stress. Others find that listening to music, spending time with friends and family, or practicing relaxation techniques like yoga or meditation works better for them. Experiment with different stress management techniques and find the ones that work best for you.
  4. Make time for things that are important to you and make you happy. When you’re feeling stressed, it can be tempting to put your hobbies and interests on the back burner. But making time for things that are important to you can actually help reduce stress. Whether it’s taking a dance class, going for a hike, or reading a book, do something that makes you happy and relaxed on a regular basis.
  5. Don’t try to do everything yourself—delegate and ask for help. Trying to do too much can lead to stress. If you’re feeling overwhelmed, delegate tasks to others or ask for help. Accepting help from others is not a sign of weakness—it’s a sign of wisdom.
  6. Seek professional help if you need it. If stress is affecting your ability to function on a day-to-day basis, it’s time to seek professional help. A therapist can help you identify and cope with the sources of stress in your life. Don’t wait until things are so bad that you’re feeling hopeless—get help as soon as you start to feel overwhelmed by stress.
  7. Learn how to say “no.” You don’t have to say yes to everything. If you’re feeling stretched too thin, it’s okay to say no to requests for your time and energy. This will help you focus on the things that are most important to you and reduce stress in your life. Learning to use your voice and to speak up for your needs can help with both perceived and real levels of control. 

Managing stress is an important part of maintaining your health and well-being. By taking steps to reduce stress in your life, you can improve your physical and mental health. And when you feel better, you’re better able to cope with the demands of life.