Stress. Anxiety. Depression.
Sound familiar ?
Let's take a deep-dive into cortisol, what it does and why keeping your levels regulated are crucial to your menopause journey.
What is Cortisol and why should I care ?
Cortisol is a steroid hormone produced by the adrenal glands, located on top of the kidneys. It plays a crucial role in regulating various bodily functions, particularly in response to stress. Some of the main roles of cortisol include:
Regulating metabolism: Cortisol helps control how the body converts proteins, carbohydrates, and fats into energy.
Managing stress: Often called the "stress hormone," cortisol levels rise during times of physical or emotional stress, helping the body respond effectively.
Reducing inflammation: Cortisol has anti-inflammatory properties, helping to control the immune system’s response to injury or infection.
Maintaining blood pressure: It plays a role in regulating blood pressure and cardiovascular function.
Balancing blood sugar: Cortisol increases blood sugar (glucose) levels by promoting gluconeogenesis (the production of glucose from non-carbohydrate sources in the liver).
Cortisol levels follow a diurnal rhythm, peaking in the morning and declining throughout the day, but they can also spike in response to stress. Chronic high cortisol levels are associated with health problems like anxiety, weight gain, high blood pressure, and weakened immune function.
What are some of the obvious symptoms of high cortisol levels in a Peri/Menopausal woman?
Weight Gain, Especially Around the Abdomen
Abdominal Fat: High cortisol often leads to increased fat storage, particularly around the midsection (abdominal area), even if the rest of the body doesn't gain as much weight.
Difficulty Losing Weight: Women may struggle to lose weight, especially despite diet and exercise efforts, due to the metabolic effects of high cortisol.
Increased Appetite and Cravings
Cravings for Sugary and Fatty Foods: Elevated cortisol can cause increased hunger and cravings for high-calorie, sugary, and fatty foods.
Emotional Eating: Stress-induced eating becomes more common as cortisol triggers hunger even when the body doesn't necessarily need more energy.
Mood Swings, Anxiety, and Irritability
Emotional Instability: High cortisol levels can cause frequent mood swings, leading to feelings of irritability, frustration, or anger.
Anxiety and Nervousness: Cortisol is linked to the body's stress response, so heightened levels can lead to chronic anxiety and a persistent feeling of being overwhelmed.
Fatigue and Low Energy
Constant Tiredness: Despite having high cortisol (which should theoretically provide energy during stress), prolonged elevated levels can lead to adrenal fatigue, causing feelings of exhaustion.
Sleep Problems: High cortisol can interfere with sleep, leading to insomnia, restless sleep, or waking up frequently during the night.
Sleep Disturbances
Difficulty Falling or Staying Asleep: Cortisol should decrease at night, but elevated levels can disrupt the body’s natural sleep-wake cycle, making it hard to fall asleep or stay asleep.
Waking Up Feeling Unrefreshed: Even after a full night’s sleep, women with high cortisol often wake up feeling tired or unrefreshed.
Menstrual Irregularities
Irregular Periods: High cortisol levels can interfere with reproductive hormones, leading to irregular or missed periods.
Decreased Fertility: Chronic stress and high cortisol can affect ovulation and fertility, making it more difficult to conceive.
Weakened Immune System
Frequent Illnesses: High cortisol suppresses the immune system, making women more susceptible to infections, colds, or flu.
Slower Healing: Wounds or infections may take longer to heal because cortisol reduces the body’s ability to respond to injury or infection.
High Blood Pressure
Hypertension: Cortisol causes blood vessels to constrict and raises blood pressure over time, increasing the risk of hypertension and related cardiovascular problems.
Muscle Weakness and Loss of Muscle Mass
Muscle Breakdown: Elevated cortisol can lead to the breakdown of muscle tissue, causing muscle weakness or a reduction in muscle mass, particularly in the arms and legs.
Digestive Issues
Indigestion and Bloating: High cortisol disrupts normal digestion, leading to symptoms like bloating, indigestion, or discomfort after eating.
Irritable Bowel Syndrome (IBS): Stress-related digestive disorders like IBS may worsen with prolonged high cortisol levels.
Thinning Skin and Slow Wound Healing
Thin or Fragile Skin: High cortisol can cause the skin to thin and become more prone to bruising, stretch marks, and slow healing of cuts or injuries.
Stretch Marks: In some cases, high cortisol can lead to the development of purple or red stretch marks, particularly on the abdomen, thighs, or arms.
Brain Fog
Difficulty Concentrating: High cortisol affects memory and concentration, leading to "brain fog," where it becomes harder to focus, think clearly, or make decisions.
Memory Problems: Cortisol can impair the hippocampus, the part of the brain responsible for memory, leading to forgetfulness or trouble recalling information.
Acne and Skin Problems
Increased Breakouts: Cortisol stimulates oil production in the skin, leading to clogged pores and acne breakouts, particularly during times of stress.
Bone Loss or Osteoporosis
Decreased Bone Density: Over time, high cortisol can reduce bone density, increasing the risk of fractures and osteoporosis, particularly in postmenopausal women.
Hair Loss
Thinning Hair: Elevated cortisol can contribute to hair thinning or hair loss, particularly when combined with other hormonal imbalances or stress factors.
Salt Cravings and Fluid Retention
Water Retention: Cortisol can cause the body to retain more salt and water, leading to puffiness or swelling, particularly in the face, hands, and feet.
Increased Risk of Depression
Mood Disorders: Prolonged high cortisol levels can increase the risk of developing depression due to its impact on brain chemicals and emotional regulation.
Frequent Headaches
Tension Headaches: High cortisol and chronic stress can lead to tension headaches, which are often exacerbated by lack of sleep or poor nutrition.
Moon face
This is a physical symptom that occurs when cortisol levels are elevated for an extended period, particularly in conditions like Cushing’s syndrome or from prolonged use of corticosteroid medications (such as prednisone). It refers to the development of a round, puffy, and swollen appearance of the face, often making it look fuller and more prominent. The swelling occurs due to fat deposits accumulating around the face as a result of excess cortisol.
Round and Full Face: The face becomes visibly rounder, which contrasts with other parts of the body that may remain unaffected.
Puffiness or Swelling: The cheeks often appear swollen and more pronounced.
Reddened Skin: Sometimes, the face may also take on a reddish or flushed appearance.
Fat Accumulation: Fat tends to accumulate not only in the face but also in areas like the upper back (resulting in a "buffalo hump") and abdomen, while the limbs may remain relatively thinner.
Fat Redistribution: Cortisol affects the way the body stores fat, leading to fat redistribution from the limbs to areas like the face, neck, and abdomen.
Fluid Retention: High cortisol levels also promote water and salt retention, causing the face to appear puffier due to fluid buildup.
How can I lower my cortisol levels naturally ?
Lowering cortisol levels involves managing stress, improving lifestyle habits, and incorporating strategies to support overall well-being:
Stress Management
Practice Mindfulness and Meditation
Yoga, Tai Chi
Cognitive Behavioral Therapy (CBT)
Anything you find relaxing and meditative. Art, for example, or playing music. Or walking through nature. Whatever interest you enjoy that removes your mind from the everyday hustle and bustle of life, spend some time doing that.
Regular Physical Activity
Moderate Exercise - anything. Just go and do something you love.
Strength Training - any type of resistance training is great. Weights, body weight, walking through water, yoga - it's all resistance and it all helps.
Adequate Sleep
Prioritise Sleep: Poor sleep or lack of sleep raises cortisol. Aim for 7-9 hours of quality sleep per night. Establishing a regular sleep routine (same bedtime and wake time) and creating a relaxing bedtime environment can help regulate cortisol.
Reduce Screen Time Before Bed: The blue light from devices can disrupt melatonin production and affect cortisol levels, making it harder to fall asleep.
Healthy Diet
Eat a Balanced Diet: Focus on whole foods like vegetables, fruits, proteins, and healthy fats, which supports hormone balance and reduces stress on the body.
Limit Caffeine and Sugar: Caffeine and high-sugar diets can spike cortisol levels. Reducing or eliminating excess caffeine and refined sugars can help maintain stable cortisol levels. I am cutting caffeine myself as I drink far too much black coffee. We just have to do what we have to do to make the journey as easy as possible !
Increase Omega-3s: Foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel) and flaxseeds, can help lower cortisol and reduce inflammation.
Stay Hydrated
Drink Enough Water: Dehydration can increase cortisol levels. Ensure you drink enough water throughout the day, especially if you are active or live in a hot climate.
Social Connections and Support
Maintain Healthy Relationships: Strong social connections and a support network help buffer against stress and lower cortisol levels. Spend time with friends, family, or participate in social activities that make you feel connected.
Laughter and Positive Experiences: Laughter and spending time doing things that bring joy can significantly reduce cortisol levels.
Limit Alcohol and Smoking
Reduce Alcohol Intake: Excessive alcohol consumption can lead to increased cortisol production. Limiting alcohol or drinking in moderation can help.
Quit Smoking: Smoking is a source of chronic stress for the body, and it can raise cortisol levels.
Supplements and Herbs ( there are many more that I will list in a more extensive post )
Ashwagandha: An adaptogenic herb known for its ability to reduce cortisol and help manage stress.
Magnesium: Magnesium deficiency is linked to elevated cortisol, so taking magnesium supplements or eating magnesium-rich foods (nuts, seeds, leafy greens) can help.
Probiotics: Probiotics support gut health, which in turn can influence cortisol levels. Studies have shown that a healthy gut microbiome helps reduce stress and anxiety, lowering cortisol as a result.
B Vitamins: B vitamins, particularly B5 (pantothenic acid), B6, and B12, support adrenal function and help regulate the body’s response to stress. They are essential for energy production and mental clarity, reducing the impact of stress on cortisol levels.
Can I get my Cortisol levels tested ?
If you want to then yes, you can get your cortisol levels tested, which can be done through several methods. Cortisol tests are typically done via blood, saliva, or urine, and are used to assess how your body is responding to stress or to check for conditions like Cushing’s syndrome or adrenal insufficiency.
Visit a Doctor
Schedule an appointment with your GP to discuss your symptoms. If your doctor suspects high or low cortisol levels, they will order a cortisol test to be done at a lab or they may recommend a specialist (such as an endocrinologist) if needed.
Blood Test: A blood sample is taken, usually in the morning when cortisol levels are highest, and sent to a laboratory for analysis.
Saliva Test: A saliva test is often used to measure cortisol levels at different times of the day (such as morning, afternoon, and evening) to observe how your cortisol levels fluctuate.
24-Hour Urine Test: In some cases, a 24-hour urine test may be used to measure cortisol output over the entire day.
Private Testing Clinics
If you prefer a private cortisol test without a GP referral, some private clinics and laboratories in New Zealand offer hormone testing. These may include saliva cortisol testing kits you can use at home and send back to the lab for analysis.
Private Hormone Test Providers: These clinics may offer testing services without needing a referral, but you’ll likely have to pay out-of-pocket.
Endocrinologist Referral
If your cortisol levels are abnormal or if further investigation is required, your GP may refer you to an endocrinologist, a specialist in hormones and the endocrine system.
What to Expect
Fasting: For a blood cortisol test, you may need to fast or have the test done early in the morning for accurate results.
Results: Blood test results typically come back in a few days, while saliva or urine tests may take longer, depending on the type of test.
I really do hope I've outlined what you need if you're concerned about your cortisol levels. The first step is taking stock and figuring out whether you have a cortisol issue, and that your symptoms aren't associated with the other hormone issues you may be experiencing during your perimenopausal / menopausal journey. Then decide how you want to tackle the situation. It's your body, it's your life. You'll figure out what's best for you.
Enjoy your journey x
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