The Impact of Stress and Cortisol on Women in Midlife

We are all bombarded by the daily stresses of life. Some people are better at coping with stress than others. The body’s stress response is a normal process and is meant to help keep you away from harm. After the pressure or danger has passed, your cortisol level should calm down. Your heart rate, blood pressure, and other body systems will go back to normal. But what if you’re under constant stress and the alarm button stays on?

Stress causes a waterfall of chemical reactions.  One of them is the release of cortisol, which fuels the blood with energy in the form of sugar, enabling us to flee from potential dangers.  But we are seldom, hopefully seldom, in the kind of danger that warrants the levels of cortisol that is released.  But because we tend to stress about things like our bills, our workload, deadlines, and so many other things that we worry and stress about habitually, our cortisol levels stay chronically high. That’s not good.

The Stress Hormone

As your body perceives stress, your adrenal glands make and release the hormone Cortisol into your bloodstream. Often called the “stress hormone,” cortisol causes an increase in your heart rate and blood pressure. It’s your natural “flight or fight” response that has kept humans alive for thousands of years.

Normal levels of cortisol also are released when you wake up in the morning or exercise. These levels can help regulate your blood pressure and blood sugar levels and even strengthen your heart muscle. In small doses, the hormone can heighten memory, increase your immune system and lower sensitivity to pain.

But the impact of a fast-paced culture, however, is that many of us are constantly in high-stress mode. If your body experiences chronic stress, you may begin to feel unwanted and even harmful effects1 , such as:

  • Fatigue
  • Irritability
  • Headaches
  • Intestinal problems, such as constipation, bloating or diarrhea
  • Anxiety or depression
  • Weight gain
  • Increased blood pressure
  • Low libido, problems with regular ovulation or menstrual periods
  • Difficulty recovering from exercise
  • Poor sleep

For women in midlife, their chronic stress and higher than normal levels of cortisol are depleting the already decreasing levels of estrogen, progesterone, and testosterone that occurs during menopause. Cortisol levels are often elevated when experiencing menopause and can make menopause symptoms much worse.2

Stress and Hormone Replacement Therapy

Most women in midlife will start to weigh their options and explore the idea of hormone replacement therapy when they start experiencing perimenopause symptoms or when they undergo a surgery that puts them into immediate menopause (induced menopause/surgical menopause).  Others will look first for holistic options and supplements to treat their symptoms.  While lifestyle factors such as diet, exercise, sleep, stress, smoking, alcohol consumption should always be considered when seeking strategies and recommendations for relief from menopausal symptoms, hormone replacement therapy should also be considered as part of an overall strategy.3 

Hormone replacement therapy (HRT) can help reduce your menopausal symptoms including stress.  HRT has been shown in recent studies to counteract the effects of excess cortisol.4 During menopause, when estrogen levels start to decline, cortisol levels rise and trigger stress responses. There are studies that show how critical cortisol levels are in sleep-wake patterns, eating, physical activity, and basically how a person adapts to challenges in life.5 When women are on HRT they have lower levels of cortisol and may react more calmly to stress during and after menopause.6 

Winona is an approach to HRT available to midlife women who suffer from hormonal changes during perimenopause and menopause. Winona developed FDA-approved products and personalized treatments that are backed by research and recommended by doctors.  Their treatments are natural and cannot be purchased over-the-counter.  Instead, a prescription for their treatments is always required by one of their licensed doctors after completing a free telehealth visit.

The way we live today’s is highly stressful. While we aren’t being chased by saber-tooth tigers, we are chasing ambition, achievement, being the best, being the first, being the only, or from striving to be safe, secure, and protected from unwanted circumstances. In many respects, our modern society has benefited from our overzealous behavior.  But we are paying a considerable cost living with the chronic stress that results from such behavior and circumstances. Stress management, through lifestyle changes or through other therapies and interventions, is imperative for women in midlife struggling through perimenopause and menopause. Finally, there are options available today to mitigate stress during this pivotal stage in a woman’s life.

1.  Hormone Health Network. “Stress and Your Health | Hormone Health Network.” Hormone.org, Endocrine Society, 15 November 2021, https://www.hormone.org/your-health-and-hormones/stress-and-your-health

2.  North American Menopause Society. “Changes in Hormone Levels.” menopause.org, https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-hormone-levels

3.  R. J. Baber, N. Panay & A. Fenton the IMS Writing Group (2016) 2016 IMS Recommendations on women’s midlife health and menopause hormone therapy, Climacteric, 19:2, 109-150, DOI: 10.3109/13697137.2015.1129166 https://doi.org/10.3109/13697137.2015.1129166

4. University of Southern California. “Hormone replacement therapy may be beneficial for women’s memory: Women who had undergone hormone replacement therapy had better working memory than women who did not..” ScienceDaily. ScienceDaily, 2 November 2017. www.sciencedaily.com/releases/2017/11/171102140518.htm

5. “Cortisol Levels during the Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study.” Menopause. 2009 Jul–Aug; 16(4): 708–718. doi: 10.1097/gme.0b013e318198d6b2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2749064/

6.  University of Southern California. “Hormone replacement therapy may be beneficial for women’s memory: Women who had undergone hormone replacement therapy had better working memory than women who did not..” ScienceDaily. ScienceDaily, 2 November 2017. www.sciencedaily.com/releases/2017/11/171102140518.htm