The truth about menopause and cortisol levels

Here’s the truth about menopause and cortisol: when your sex hormones start to drop during perimenopause and menopause, the stress hormone cortisol can rise and try to dominate the changing hormonal landscape. If you’re not careful, this can lead to fatigue, weight gain, heart disease, and more.

That’s because when your adrenal glands get the signal to start pumping out cortisol, they don’t prioritize anything else. Which in turn messes with your sleep, your sex drive and your mood.

Now, we don’t want to demonize cortisol. Cortisol is important for waking you up in the morning and is vital for your immune system. Cortisol is the hormone that helps you choose to “fight or flight” in a dangerous situation — so we don’t want it to go away completely! (1)

But when cortisol gets out of balance, it’s a serious health issue for menopausal women. Let’s talk about why it happens and how to put cortisol in its place.

What is cortisol?

Cortisol is what we call the “stress hormone.”

It is produced by your adrenal glands in response to stress.

And it does a lot of other important things, too.

But for now, let’s see how it causes problems.

First, your body is designed to release cortisol in response to acute stressful situations. Things like avoiding being attacked by a wild animal or migrating on foot from one part of a country to another – these are things that cortisol is meant to prepare your body for.

The problem is that to your body’s more primitive stress response system, many aspects of modern life seem like acute stressful situations.

So things like an angry email from your boss, too much blue light from your computer screen, or an intense workout can all trigger the same cortisol response from your body.

As time goes on and both estrogen and progesterone levels decrease further during menopause, the increased cortisol problem can be amplified. This is when we often begin to see a correlation between low estrogen and cortisol levels.

Again, if your body senses stress, your adrenal glands go into cortisol production mode. Which means they don’t go in and help make other hormones. This means that the synthesis of estrogen, progesterone and testosterone are not prioritized. Which leads to even lower levels of sex hormones, just when you need them most.

Throw in a little stress in midlife and you can find yourself in a state of hormonal imbalance that is very difficult to escape. Because battling high cortisol and menopause at the same time leaves you feeling tired, increases weight gain, and isn’t good for your heart health.

Let’s take a look at how cortisol, menopause, and your symptoms intersect.

Menopause Cortisol weight gain

Cortisol is a critical part of your metabolic processes. Again, because it is released in response to stress, it is a fat storage hormone.

Your body needs fat to survive, so if it senses you’re under pressure, it will activate any mechanism it can to hold on to your fat. In case you need it for survival.

Cortisol is able to perform this task because it counteracts insulin. It literally tells your body to increase glucose production and hold on to fat. This is something we see even in younger people, not just menopausal women. (2)

Cortisol and hot flashes

There is some evidence to suggest that cortisol dysregulation is associated with hot flashes in menopause. (3) But other research contradicts these findings. (4)

While we don’t have much good evidence to support either theory, one thing is certain: hot flashes cause anxiety. So, in turn, they could end up raising your cortisol levels.

Cortisol and sleep

Here’s something else we know for sure. Hot flashes can wake you up and wreak havoc on your sleep. Which in turn increases your cortisol. (5,6)

And it seems to operate in a constant negative feedback loop. Lack of quality sleep can increase cortisol, and cortisol can affect sleep quality. It’s one of the hardest things to fix when it comes to adrenal dysfunction.

Your heart and cortisol

Stress is bad for your heart health, girlfriend.

In fact, elevated cortisol is linked to an increased risk of high blood pressure, heart attack, and stroke, even among people who start out with normal blood pressure. (7)

Bottom line: that’s why we call stress the silent killer. It’s not just an inconvenience, it can actually be fatal.

Cortisol Menopausal Fatigue

When cortisol rises and sex hormones drop, it makes you feel very, very tired. This is where you will often feel like you are tired all the time and just have no energy.

Additionally, high cortisol worsens the brain fog and mood symptoms we often see in menopause.

Turning off this out-of-control cortisol production can help you regain your energy.

Here’s how to do it.

How to lower cortisol in menopause

Balancing Cortisol in Menopause Can Be Done! It takes some rearranging of priorities, but it is doable.

Here are my top recommendations for conquering cortisol when it’s out of control.

Radical self-love

Reducing cortisol in menopause requires things that most people in our modern world struggle with—things like self-care, play, and presence.

We’ve all been taught that stress is something we can’t avoid. It’s everywhere, and we just have to accept it.

But ultimately, stress is something we choose. Which means it’s something we can choose not to participate in.

You can learn to say no to things that don’t serve you…and say yes to things that make you feel alive.

One crucial thing that I think women often forget in the “self care” department is sex. Sex can encourage the production of oxytocin, a hormone that perfectly opposes cortisol.

When you choose yourself and allow yourself time to be truly present in your life and make choices that bring joy – you fight cortisol, one choice at a time.

Honor your circadian rhythm

Remember the sleep problems we talked about earlier?

You can encourage your adrenals to normalize when you give them the proper rest they need.

A great thing you can do to help get things back on track is to be outside at first light and as the sun sets. This can help you adjust your internal body clock, sleep easier, and generally feel less stressed.

Exercise and eat real food

When it comes to high cortisol and weight loss, you need to prioritize your insulin sensitivity.

The best way to beat the weight gain and insulin resistance that high cortisol causes is to start eating real, whole foods.

A diet high in vegetables and healthy fats like avocado and olive oil and low in refined carbohydrates will naturally help improve insulin resistance. I’m personally a big fan of the Keto-Green® diet that focuses on whole foods, especially those green vegetables.

When it comes to exercise, finding the right balance can be difficult. While exercise can lower cortisol levels, too much exercise that is too intense can trick your body into thinking it is under stress and lead to more cortisol production. (8)

So you have to find the sweet spot that is right for you and your body. I often recommend that my patients walk at a moderate pace, especially earlier in the day.