How Stress Affects Women’s Brains

March 16, 2023 Dr. Anna Cabeca

One of the primary health complaints I used to see in my medical practice and that I continue to see within my community – really growing at alarming rates - is relating to symptoms such as anxiety, loneliness, brain fog and fatigue.

Women will tell me that they feel like their body and mind are betraying the loving and positive soul they know themselves to be. When we talk about it there is often a single root cause: a woman’s body reacting to some type of chronic stress in her everyday life.

The ongoing stress could simply be the result of dealing with everyday life as a parent, spouse, caregiver or career woman (or all of those!); or it could be due to a past childhood trauma or even PTSD (post-traumatic stress disorder) from any number of events including social media bullying or shaming. Even watching the news these days, bringing violence and so many natural disasters and global concerns directly into our homes real-time, can create a sense of anxiety and overwhelm.

Stress can impact us so severely – both mentally and physically - yet most of us treat stress as if it is as normal as seeing those gray hairs spring up as we age…we simply rationalize it as,

“It’s just a part of life, right?

And besides, I can’t get rid of the stressors so I just need to grind through them.”

But medical experts agree that stress shouldn’t be viewed as normal, and more and more research is tying chronic stress to significant health issues relating to our immune system, our metabolic physiology and even the performance and ongoing health of our brain. (1)

A Stressed Brain is not a Healthy Brain

Stress literally causes an imbalance of our neural circuitry and has been shown to negatively impact both cognition and decision making, as well as result in symptoms of anxiety, mood disorders, libido issues and insomnia.

Unchecked stress can contribute to high blood-pressure, blood sugar issues, cardiovascular issues, obesity and may even increase our risk for dementia (stress can literally shrink our brain!).

It can also leave us in a disconnected state where we may feel like opting out on our family, friends and all of the things we used to love.

Many of you may already know that years ago I went through a particularly stressful trauma when my young son died in a tragic accident. I suffered from PTSD and found myself depressed and disconnected, thrown into early menopause, fat and miserable. It was a long hard journey that finally led to happiness again (and a new baby girl)…but also eventually resulted in my divorce.

As a result of my own experience I have continually monitored emerging research and have learned a lot about the science behind stress. I’ve seen how lingering stress can add to a neurologic vulnerability that we women (especially those of us over 40) already have as we approach and proceed through menopause.

So today I want to talk about how stress and trauma affects us and what we can do about it.

How Women’s Brains Are Impacted By Stress

Why do researchers think women are experiencing this vulnerability? Sure we are likely doing too much and not prioritizing self-care. But it is also in our DNA. Gender has been shown to be an increased risk factor for a less than optimal stress response. Women are at increased risk for developing anxiety disorders as well as for developing PTSD after a trauma. Women are more vulnerable to developing dementia and Alzheimer’s. (2)

Women’s brains are particularly impacted because of:

Adrenal dysfunction (too much cortisol!) resulting in increased inflammation, reduced immunity and greater risk for disease. Women experience too much stress as parents, spouses, caregivers and career women. We’re not just Super Women, we are super stressed! I estimate that 90% of the women in my hormone reset programs are experiencing some level of adrenal dysfunction at the start!
Brain physiology changes: (our brain’s alarm system, the amygdala, taking over long-term!) Hormonal responses and inflammation due to chronic stress cause different parts of the brain to “take over” resulting in cognitive changes and negative changes in our social engagement and mood.
A further loss of protective hormones: Stress is a double whammy for women over 40 who are already experiencing natural declines in protective hormones. This decline can be even greater if a woman is experiencing adrenal dysfunction as her body may start to actually steal vital hormones (such as progesterone) to convert them into more of the stress hormone, cortisol.

Let’s talk in more detail about what is happening to our brains on stress.

Adrenal Dysfunction

If you’ve followed me for any period of time you’ve heard me talk about cortisol and how it has gotten somewhat of a bum rap in a way and is often viewed as only a bad guy. But cortisol is an important and much-needed hormone! It is anti-inflammatory and supports our immune system health. It gets us going in the morning and supports a healthy circadian clock. When cortisol starts pumping when we are faced with a short-term stress, it gives us that surge of focus and energy we sometimes need, such as acing that job interview. All of that is good…as long as it is temporary.

But too often our stress isn’t short-term. We’re caregiving for our elderly parents or parenting our kids (or often doing both while working too!). Our bodies are under constant stress and churning out more and more cortisol. We may be reliving a trauma, hypervigilant and fearful, the emotions still raw.

Parts of our brain activated by stress (the paraventricular nucleus and amygdala) continue to engage in the primal responses of fight or flight. Our body stays diligently prepared to fight the tiger, yet there is no tiger anywhere to be seen. Fatigue sets in; high cortisol levels affect our metabolism, resulting in both our packing on the belly fat as well as our bodies starting to metabolize protein (resulting in weakness and muscle pain).

This finally takes a toll; our adrenal glands (which produce all of that cortisol) get burnt out trying to produce more and more cortisol. The adrenals eventually start to even steal other protective hormones such as progesterone, pregnenolone and DHEA in order to make more cortisol.

At a given point the adrenals eventually can no longer function and produce too little cortisol. Remember, the right amount of cortisol is protective and anti-inflammatory…so with low levels of cortisol adrenal dysfunction occurs. Adrenal dysfunction results in our bodies not being as well protected against inflammation and our immune system weakens; we’re now at greater risk for disease.

Science tells us that some 90% of chronic disease is rooted in inflammation; we may see high blood pressure, high blood sugar, immune system suppression, insomnia, and other health issues (diabetes, cardiovascular disease, cognitive impacts and hypothyroidism).

Adrenal dysfunction can often result in anxiety, depression, fatigue and a growing sense of social disconnect. We start to focus inwardly versus on the people and activities we loved. Too much “fight or flight” hormones over too long of time make us do just that…withdraw and walk away.

How women are impacted by chronic stress

Brain Physiology Changes

At the same time the regions of our brain are reacting to these hormone changes and the resultant inflammation. Different parts of the brain react as the body’s energy shifts in response to hormone imbalances. If presented with a short-term stressor (like the tiger chasing you), the brain’s amygdala engages and the prefrontal cortex slows down. The amygdala is the part of the brain that engages with your survival instincts (“fight or flight”), your body’s alarm system, so this shift in brain energy helps you survive.

Your prefrontal cortex, on the other hand, is where you handle higher-order tasks (like clear thinking, impulse control, complex thought and memory). In chronic stress (like when your caregiving and child-rearing obligations are wearing you down) the amygdala taking over can result in bypassing the more rational thinking prefrontal cortex. Poor decisions can be made; there can be brain fog, cognition and memory issues. Poor decisions, by the way, can lead to unhealthy lifestyle choices such as a poor diet, lack of sleep and isolating behaviors (electronics, binge watching TV, drinking, medicating, etc.)…all of which likely result in even more inflammation and social disconnect. It’s a vicious cycle.

I recently interviewed Dr. David Perlmutter about what he calls the amygdala-prefrontal cortex disconnect, you can find that podcast at the provided link. It’s a fascinating interview that discusses how increased inflammation leads to this disconnect and how the brain’s resultant physiological changes themselves can lead to impulsivity, a lack of satisfaction, a sense of isolation and disconnect. He discusses lifestyle interventions to address the inflammation, one being focusing on better sleep hygiene! You can hear how a poor night’s sleep can result in 60% more activity in the amygdala (explaining that poor decision making and other negative mental effects that you may experience).

A Further Loss of Protective Hormones – Women’s Neurological Vulnerability

Along with chronic stress’ effects relating to adrenal dysfunction and our brain’s prefrontal cortex losing its control, women over 40 are also already in a period of sexual hormone decline and imbalance. This makes us even less resistant to the effects of chronic stress. Some 80% of women experience neurological symptoms during menopause. Social disconnect is seen as one possible effect of both adrenal dysfunction and the amygdala-prefrontal cortex disconnect.

During our transition to menopause a woman’s brain starts to energize and respond differently. Listen to this informative podcast with Dr. Lisa Mosconi regarding how women’s brains change as we go through menopause. Women’s brain scans show both a decrease in brain activity as well as an onset of Alzheimer’s plaques as they age and go through menopause.

Estrogen literally feeds our brains and its decrease and the decrease of other protective hormones are likely why so many more Alzheimer’s patients are women. Dr. Mosconi talked about how research has shown that when a woman’s ovaries are removed (no more estrogen production) and no hormone replacement therapy provided, women showed a 70% increased risk for developing Alzheimer’s.

You can read much more about how women’s neurological vulnerability is impacted by our natural hormone decline at this linked to article.

So if women are at increased risk relating to the effect of chronic stress on our brain function and health, what can we do?

We know that we often can’t remove the stressors! We also can’t turn back the clock as we proceed into and through menopause.

So what can women do to protect our emotional and physical health (and our brain)?

Oxytocin To The Rescue!

While we usually can’t remove ongoing stressors (or we may still be struggling with a long ago trauma) we can usually work to improve our body’s reaction to that stress; we can do a lot to build up our stress resilience.

I’ll talk in a moment about some preventative steps one can take as well as ways to incorporate stress-reduction and stress-management techniques into your everyday life.

But first I want to talk about one important hormone that can immediately help! It is a hormone that is readily available and doesn’t have to cost you a cent.

That hormone, my favorite hormone, is Oxytocin.

Oxytocin is our hormone of connection, of nurturing, attachment and relationships.

It is produced by the mother during labor and helps support the bonding that occurs at childbirth. It is produced during breast-feeding, making the mother-child bond grow even deeper.
It is produced during physical touch including hugging, kissing and orgasm. It helps bond us to our partners.
It is produced when we laugh, when we spend time in nature or with a beloved pet, during giving, and with all things pleasurable (including when we have a satisfying meal).
It makes us feel empathy, affiliation and trust.
It is a “tend and befriend” hormone like progesterone and pregnenolone (and on the opposite end of the see-saw from our “flight or fight” hormone, cortisol...when cortisol is high you can bet oxytocin is low).

But it is even more than our hormone of love, bonding and connection!

Research has found that Oxytocin has anti-stress and other health effects. (3)

For years I have described many of the natural ways to increase oxytocin to everyone, yet occasionally, we need additional support. In the cases of significant burn out, PTSD, and chronic stress, I have prescribed oxytocin in a troche, typically in doses of 10 - 30 units daily. I had one physician patient who I prescribed oxytocin to take on her way home from work; this significantly helped her as a busy mom and wife as when she walked into her home she felt more relaxed and reset, so to speak, after her challenging job in the ER.

Here are just a few of oxytocin’s health benefits:

Oxytocin release helps our body both counter and recover from stress. The oxytocin system (hormone, receptors and other chemicals such as dopamine) is critical to our stress response. It helps counter cortisol’s actions. It influences activities of other transmitter systems and stimulates a part of the brain focused on social rewarding. It enhances sociality. (4-6).
Oxytocin appears to decrease activation of the amygdala in some cases, decreasing anxiety. (7)
Oxytocin is being evaluated as an intervention in the treatment of obesity and metabolic disorders, including diabetes. A 2017 study found that it may increase insulin sensitivity; a single intranasal dose of oxytocin resulted in reduced caloric intake, increased fat oxidation and improved insulin sensitivity in men. Another 8 week pilot study found that oxytocin treatment in adults who were overweight or obese led to substantial weight loss. Another study found that oxytocin may in fact play a role in controlling hunger (and helping people with impulse control relating to unhealthy cravings!) by calming down the amygdala.(8, 9)
Oxytocin has been shown to stimulate positive social interaction relating to autism, social anxiety disorder, schizophrenia and PTSD victims. It has been found to help PTSD victims get beyond their emotional numbing and fear response. One early study showed that just a sniff of oxytocin caused acute PTSD symptoms to subside. In a 2014 study with men having autism spectrum disorder, a single dose of oxytocin nasal spray improved signaling in the prefrontal cortex region (associated with emotional recognition and empathy). While there is still a great deal to learn about oxytocin’s use in such therapies there are treatments happening today where oxytocin is successfully used in conjunction with other therapies in cases of PTSD, social anxiety disorder, trauma support and more. (10,11)

More research is required related to providing oxytocin outside of these specific therapies as dosage requirement is tricky due to its short half-life when administered (another reason to produce it from within your own body!)

So...are you producing enough oxytocin to help mitigate stress and its effects? Take my free oxytocin quiz to find out! You’ll receive your score and helpful information on how to boost up your oxytocin levels naturally.

And here are other techniques you may want to consider to improve your stress response.

Techniques Proven To Help Improve Your Stress Response

While we often can’t prevent the actual stressors from continuing to occur, we can optimize our immune system, hormone balance and overall inflammatory state, via:

Easy lifestyle upgrades
Focusing on your brain health
Increasing your stress resilience
Mind-body approaches and stress management (apps, too)
Considering other behavioral or psychotherapy treatments

Easy lifestyle upgrades that can help:

An alkaline diet like found in my Keto-Green® Diet and Lifestyle program – reduces overall inflammation, improves circadian rhythm control and cortisol management (all important in reducing the effects of stress). Significant research has found maintaining an alkaline pH level may lower inflammation and the risk for diseases such as insulin resistance, metabolic disorders, cardiovascular disease and diabetes.

Note that your body’s alkalinity is about more than just the food you eat. You can learn about living a more alkaline lifestyle, as well as about how you can test for alkalinity using simple urine pH strips, at the linked article.

I also recommend intermittent fasting as part of Keto-Green living because research has found it supportive of metabolic function, a healthy circadian clock, optimal brain function and more. Intermittent fasting supports enhanced mitochondrial health (our source of energy) and an important process called autophagy (literally cleaning out old and dangerous cells from our body).

Improve your quality of sleep – Supportive of hormone balance, a healthy circadian rhythm and improved stress response. Check out the tips for getting a better night’s sleep at this blog.
Support your adrenals – I recommend adrenal adaptogens such as maca. Cortisol levels can also be tested via saliva tests, I recommend www.zrtlab.com/ for saliva tests.
Bump up your oxytocin production! As mentioned earlier, you can take my free quiz to find out your oxytocin levels and to gain free tips on improving your score.
Support your immune system – You should be taking a daily probiotic and keeping all of your key vitamin levels up; in particular, many women are deficient in vitamin D. Here is a great review of easy things you can do to better support your immune system (and not get sick)
Test your inflammation level (hs-CRP) and check for vitamin D deficiency. Actually there are four important lab markers I feel that everyone should know, including these! Check them out.

Focus on your brain health

As women we also need to learn about and focus on addressing the neurological vulnerability that our female bodies have, especially as we approach and proceed through menopause.

Are you starving your brain without enough fuel and protective hormones? There are several approaches to ensuring our bodies aren’t starved of important protective hormones such as estrogen, progesterone and pregnenolone (especially important as we enter and go through menopause).

Bio-identical hormone replacement may be a therapy you could benefit from Read this informative article and then talk with your doctor about whether it is an option for you. Remember that our vulnerability increases as key protective hormones naturally decline with age.

Try my Balance Cream in the meantime to help with sleep and mood. Remember how important sleep is to countering stress.

Supply your brain with ketones (versus estrogen) as its fuel source! Read my earlier article on the research behind ketones and brain health. Research tells us that ketones have a positive effect on brain health as well as on our risk for dementia and Alzheimer’s disease.

Is your brain in disconnect? If you didn’t listen to my podcast with Dr. Perlmutter, please do. Learn how inflammation (inflammatory diets, poor sleep and more) as well as our absorption with our digital world may be literally disconnecting parts of our brain!

Oh, and after you take a listen, go for a short walk out in nature…we’re all so disconnected from nature these days and you’ll find that basking in nature’s bliss can really help tone down your cortisol (while bumping up your oxytocin production, too!) Extra points if you take a family member, friend or beloved pet along for the walk.

Increase your stress resilience

We can also build up our stress resilience (more effectively managing our thoughts and reactions around stress). One of my favorite podcasts with one of my favorite people (Dr. Srini Pillay) talks about how to deal with stress and thrive after a trauma by increasing your stress resilience. He uses a beautiful visual of shining a flashlight. When you consciously choose to shine your flashlight away from a stress and instead shine it on a more positive feeling or outcome, you can gain more happiness and a healthier brain.

Live with an attitude of gratitude! Try gratitude journaling as a way to cut through all the noise in your life and instead focus on the positives you have going on. Here are some other easy-to-implement suggestions on how to incorporate positivity and gratitude into your life. This is mental detox and can help get rid of the toxic clutter! It can reduce your stress and improve your resilience.

Mind-body approaches and stress management

There are many mind-body approaches that do not involve medication which have been shown to help reduce stress effects and also help people heal from trauma. Just a few include meditation, deep-breathing exercises, yoga, tai chi, mindfulness training, massage, dance or movement therapy, acupuncture, mantra-based meditation, virtual reality exposure therapy, progressive relaxation and biofeedback. I’ll talk about a few here but you can find info on most of these online. Especially if you have any type of underlying health issue I would suggest you always run things by your physician.

The American Institute of Stress also maintains a page which has a large number of free apps relating to relaxation, stress reduction and stress management. I haven’t used these but provide them as a possible source of help for you to try.

Meditation – I used to gravitate towards yoga as I found other forms of meditation a challenge (too much going on in my mind so I wasn’t getting either the presence or the benefits from a variety of different meditation attempts). But then I found the MUSE Brain-sensing Headband which has really helped me develop a sustainable stress reducing meditation practice that provides me measurable benefits. Learn more in this podcast.

Many of my clients also find that HeartMath® works well for them. Heartmath is focused on your managing your heart rhythms, which change based on heart activity as a result of different emotional states you may be experiencing. Different rhythms have their own effect on our cognitive and emotional function; so when we’re anxious our brain may have inhibited functions with cognition (such as difficulty in focusing and making decisions)…this is similar to what we see when our amygdala takes over! We may act impulsively.

Consider other behavioral or psychotherapy treatments

Finally, there are a number of behavioral or psychotherapy approaches that have been shown to help with chronic stress, social anxiety, trauma and PTSD.

EFT (Emotional Freedom Technique, sometimes referred to as EFT Tapping) – This is a psychological acupressure of sorts, recommended to help get you through emotional barriers you may have due to negative events or emotions in your life, physical pain and even food cravings. Learn more (you can easily learn to perform this technique on yourself) from the video posted here.

Self-regulation Therapy - Listen to this informative podcast with Tara Miller to learn more about the process and benefits of this therapy. This therapy requires a trained therapist although they can sometimes join you via teleconferencing if there isn’t a therapist near you.

EMDR (Eye Movement Desensitization and Reprocessing) – This is an integrative psychotherapy approach which has been used extensively and shown to be effective in the treatment of trauma. EMDR is usually used in conjunction with Cognitive Behavioral Therapy (CBT). This treatment addresses “difficult memories” occurring from a wide spectrum of traumas including childhood experiences to combat-related PTSD events. It requires a trained EMDR therapist. A therapist will guide a patient through a memory of a traumatic event, saying subconscious thoughts out loud, while that individual sits in front of a moving light which trails their eyes back and forth. The movement of the eyes with the trauma recall is thought to help the brain reprocess the event, leaving the patient with relief from flash backs, stress dreams, anxieties and other mental impacts. Learn more at: https://www.emdria.org/

Final Words on Stress and Your Brain!

I hope these recommendations help you or can help someone you know who is suffering from the effects of chronic stress, socially isolating behaviors, anxiety, trauma or even PTSD. Understanding what is going on, how it can so dramatically affect you (and your brain health), and learning more about things you can do to minimize the negative effects, is all so important.

I’ll end this blog by telling you not to stress out about being stressed out! That’s only going to make things worse...your amygdala will stay engaged, adrenal dysfunction will kick in, you may just go into overwhelm and pull out that quart of ice cream! Seriously though, the important thing is to just start implementing even a few of these recommendations today.

You can easily start adjusting your diet and lifestyle to be more alkaline. Try maca to help support your adrenals (better yet, try my Mighty Maca® Plus, my Keto-Green superfoods blend, to get all of the other health benefits beyond maca, too. Try the free trial pack and just pay for shipping.)

Bump up your immunity (most of us our deficient in vitamin D if we aren’t supplementing already) and add a few mental detox practices to your routine to help tamp down your stress response. Reducing your interaction with devices and technology, by instead increasing your interaction with people, pets and nature, can help. Plus all of that oxytocin production feels so good!

Incorporating more oxytocin in your life helps counter stress and it will help with feelings of social disconnect. Research shows that having adequate social support can also counter the negative effects of stress and help protect against cognitive decline and symptoms (mood changes, fatigue, etc.), so maintaining connections with family and friends, or other affiliations (hobbies, associations, etc.) is important. (12)

how to boost oxytocin