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 up and try to dominate the shifting hormonal landscape. If you’re not careful, that can lead to fatigue, weight gain, heart disease, and more.

That’s because when your adrenals get the message to start pumping out cortisol, they prioritize nothing 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 it’s vital to 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 gone 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’s produced by your adrenal glands in response to stress.

And it does many other important things, too.

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

For one thing, your body was designed to release cortisol in response to acute stressful situations. Things like avoiding an attack from a wild animal or migrating on foot from one part of a country to another — those are things that cortisol is meant to prepare your body for.

Problem is, to your body’s more primitive stress response system, many facets of modern life feel 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 that same cortisol response from your body.

Perimenopause And Cortisol

So what do cortisol and perimenopause have to do with each other?

Well, starting in perimenopause, your progesterone production begins to slow significantly.

Which is a major source of problems for women.

You see, progesterone is a calming force in your body. It helps counteract estrogen’s wild side. So without as much of it circulating, uncomfortable menopause symptoms tend to emerge.

Things like headaches, hot flashes, and anxiety.

But, if your body perceives that you’re under stress and starts dumping out cortisol during this time, it exacerbates the low progesterone issue.

How? Cortisol is produced in your adrenal glands, which also make precursors to your sex hormones.

Now, your adrenals aren’t great at task-switching. If they are focused on cortisol production, they aren’t making sex hormone precursors. That leads to an even further drop in that precious progesterone.

What’s more, cortisol is made with progesterone. So when your body is making cortisol, it’s using up progesterone that could be diverted to other more critical functions — which could make you feel less anxious, and get better sleep.

And then there’s the fact that if your body is producing cortisol, it is going to de-prioritize ovulation, which is the key progesterone-producing activity in your body.

All of this combines to create a situation where progesterone is low and estrogen is left to run wild and make you feel horrible.

The Impact Of Cortisol During Menopause

As time goes on and both estrogen and progesterone levels decline further during menopause, the increased cortisol issue can amplify. This is when we often start to see a correlation between low estrogen and cortisol levels.

Again, if your body perceives stress, your adrenals switch to cortisol-production mode. Which means they aren’t pitching in and helping produce any other hormones. So that means estrogen, progesterone, and testosterone synthesis are all de-prioritized. Which leads to even lower sex hormone levels, just when you need them the most.

Throw in some midlife stress, and you can find yourself in a hormone imbalance situation that feels very difficult to climb out of. 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, either.

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

Menopause Cortisol Weight Gain

Menopause Cortisol Weight Gain

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

Your body needs fat to survive, so if it senses that you’re under stress, it’s going to activate any mechanism possible to hold onto your fat. Just in case you need it for survival.

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

Cortisol And Hot Flashes

Cortisol And Hot Flashes

There’s some evidence to suggest that cortisol dysregulation is related to hot flashes in menopause. (3) But other research counteracts those findings. (4)

While we don’t have a mountain of good evidence to support either theory, there’s one thing that’s certain: hot flashes are stressful. So they, in turn, could end up raising your cortisol levels.

Cortisol And Sleep

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 raises your cortisol. (5,6)

And it appears to work in a constant negative feedback loop. Lack of quality sleep can raise cortisol, and cortisol can interfere with quality sleep. It’s one of the most challenging things to rectify when it comes to adrenal dysregulation. 

Your Heart and Cortisol

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 off with normal blood pressure. (7)

Bottom line: this is why we call stress the silent killer. It’s not just something that causes discomfort, it really can be fatal. 

Cortisol Menopause Fatigue

Cortisol Menopause Fatigue

When cortisol goes high, and your sex hormones go low, it makes you feel very, very tired. This is where you’ll often feel like you’re tired all the time and you simply have no energy.

Plus, high cortisol exacerbates the brain fog and mood symptoms we often see in menopause.

Turning off that out-of-control cortisol production can help you get your energy back.

Here’s how to do it.

How To Reduce Cortisol In Menopause

Balancing cortisol in menopause can be done! It takes some rearranging of priorities, but it is possible.

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

Radical Self-Love

Reducing cortisol in menopause takes things that most people in our modern world have a hard time with — things like self-care, play, and presence.

We’ve all been taught that stress is something we can’t avoid. It is everywhere, and we should just 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 about in the “self-care” department is sex. Sex can encourage the production of oxytocin, a hormone that opposes cortisol beautifully.

When you choose yourself and allow yourself time to truly be present in your life and make choices that spark joy — you are battling cortisol, one choice at a time. 

Honor Your Circadian Rhythm

Remember the sleep issues we talked about earlier?

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

One 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 regulate your body’s internal clock, help you get to sleep easier, and overall feel less stressed.

Exercise And Eat Real Food

Exercise And Eat Real Food

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

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

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

When it comes to exercise, finding the right balance can be tricky. While exercise can lower cortisol levels, too much exercise that’s too intense can make your body think it’s under stress and lead to more cortisol production. (8)

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

Adaptogens For Menopause And Cortisol

My ultimate secret weapon for getting menopausal cortisol issues under control is a class of herbs known as adaptogens.

Adaptogens are so named because they help your body ‘adapt’ to stress.

Ultimately, they support your adrenals and help to balance cortisol production.

In my opinion, the best adaptogen on the planet is called maca. It’s a Peruvian root that’s been used for centuries to help support the adrenals and balance cortisol.

It’s also the lead actor in my powerful Mighty Maca® superfood drink mix.

When you support your adrenals the right way, they can normalize cortisol production and give you your energy and your life back. It’s the perfect helping hand to jumpstart your cortisol-healing journey while you work on implementing self-love practices and finding your exercise sweet spot. 

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Dr. Anna Cabeca

Dr. Anna Cabeca

Certified OB/GYN, Anti-Aging and Integrative Medicine expert and founder of The Girlfriend Doctor. During Dr. Anna’s health journey, she turned to research to create products to help thousands of women through menopause, hormones, and sexual health. She is the author of best-selling The Hormone Fix, and Keto-Green 16 and MenuPause.

Learn more about my scientific advisory board.