Cortisol in Menopause, is it Good for Your Health?

Introduction

Cortisol often gets a bad rap, especially during menopause. But is this stress hormone really the villain it’s made out to be, or does it have a role to play in keeping us healthy? 

If you’re navigating the ups and downs of peri or postmenopause, understanding cortisol is key to balancing your energy, mood, and even your waistline. 

In this post, we’ll dive into the good, the bad, and the surprising ways you can manage cortisol for a smoother menopause journey. Ready to take control of your hormones? Let’s get started!

What is Cortisol?

Cortisol is a steroid hormone produced by the adrenal glands, which are located on top of our kidneys. Known as the body’s “stress hormone,” cortisol is released in response to stress and low blood glucose levels. It’s essential for many important body functions, including regulating metabolism, controlling blood sugar levels, and reducing inflammation. While often associated with the body’s “fight-or-flight” response, cortisol is also involved in other daily processes, including energy management and immune response.

Most of us know that cortisol is one of the primary hormones released when we’re under stress.  When you perceive stress, whether it’s from physical activity, emotional challenges, or illness, your brain sends signals to your adrenal glands to produce cortisol. This response is part of the body’s natural defense mechanism, ensuring you have the energy and focus to handle the situation.

Key Roles of Cortisol in the Stress Response

• Fight-or-Flight Activation: Cortisol increases blood sugar (glucose), giving our muscles immediate energy.
• Suppression of Non-Essential Functions: During stressful moments, cortisol diverts energy away from non-essential processes like digestion and reproduction, so the body can focus on handling the stress.
• Anti-inflammatory Effects: While it helps reduce inflammation in the short term, chronic elevated cortisol can suppress the immune system and lead to negative effects, such as increased vulnerability to illness.

Cortisol’s Other Jobs

Cortisol plays a crucial role in energy regulation by determining how your body uses its main fuel sources: carbohydrates, fats, and proteins.

• Energy Management: Cortisol helps maintain blood sugar levels, especially during times of fasting, and works to release stored energy from fat and glucose to keep our bodies fueled. It also encourages fat storage around the abdomen when levels are consistently high (which we will talk about later), which can contribute to weight gain.
• Metabolism Regulation: Cortisol influences how your body processes carbohydrates, fats, and proteins. Under chronic stress, your body tends to store more fat, especially in the midsection, and may break down muscle tissue for energy. This shift can contribute to insulin resistance and often makes losing weight more difficult.
• Stress Response: Cortisol prepares your body for a quick response to stress by mobilizing energy reserves and enhancing focus. However, when stress becomes chronic, high cortisol levels can lead to problems such as fatigue, insomnia, mood swings, and weight gain, as the body remains in a heightened state of stress for too long.

How Cortisol is Produced in the Body

Cortisol is produced through a signaling system known as the hypothalamus-pituitary-adrenal (HPA) axis. This axis involves a three-step communication process between the hypothalamus, the pituitary gland, and the adrenal glands, ensuring that cortisol is produced in response to your body’s needs.

The HPA Axis:

1. Hypothalamus: When your brain detects a stressor (physical, emotional, or mental), the hypothalamus sends a signal via corticotropin-releasing hormone (CRH) to the pituitary gland.
2. Pituitary Gland: In response, the pituitary releases adrenocorticotropic hormone (ACTH) into the bloodstream.
3. Adrenal Glands: ACTH then stimulates the adrenal glands to produce and release cortisol into the bloodstream.

Cortisol Levels Throughout the Day 

Cortisol follows a natural circadian rhythm, meaning its levels fluctuate throughout the day. This rhythm plays a key role in regulating our sleep-wake cycles as well as our energy levels.

• Morning Peak: Cortisol levels are at their highest in the morning, typically around 8 AM, helping you wake up and feel energized. This spike prepares your body for the day by increasing blood sugar levels, providing energy, and enhancing alertness.
• Evening Low: As the day progresses, cortisol levels gradually decline, reaching their lowest point in the evening to help your body wind down and prepare for sleep. This natural rhythm is essential for a healthy sleep cycle and energy management throughout the day.

When this rhythm is disrupted—by stress, poor sleep, or irregular schedules—it can lead to elevated cortisol at night, causing difficulty in either falling asleep or waking up in the middle in the night and not being able to get back to sleep.

Acute vs. Chronic Cortisol Production

Acute Cortisol Production

• Acute cortisol production occurs in response to short-term stressors, such as a challenging workout, an immediate work deadline, or a minor injury. In these situations, cortisol helps the body cope with the stress by providing quick energy and reducing inflammation.
• Once the stressor passes, cortisol levels naturally decline, allowing the body to return to its normal state. 
• This short-term increase in cortisol is beneficial and helps the body recover from stress.

Chronic Cortisol Production

• Chronic stress leads to continuous or frequent cortisol production.  Prolonged elevated cortisol levels can result from ongoing work pressure, unresolved emotional issues, lack of sleep, or an unhealthy lifestyle.
• Long-term elevated cortisol contributes to several health issues, such as weight gain (especially around the abdomen), sleep problems, anxiety, weakened immune system, and even cognitive decline.
• In menopause, the combination of hormonal changes and chronic stress can exacerbate these negative effects, making it even more important for us to manage our cortisol levels during this period of life.

Benefits of Cortisol

• Supports wakefulness and energy levels, especially in the morning.
• Helps in managing stress by regulating the fight-or-flight response.
• Aids in controlling blood sugar and reducing inflammation.
• Helps in maintaining blood pressure.

Negative Effects of Excess Cortisol

While cortisol is essential for managing stress and maintaining energy, chronic high levels can have detrimental effects on various aspects of health, especially in peri and postmenopause.

How Chronic Stress Leads to Sustained High Cortisol Levels

• The Stress Loop: Chronic stress, whether from emotional, physical, or environmental sources, triggers the HPA axis to constantly produce cortisol. Unlike short-term stress where cortisol levels drop after the stressor is resolved, chronic stress keeps the body in a heightened state of alert, maintaining elevated cortisol levels.
• Feedback Disruption: Over time, the body becomes less sensitive to cortisol’s feedback signals, leading to an overproduction of cortisol that disrupts normal physiological processes.

Impact on Sleep Quality and Energy Levels

Sleep Disruption

As we discussed above, cortisol’s natural rhythm is supposed to peak in the morning and decline in the evening. Chronic stress can reverse this pattern. High cortisol levels at night make it difficult for us to fall asleep or stay asleep, leading to poor-quality rest and sleep fragmentation. This not only impacts energy levels during the day but also perpetuates a cycle of stress, fatigue, and elevated cortisol.

Fatigue and Burnout

The continuous production of cortisol eventually wears down the body’s energy reserves. What starts as a high-energy stress response turns into chronic fatigue, where we feel tired yet wired, unable to rest and recover properly.

Effect on Weight Gain, Particularly Abdominal Fat

Fat Storage

Excess cortisol signals the body to store fat, especially around the abdomen. This visceral fat is more metabolically active, producing inflammatory markers that can further disrupt hormone balance and increase the risk of chronic conditions like insulin resistance and cardiovascular disease.

Increased Appetite and Sugar Cravings

Elevated cortisol also stimulates appetite, particularly for high-calorie, sugary foods. This makes it harder to maintain a healthy diet and can lead to overeating, further impacting weight gain.

Other Negatives Effects of Chronic Elevated Cortisol

Decreased Bone Density

Cortisol interferes with bone remodeling by inhibiting the cells that form new bone. Chronic high levels of cortisol reduce bone density, increasing the risk of osteoporosis—a particular concern in menopause, as we are already more prone to bone loss due to our declining estrogen levels.

Muscle Loss

Cortisol promotes the breakdown of protein in muscles for energy, leading to muscle wasting over time. This makes it harder to maintain muscle mass, which is crucial for strength and metabolism, especially since we already experience natural muscle loss due to the aging process.

Suppression of Our Immune System

Prolonged high cortisol suppresses the immune system, making the body more vulnerable to infections and slower to heal from injuries. 

Cortisol and Mental Health

Mood Swings and Irritability

Elevated cortisol interferes with neurotransmitters like serotonin and dopamine, which regulate mood. This can lead to irritability, mood swings, and difficulty regulating our emotions.

Anxiety and Depression

Chronic stress can worsen anxiety, as cortisol keeps the body in a constant state of hyper-alertness. Over time, the depletion of feel-good chemicals like serotonin can also contribute to depression. Cortisol imbalances may be a big factor in why many women in peri and postmenopause report heightened anxiety and depressive symptoms.

Cortisol Changes in Menopause

Menopause introduces hormonal fluctuations that can significantly impact how cortisol behaves in the body. Declines in estrogen and progesterone create a cascade of effects that make it harder to manage stress and maintain balanced cortisol levels.

How Estrogen and Progesterone Fluctuations Impact Cortisol

Estrogen’s Role

Estrogen helps buffer the body’s response to stress by modulating cortisol production. As estrogen levels drop during menopause, this protective effect diminishes, leading to a heightened stress response and increased cortisol production. Lower estrogen levels also affect the sensitivity of cortisol receptors, making the body less efficient at regulating stress.

Progesterone’s Role

Progesterone has a calming, anti-anxiety effect and helps promote better sleep. As progesterone levels fall in menopause, we may experience more difficulty calming down after stressful events, resulting in prolonged cortisol production and higher stress levels.

Increased Sensitivity to Stress During Menopause

Heightened Sensitivity

With the decline of estrogen and progesterone, many of us become more sensitive to stress during menopause. Everyday stressors that may have previously been manageable now trigger stronger cortisol responses, leading to frequent spikes in cortisol levels.

Reduced Coping Capacity

As the body’s stress-handling systems become less efficient, women may find it harder to recover from stress and keep cortisol levels in check. This makes it more difficult to relax and increases the risk of chronic high cortisol, contributing to many of the physical and emotional challenges we have been discussing.

Elevated Cortisol and Weight

Abdominal Weight Gain

The hormonal shifts in menopause, combined with elevated cortisol create a perfect storm for weight gain, particularly around the abdomen. This belly fat, or visceral fat, is not just cosmetic.  It poses a greater risk for metabolic diseases, such as diabetes and heart disease.

Insulin Resistance

Elevated cortisol also contributes to insulin resistance, where the body becomes less effective at using glucose for energy. This further promotes fat storage, leading to a cycle of weight gain that is hard to break.

Cortisol, Sleep and Hot Flashes

Sleep Issues

As we have discussed, cortisol’s circadian rhythm is crucial for regulating our sleep. In menopause, disrupted sleep patterns (often due to night sweats or insomnia) further worsen cortisol dysregulation. High cortisol levels at night make it difficult to fall asleep, and poor sleep increases stress and leads to even more cortisol production—a vicious cycle.

Hot Flashes

Hot flashes, another common symptom of menopause, are also linked to fluctuations in cortisol. The body’s stress response to these sudden surges in heat can trigger a cortisol spike, leaving us feeling anxious, stressed, or fatigued. Repeated hot flashes throughout the night disrupt sleep, leading to greater fatigue, higher stress levels, and more cortisol.

How to Manage Cortisol Levels in Menopause

There is hope.  Despite all the negative effects of chronic cortisol, we do have control.  There are so many ways we can help combat this, through what we eat, how we move and sleep and how we live our lives.  

Diet: Managing Cortisol through Balanced Nutrition

A well-rounded, anti-inflammatory diet is crucial for keeping cortisol levels in check, particularly during menopause when hormonal changes can exacerbate stress responses.

Whole Foods

A diet rich in whole foods—fruits, vegetables, whole grains, nuts, seeds, and legumes—provides essential nutrients that help regulate cortisol levels. These foods are high in antioxidants and fiber, which combat inflammation and stabilize blood sugar, reducing cortisol spikes.

Healthy Fats

Omega-3 fatty acids, found in foods like flaxseeds, walnuts, and chia seeds, have anti-inflammatory properties that can help lower cortisol. They support brain health, reduce stress-related inflammation, and enhance the body’s ability to recover from stress.

Fiber

High-fiber foods help maintain stable blood sugar levels, preventing the blood sugar crashes that trigger cortisol release. Fiber-rich meals help you stay full longer and reduce the stress-related overeating that contributes to weight gain and higher cortisol levels.

Anti-Inflammatory Diet in Menopause

Avoiding Stimulants Like Caffeine, Which Can Spike Cortisol

I love coffee, the taste, the ritual in the morning, how it makes me feel, the smell.  I could go on and on.  I have two cups each morning and I definitely don’t feel that great if I over do it.  I have gone through periods where I stopped drinking coffee and felt great.  

When we have coffee or anything with caffeine for that matter, it stimulates our nervous system, prompting our adrenal glands to release cortisol.  When taken in small amounts caffeine can boost our energy and promote alertness which is why many of us consume it.  

Here lies the problem, when we take in too much caffeine, especially in menopause this can lead to prolonged cortisol elevation, anxiety, and disrupted sleep patterns. There are several ways to combat this, one is to avoid caffeine all together (something I am not willing to do).  Another tip is to try and consume caffeine as early in the day as you can as it has a long half life and can remain in your system for hours.  

Benefits of Adaptogens

Ashwagandha

This adaptogenic herb is widely known for its ability to reduce stress and balance cortisol levels. Studies suggest that ashwagandha can lower cortisol and help the body adapt to both physical and emotional stress, making it a valuable tool for menopausal women dealing with chronic stress.

Other Adaptogens

Rhodiola, holy basil, and licorice root are other adaptogens that support adrenal health and reduce cortisol production. These herbs help balance hormones and improve resilience to stress, making them a helpful addition to a menopausal woman’s routine.

Dr. Stacy Sims has a great article on adaptogens that you can read for more detailed information:

What Women Should Know About Adaptogens

Balancing Physical Activity for Cortisol Management

Physical activity is a powerful tool for lowering cortisol levels, but finding the right balance between intense exercise and recovery is key to preventing overproduction of cortisol.

How Strength Training Can Lower Cortisol Levels Long-Term

Strength training helps regulate cortisol by promoting muscle growth, improving metabolism, and reducing overall stress on the body. When done consistently, strength training can lower baseline cortisol levels, reduce abdominal fat (which is associated with high cortisol), and improve mental well-being.

As cortisol contributes to muscle breakdown, strength training helps counteract this by promoting muscle retention, especially important for women in menopause who experience age-related muscle loss.

Strength Training for Women Over 40: A How to Guide

Importance of Balancing Intense Exercise with Recovery and Relaxation

Avoiding Overtraining

While intense exercise (like HIIT) can temporarily increase cortisol, doing too much without adequate recovery can lead to chronically elevated cortisol levels. Overtraining stresses the body, especially during menopause, when hormone fluctuations make it harder to recover from intense activity.

Incorporating Recovery Activities

Gentle exercises like yoga, tai chi, walking, and stretching promote relaxation and reduce cortisol. These activities stimulate the parasympathetic nervous system (the body’s “rest and digest” mode), helping lower stress hormones and improving overall mental and physical recovery. Incorporating them between strength-training sessions allows the body to recover without adding to stress.

Sleep: Prioritizing Rest to Reduce Cortisol

Sleep is essential for regulating cortisol. Poor sleep can lead to elevated cortisol levels, especially for us women in menopause as we often experience sleep disturbances due to hot flashes or hormonal fluctuations.

Prioritizing 7-9 Hours of Quality Sleep

• Cortisol and Sleep Quality: When you don’t get enough sleep, cortisol levels rise, increasing stress and making it harder to sleep the next night. Establishing consistent sleep habits is crucial to keeping cortisol under control and ensuring restorative rest.
• Improving Sleep Hygiene: Creating a sleep-conducive environment—cool, dark, and quiet—helps align cortisol with its natural rhythm, ensuring it lowers at night and peaks in the morning.

Creating a Bedtime Routine to Reduce Cortisol at Night

• Wind-Down Rituals: Establishing a calming bedtime routine can signal to your body that it’s time to relax, helping to lower cortisol. Activities like reading, taking a warm bath, practicing relaxation techniques, or listening to calming music can shift your body into a relaxed state before bed.
• Limit Screen Time: The blue light from phones and computers can interfere with melatonin production and keep cortisol levels high. Turning off screens at least an hour before bed helps regulate the body’s natural sleep-wake cycle.

Importance of Managing Sleep Disturbances Common in Menopause

• Hot Flashes and Cortisol: Nighttime hot flashes can trigger cortisol spikes, disrupting sleep. Cooling techniques, such as using a fan or lightweight bedding, or taking natural supplements like black cohosh, can help minimize hot flashes.
• Supportive Sleep Aids: Supplements like magnesium, melatonin, and valerian root may help improve sleep quality, ensuring cortisol levels return to normal during the night.

Stress Management: Tools to Lower Cortisol Naturally

Managing stress is essential for controlling cortisol levels, especially during menopause when hormonal fluctuations increase sensitivity to stress.

Breathwork

Practicing slow, deep breathing can activate the parasympathetic nervous system, which lowers cortisol levels by reducing the body’s stress response. Techniques like diaphragmatic breathing or box breathing can be done anytime you feel stressed.

Meditation and Mindfulness

Mindfulness meditation helps manage stress by focusing attention on the present moment, preventing the mind from spiraling into stress-inducing thoughts. Studies show that regular meditation can significantly lower cortisol levels, helping women in menopause better manage their stress.

Yoga and Relaxation Practices

Yoga, especially practices that emphasize slow, deliberate movement and deep breathing, can calm the nervous system, reducing cortisol production and enhancing relaxation.

The Role of Hobbies, Community, and Social Support in Lowering Stress

Engaging in Enjoyable Activities

Hobbies that bring joy and relaxation—such as reading, gardening, or creative activities—offer a break from stress and help lower cortisol levels. Finding time for enjoyable, non-stressful activities is critical for cortisol management.

Social Support

Strong social connections can act as a buffer against stress, lowering cortisol levels. Whether it’s spending time with family, friends, or joining support groups, socializing provides emotional comfort and helps the body release oxytocin, a hormone that counters cortisol.

Building a Support Network

 For women in menopause, talking with others going through similar experiences can reduce feelings of isolation and stress, creating a sense of community that helps lower cortisol.

Conclusion

To quickly recap, cortisol is not all bad.  It has many beneficial functions in our body, and we cannot not survive without it.  When our hormone levels begin to fluctuate in perimenopause, this can greatly impact our cortisol levels, sometimes in negative ways.  Especially if we are not putting our health first.  

We have control.  By focusing on balanced nutrition, appropriate exercise, quality sleep, and effective stress management techniques, we have the ability to keep cortisol levels in check and get better with age.  

Please let me know in the comments below if you have any questions or concerns.  If you have a friend or family member who you think may benefit from this blog post, feel free to forward this on to them. Also, check out my FREE guide on how to build muscle and lose fat in menopause.  It is a 20-page document that gives you 6 tips that are easy and don’t require a lot of time or money.  

I also have a new coaching program that I am launching.  It is called Better With Age and is a 12-week program with 1:1 coaching with me.  We talk about diet, exercise, stress management, hormones, skin care, self-image, and many more things.  You can learn more here.