Most of us know how stress manifests for us personally. For some it’s trouble falling asleep and increased irritability, for others it shows up as anxiety or a lack of energy and motivation. But how does stress affect us on a physiological level, and how does it impact our sex hormones? What’s happening inside our body before we get to the point of being irritable and drained of energy?
To fully understand how stress impacts our menstrual cycle and sex hormones, first let’s take a look at the stress response.
When we talk about stress we need to distinguish between stressors and stress. Stressors are things that activate our stress response, such as work, financial issues, relationship tension, illness, etc. The stress response is a system of changes activated in our brain and body in response to stressors.
There are three main types of stressors:
Mental/emotional: feelings such as fear, guilt, worry, anxiety, grief, sadness, existential angst, etc. (mental and emotional stress is perceived, and therefore different for everyone)
Physical/trauma – fractures, muscle injuries, nerve compression, sleep deprivation, chronic illness, chronic dieting, etc.
Chemical/biochemical – blood sugar imbalances, food allergies/sensitivities, alcohol, drugs, parasites, bacteria, viruses, etc.
The hypothalamus-pituitary-adrenal (HPA) axis is responsible for controlling the stress response in the body. The hypothalamus sends signals to the pituitary, which in turn sends messages to the adrenal glands. The adrenal glands are endocrine glands that sit above the kidneys. The adrenals are made up of two main parts - an outer cortex and an inner medulla. The outer cortex is divided into three zones – zona glomerulosa, zona fasciculata and zona reticularis.
The stressors we experience are sensed by our sympathetic nervous system, which stimulates the adrenal medulla to release adrenaline. The hypothalamus then senses the adrenaline in the bloodstream and releases corticotropin-releasing hormone (CRH), which is sent to the pituitary. The pituitary then releases adrenocorticotropic hormone (ACTH), which is sent to the adrenals. The zona fasciculata region of the cortex releases cortisol. Cortisol enhances adrenaline and supports the fight, flight or freeze stress response.
We’re all familiar with this response. It’s designed to protect us and save our lives in the case of danger. When this happens the body is worried about survival, and survival only. Your body isn’t worried about digesting food, getting pregnant, or building muscle. Unfortunately the stress response hasn’t adapted enough to know the difference between a tiger chasing you in the wild and you fighting with your significant other, so this stress response can be activated frequently if you deal with chronic stress or don’t handle stress well (I’m talking to my fellow highly sensitive people and empaths here).
In a normal stress response, once our body knows we are safe and have survived the stressor our cortisol levels return to normal and adrenaline decreases, thanks to the HPA negative feedback loop.
When we are under chronic stress, the hypothalamus can have a reduced sensitivity to cortisol. Cortisol levels stay elevated, and cortisol dominance occurs.
In the zona reticularis section of the adrenal cortex, DHEA and androgenic steroid hormones are produced. DHEA is the precursor hormone of androstenediol, androstenedione, testosterone and estrogens. While the majority of estrogen and androgens are produced in the ovaries (we know a large amount of estrogen is produced by the maturing follicle during the follicular phase of the cycle, and by the corpus luteum during the luteal phase), this estrogen conversion is still important.
DHEA also serves as a counter-regulatory hormone to cortisol. It is an anabolic hormone that promotes the growth and repair of protein, especially muscle tissue. DHEA helps to negate the harmful effects of excess cortisol. But when we are experiencing chronic stress the pituitary can end up sending more ACTH to the zone that produces cortisol, and less to the zone that produces DHEA. If this continues on long enough it results in not only lower DHEA levels (and an imbalanced cortisol to DHEA ratio) but also decreased testosterone and estrogen levels.
So if we are experiencing chronic stress what can we do to prevent this hormonal cascade? This is when we need to complete the stress cycle.
The Stress Cycle
The advice “reduce stress” or “stop stressing so much” has never resonated much with me. As a chronically stressed out person myself, I know stress is inevitable. We can’t always reduce stress in our lives. However, what we do need to do is allow the stress cycle to complete.
In Come As You Are, author Emily Nagoksi, Ph.D. states “The key to managing stress (so it doesn’t mess with your sex life) is not simply “relaxing” or “calming down”. It’s allowing the stress response cycle to complete.”
How do we let the stress cycle complete? We can do this by relaxing (think breathing and being mindful, not staring at a TV screen), physical activity, or feeling alllll your feels, to name a few.
As I mentioned above, our stress response is fight, flight or freeze.
During a stress cycle there is a beginning (the threat or risk), a middle (the action taken – fighting, taking flight or freezing) and an end (hopefully a feeling and realization of “I’m safe!”).
Unfortunately, we’ve got a lot more chronic stressors than acute stressors. Acute stress doesn’t last long. It’s being written up for being late to work, as opposed to the chronic stress of walking into a job everyday that you hate with coworkers you don't get along with. Acute stressors have a clear beginning and end. Where chronic stressors are never-ending, or at least they feel that way.
If we live with chronic stress we aren’t allowing the stress cycle to complete. This is especially true if we often find ourselves running around from place to place and not taking the time to relax, sit with our emotions or move our body in a way that feels good. If you find yourself frequently in a place that isn’t appropriate to complete the stress cycle or constantly surrounded by people who are uncomfortable with you fully expressing your emotions and feeling all your feels, it may be time to reevaluate your schedule and surroundings.
So what do we do?
We can complete the stress response cycle by allowing our emotions to work through us fully. This means we run, we move, we cry, we journal, we meditate, we talk it out. Whatever works best for us personally.
This is where our intuition comes into play. We can ask ourselves “what does my body need right now?”. Sometimes we need to dance it out. Sometimes we need to lift weights. Sometimes we need to talk it out with someone who is good at listening. Expressive self-care such as art or journaling can help. Other times we just need to scream in our car on the drive home from work until tears are streaming down our face and we feel better.
What does your body need? What ways do you complete the stress cycle?
A final note on dealing with the stressors vs. dealing with the stress:
Have you ever completed a stressful week at work with tons of deadlines only to feel just as stressed as you were when the week began? Or you collapse into exhaustion at the end of the week? It’s because you have dealt with the stressor (all of the deadlines and projects) but your body still needs to finish dealing with the stress (meaning you need to complete the stress cycle). Make sure you are taking time to complete the stress cycle before you go all in on the next project.
Need some help with identifying the stressors in your life and coming up with ways to complete the stress cycle? Download the free PDF worksheet I created here. It’ll help you to feel all your feels and work through them without any judgement or shame.
More questions on the stress cycle, your menstrual cycle or interested in working with me to balance your hormones? Contact me at email@example.com.