Hormones are pivotal in orchestrating various bodily functions and profoundly influence our physical and mental well-being. Among these, cortisol, often referred to as the "stress hormone," and estrogen, a key player in reproductive health, stand out for their multifaceted impacts.
In this article, we will discuss the intricate interplay between cortisol and estrogen, delving into their effects on health and unveiling strategies to achieve hormonal equilibrium. By dissecting the relationship between the two, we aim to illuminate the pathways to optimal health and well-being in the face of hormonal fluctuations.
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Cortisol and Estrogen: What Are They?
Learn all about these important hormones:
Understanding Cortisol
Cortisol is a steroid hormone responsible for regulating stress throughout the body. During times of stress, our nervous system responds to a perceived threat by activating the fight-or-flight response, which then activates the hypothalamic-pituitary axis (HPA).
When the HPA axis is activated, adrenocorticotropic hormone (ACTH) is released and signals the adrenal glands to release cortisol. Cortisol also helps control the inflammatory response throughout our bodies, regulate metabolism, and control immune function (35).
Understanding Estrogen
Estrogen is a steroid a hormone responsible for developing female sexual characteristics, menstruation, pregnancy, and menopause. Estrogen regulates many processes, such as blood sugar levels, brain function, cholesterol levels, bone mass, collagen production, and blood flow.
The three forms of estrogen are estrone, estradiol, and estriol. Estradiol is the most potent form of estrogen and most prevalent during a woman's reproductive years. Estradiol is a signaling hormone and works on receptors all over the body (14).
How Cortisol and Estrogen Interact
The physiologic relationship between cortisol and estrogen is multifaceted. When we are under chronic stress, the body is constantly producing cortisol. High cortisol levels can block ovulation, the process of releasing an egg for fertilization during the menstrual cycle. During this period, a woman's body produces estrogen to prepare for ovulation.
High cortisol levels disrupt this process, resulting in low estrogen levels. Chronic stress and cortisol dysregulation can disrupt women’s menstrual cycle (36).
On the contrary, high estrogen levels can directly increase cortisol levels by increasing cortisol-binding globulin (CBG) concentration. Women taking oral birth control medication are at increased risk of developing high cortisol levels due to this mechanism (32).
The Effects of Imbalance
How do chronic stress (high cortisol) and estrogen imbalance affect the body? Below are the top signs and symptoms of imbalance (6):
- Painful sex
- Hot flashes
- Low sex drive
- Bone loss
- Increased abdominal fat
- Dry skin
- Tender breasts
- Vaginal dryness
- Irregular periods
- Hirsutism
- High blood pressure
- Hypertension
Impact of Cortisol and Estrogen Imbalance on Health
These hormones each have specific physical, mental, and emotional health effects:
Physical Health Consequences
Dysregulation of the HPA axis and chronic exposure to high levels of cortisol are associated with increased risk for diabetes, suppressed immune function, increased blood pressure, weight gain, and cardiovascular disease.
During periods of high stress, we see structural changes in the brain leading to impairment in cognition and memory. In terms of immune system health, chronic stress, and high cortisol levels change the secretion of hormones that play a critical role in the immune system. This results in a weakened immune system and increased susceptibility to infections (39).
As alterations in cortisol impact reproductive hormones, we see the consequences of low estrogen on the body. Women experiencing low estrogen will experience decreased sex drive, bone loss, amenorrhea, migraines, and vaginal dryness.
When low estrogen goes untreated, potential complications may arise. This includes an increased risk of cardiovascular disease, skin changes, or osteoporosis (6).
Mental and Emotional Health Consequences
Mental health disorders such as anxiety and depression are becoming more prevalent by the day. Imbalances in cortisol secretion may cause an increase in depression risk. About 50% of patients diagnosed with depression also have excessive cortisol secretion.
It is important to note that other conditions, such as thyroid disorders, sleep disorders, genetic factors, and/or sex hormone dysregulation, may cause depression as well.
High levels of cortisol can lead to anxiety by causing a decrease in 5-HTP, an amino acid involved in serotonin production. Decreased 5-HTP results in decreased serotonin and an increase in symptoms of anxiety and insomnia (17).
As we have discussed, elevated cortisol levels can cause low estrogen levels. Estrogen is vital in modulating brain networks, stress response, and emotional regulation. During periods of low estrogen, women are at greater risk for experiencing symptoms of depression, which occur because estrogen alters serotonin function in the brain (1).
Factors Influencing Cortisol and Estrogen Levels
What causes estradiol imbalance?
- Menopause transition
- Hypothyroidism
- Environmental toxins such as endocrine-disrupting chemicals and xenoestrogens
- Stress
- Nutrient imbalances: B vitamins, magnesium, indole-3-carbinol, and sulforaphane
- Genetics
What causes cortisol imbalance?
- Lack of exercise
- Obstructive sleep apnea
- Insomnia
- Comorbidities: Diabetes, Hypertension, Alzheimer’s
- Chronic stress
Strategies for Balancing Cortisol and Estrogen
Lifestyle Modifications
Several lifestyle modifications can be made to help manage cortisol levels and activate the parasympathetic nervous system. The parasympathetic nervous system is the part of our nervous system that regulates rest and repair.
Practicing guided meditation, breathwork, and yoga all effectively decrease cortisol levels. Another emerging technique to regulate the stress response is biofeedback, which is a technique that helps patients modify their stress response, regulate blood pressure, and promote relaxation. (26).
Medical Interventions
Implementing alternative interventions to balance cortisol and estrogen is vital during times of stress. Adaptogenic herbs can normalize endocrine function and modulate the stress response.
Eleuthero root, Holy Basil, Rhodiola, and Ashwagandha have been shown to enhance energy production, sleep quality, and immune function. These herbs are specifically indicated in times of elevated cortisol and adrenal deficiency (33).
Women with high cortisol and low estrogen may benefit from hormone replacement therapy. Estradiol replacement helps prevent impairment in memory and attention, in addition to increasing serotonin levels.
Utilizing estrogen replacement therapy may also prevent osteoporosis, weight gain, hot flashes, and other conditions associated with low estrogen. It is important to always seek the guidance of a trained physician before starting hormone replacement therapy (25).
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Key Takeaways
- Cortisol and estrogen are crucial hormones for bodily functions, impacting physical and emotional well-being.
- Cortisol, known as the “stress” hormone, and estrogen, vital for reproductive health, can impact each other during times of high stress.
- Regulating cortisol and estrogen imbalance through lifestyle, herbal medicine, and hormone replacement therapy helps negate the consequences of chronic stress.
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