Mental Health

Stress, Hormones, and Menopause – It’s All Connected

Stress is a state of mental or emotional strain resulting from adverse or demanding circumstances. Because women have many intricate roles, stress is often part of a woman’s daily life. But have you experienced more stressful episodes now that you’re in perimenopause or graduated to postmenopause?

Stress and Hormones: Yes, There Is a Connection

Everyone has stress, and everyone reacts differently to stress and stress-related anxiety. Likewise, the hormonal imbalances brought on by menopause, such as the decline of estrogen, can incur a certain level of anxiety. 

Physiologically, stress can be out of our control. When a stressful event occurs, your body produces cortisol and adrenaline hormones. These are the “fight or flight” hormones, which immediately give you the energy to flee or confront danger. During menopause, hormones react to the decrease of estrogen and the cortisol that imbibes the body during a stress reaction. An increase in cortisol can further decrease the level of estrogen in the body and cause a hormonal imbalance.

Throughout menopause, estrogen and progesterone decrease, and your body tries to compensate by making more cortisol. Then, when you are stressed, the adrenal glands (where cortisol is made) take over, and the cortisol continues to increase. The production of estrogen and progesterone, which help calm you, has been diminished by menopause, and the resulting high cortisol can cause symptoms similar to chronic stress symptoms. For example:

  • Digestion problems
  • Headaches
  • Insomnia or inadequate sleep
  • Low energy
  • Weight gain (around the middle abdominal area)

Many women don’t see the connection between hormone changes and stress. In fact, a survey of 2,000 women revealed that seventy-two percent weren’t aware that their symptoms were related to a hormone imbalance.

Can Stress Trigger Menopause? 

Stress can also affect menopause. A study showed that women who worked alternating day and night shifts experienced chronic stress due to disturbances of regular sleep patterns and concluded that these workers had a moderately increased risk of early menopause. In addition, a French study indicated that specific physical job stressors might be related to an earlier age of menopause. Other researchers found that stress can cause a woman to experience symptoms similar to menopause due to increased cortisol levels, but stress does not actually initiate early menopause. So, although there may be a connection, there is not enough evidence to show that stress causes early menopause. 

Is Menopausal Hormone Therapy Helpful for Menopausal Stress?

Looking into the relationship between age, estrogen, and stress response, another small study examined the effects of estrogen as a treatment option. Researchers discovered that treating both older and younger women with estrogen actually increased their depression and anxiety following stressful situations. However, estradiol menopausal hormone therapy (MHT) may play a significant role in helping emotional reactivity in older women. 

One study of MHT, specifically estradiol therapy, showed that estradiol may protect against certain types of anxiety when stress presents itself since estrogen can disrupt cortisol exposure, reducing the cortisol response to the stress situation. In this study, researchers also found that estrogen therapy could positively benefit memory in menopausal women. These studies have mixed outcomes, so contact your provider to discuss the best therapies for you. 

Take a few minutes each day to manage stress and anxiety. Physical activity and mindfulness activities are considered some of the best ways to deal with stress.

Lowering Stress During Menopause

Women can take proactive steps to manage stress and anxiety during menopause. With the demands of careers, families, and relationships, it is crucial to take time to learn valuable stress reduction strategies. 


Learning and regularly practicing mindfulness exercises can lower stress related to a specific situation and teach you helpful skills for dealing with stressful situations that arise in the future. There are several options to choose from. Try a few to find the one that works best for you and is a sustainable practice.

Yoga can also be considered a mindfulness practice. While yoga is a physical practice, mindfulness is an important aspect of the overall experience. If you’ve previously practiced yoga, you may recall that your instructor may open or close with meditation or incorporate different breathing exercises. Yoga and mindfulness support and enhance one another.


Just about any kind of exercise can help diffuse stress. You’ve probably heard of the runner’s high. Exercise boosts the production of your brain’s feel-good endorphins. And you don’t need to be a runner to achieve a similar feeling to the runner’s high. Any aerobic activity can achieve this result. Exercise also improves your overall health, which can help your body fight the negative effects of stress. 


More evidence points to the idea that our diet plays a significant role in supporting our brain – especially during times of physiological change, like menopause. Fueling your body with proper nutrition throughout menopause can also help manage your mood and stress. Be sure to include the following items in your daily diet:

  • Fruits and vegetables for antioxidant consumption
  • Probiotic-containing foods such as yogurt or kombucha
  • Polyunsaturated fats found in fatty fishes, walnuts, or flaxseed

Try to avoid these items that may increase a stress response or anxiety: 

  • Excessive caffeine
  • Fried food
  • Processed foods
  • Refined sugar

Identifying Chronic Stress

Stress can sometimes be a good thing, giving you the energy to complete a task or retreat from a dangerous situation. However, long-term, or chronic stress, can negatively impact a woman’s health. Long-term stress includes constant financial worries, relationship instability, or experiencing a traumatic event.

The physical signs to look out for to determine if chronic stress is impacting you are:

  • An upset stomach that is not related to illness
  • Lack of energy and focus
  • Over—or under—eating
  • Pain not related to an injury
  • Skin problems such as acne or hives
  • Headaches
  • Trouble sleeping

Stress during menopause does not have to take over your life. Contact your provider to discuss your symptoms and needs during menopause. Also, develop a stress relief action plan that includes exercise, nutrition, and mindfulness. Transforming the way you manage stress will make a positive health impact now and in the future. 

Looking for more ways to reduce stress? Download Midday from the App Store or visit us at Midday.Health.

Sara Egnatz BSN, RN-BC is a nurse and freelance health content writer.

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