Should You Be Concerned About Cortisol?

Cortisol is at the center of conversations around hot flashes, belly fat gain, fatigue and more. If you look for guidance about exercise around menopause, you’ll find sources claiming that menopausal women should avoid many types of exercise because they will generate too much cortisol.

Let’s make sense of the science and clear up the myths versus facts.

Cortisol Basics

When your brain perceives stress, your body responds automatically with a cascade of physiological “fight or flight” responses. The hormones cortisol and adrenaline (epinephrine) are released to give you the ability to quickly deal with danger.

This reaction to stress is usually extremely helpful, keeping you safe and letting you respond quickly to negative situations. Even outside of stressful situations, the 24-hour cycle of rising and falling cortisol levels helps your body wake up and become “activated” during the day, and then transition into sleep.

The stress response functions best when dealing with short-term situations. However, living in a state of chronic, unmanaged stress keeps your body’s cortisol levels elevated instead of letting them rise and fall.

Chronic high levels of cortisol can have detrimental effects on your health, including weight gain, muscle loss, insulin resistance, and increased risk of cardiovascular disease.

Cortisol and Menopause

Some sources claim that a decrease in estrogen around menopause directly causes an increase in cortisol. However, while female sex hormones play a part in regulating cortisol levels, the relationship between estrogen and cortisol is not well understood.

One frequently-cited study found that for some women, urinary cortisol levels increased transiently during the 7-12 month period after starting late perimenopause, when menstrual cycles are the most irregular. However, they stabilized around the final menstrual period.

In this study, these changes in cortisol levels were also not universal or uniform—some women experienced a significant rise and some even experienced a decrease.

Importantly, those participants who had the largest increase in cortisol levels around the menopause transition had the most severe hot flashes and night sweats. Clearly, there is a relationship between menopause symptom severity and increasing cortisol, but it is not the only factor influencing someone’s symptom experience.

A 2022 study of postmenopausal women found that treatment to reduce the severity of menopause symptoms led to a corresponding reduction in cortisol levels. This effect was present regardless of the treatment method—participants received hormone therapy, soy isoflavone supplements or acupuncture.

Because long-term elevation of cortisol is a risk for metabolic syndrome and heart disease, studies like this one support the idea that treating menopause symptoms is about more than making you comfortable—it’s about setting you up for healthier decades after menopause.

Cortisol and Exercise

Many people concerned about menopause-related belly fat gain start to be concerned about cortisol. Because prolonged, high levels of cortisol are known to contribute to abdominal weight gain, some fitness professionals recommend that women looking to lose belly fat stop any higher-intensity exercise to prevent their cortisol levels from being further elevated.

Unfortunately, this view is not backed by scientific evidence. In fact, many experts interpret the available research to say the exact opposite: exposing yourself to the stresses of exercise is the best way to help your body become less reactive to stress and lower your overall cortisol levels.

Here’s why embracing higher-intensity exercise is not only appropriate for midlife women but critical for helping your body better buffer stress:

Exercise is, by definition, a stress on the body. As such, it increases cortisol levels. As a general rule, higher-intensity exercise stimulates greater cortisol production and cardiovascular (aerobic) exercise stimulates more than strength training. The longer the aerobic exercise session, the higher the cortisol increase.

However, these cortisol increases occur only temporarily, peaking post-exercise and returning to normal in a relatively short time (a matter of minutes to hours, in most cases).

In general, higher physical activity and fitness levels actually appear to train your body to react less strongly to all kinds of stress. So, people who have consistently exposed their bodies to the stresses of exercise will have a less dramatic “fight or flight” response to future stresses.

More highly trained people have lower increases in cortisol after exercise—meaning that if you’re used to exercise, you’ll have a weaker cortisol response to it.

Furthermore, a 2021 study found that after a single 30-minute bout of vigorous exercise, subjects had a dampened increase in cortisol as a response to a psychological stress. Cortisol levels also returned to baseline more quickly. This effect was strongest with higher intensity exercise, compared to lower or moderate intensity.

Exercise Is Healthy Stress

Stress reduction through lifestyle and mindset change is an important investment in your long-term health. Chronic stress and chronically elevated cortisol levels are known to lead to long-term health risks, but the short-term and purposeful stress from exercise is not a risk for midlife women.

There are already enough barriers to exercise, especially as you age—don’t let concern about cortisol be one of them! Both moderate and high-intensity cardiovascular exercise, along with regular challenges from strength training, are important cornerstones of long-term physical and mental health.