Understanding the Link Between Stress and Perimenopause
Stress - we’re all living with it.
And you don’t need me to tell you stress isn’t great for your health…
But for women in or near perimenopause, stress deserves special mention. Research has shown chronic stress actually worsens the hormonal symptoms of perimenopause, like hot flashes and PMS - as well as weight gain, decreased sex drive, and overall feelings of wellbeing.
But as we all know, “getting rid of” stress really isn’t an option. As a long-time health practitioner, my goal isn’t to help my clients eliminate stress, but rather teach them strategies to better manage stress.
This is especially important during the perimenopause transition, when we are already in a hormonal shift and have less “wiggle room” to manage things like stress, blood sugar imbalances, and inflammation from hidden infections.
But I’m not just talking about starting a meditation practice or saying no to that extra project at work. Targeted use of the right bioidentical hormones, herbs, and adrenal support supplements can help your body handle stress better, and help you transition through menopause seamlessly.
Today, let’s explore what stress and menopause do to the body on a hormonal level - and what we can do to better support the body for more energy, less hormonal symptoms, and a better life.
How Stress Impacts Your Hormones
When I say “hormones” I don’t just mean your sex hormones like testosterone, estrogen, and progesterone. I’m also talking about adrenal hormones like cortisol and DHEA, which play a role in controlling your sex hormones as well.
During perimenopause, hormone levels fluctuate, and it's fluctuating hormones that can cause symptoms like hot flashes, mood swings, and weight gain. Research shows that stress only intensifies this.
Stress triggers the release of cortisol. This is good, as cortisol is the “fight or flight” hormone that helps us respond to danger. But when stress is on-going, it can lead to an on-going state of elevated cortisol. Elevated cortisol in turn depletes the hormone DHEA, which is already in a natural state of decline as we age.
Low DHEA is a problem for anyone, but especially for perimenopausal women because DHEA is a precursor to both testosterone and estrogen. Low levels of DHEA can therefore cause low levels of both testosterone and estrogen, intensifying the already changing hormone levels during this time.
Low DHEA & The Pregnenolone Steal
So far, we’ve covered how stress can lead to elevated cortisol, which causes lower levels of DHEA. Because DHEA is a precursor for testosterone and estrogen, it can impact sex hormones.
But why does elevated cortisol deplete DHEA? That’s thanks to a process commonly called the “Pregnenolone Steal.”
The basic premise of the pregnenolone steal is that pregnenolone - a hormone produced by the adrenal gland - is a precursor for both cortisol and DHEA. When stress is high, the body reacts by producing more and more cortisol, “stealing” all the pregnenolone and leaving none for DHEA production.
That’s a bit of an oversimplification, though. There’s not just one pool of pregnenolone that gets depleted. In reality, pregnenolone is in the mitochondria of each of the cells. Rather than thinking about pregnenolone being stolen, it's more that the body prioritizes some pathways of hormone production that are about survival (cortisol), over reproductive hormones.
That being said, no matter “how” it happens, the decrease in sex hormone production this causes is particularly inopportune during the perimenopause years, when we are already hormonally in shift. It can make it seem like we are more sensitive to stress, or that it takes less stress to cause a noticeable change in how we look and feel. Coexisting issues like blood sugar imbalance or hidden infections - which are other common triggers for cortisol release - might suddenly become a bigger problem, too.
Perimenopause and Low DHEA Symptoms
If you’re dealing with stress related hormone dysfunction on top of perimenopause symptoms, you might feel like you’ve got the worst perimenopause of anyone you know. It can cause an intensification of already-known symptoms like:
- Hot flashes
- Night sweats
- Decreased sex drive (low libido)
- Decreased sexual pleasure
- Weight gain/ weight loss resistance
- Poor sleep
- Increased cravings
- Mood disturbances (depression, anxiety, etc.)
- Low energy
- Overall lack of wellbeing
So that’s the “bad news.” Now let’s talk about the good news - all the things you can do to help rebalance hormones, support your body’s stress response, and get back to feeling like yourself.
In fact, after 1-2 months on a customized plan based on your hormone test results, most of my clients see a 75% or more reduction in symptoms.
Can Hormone Therapy Help Low DHEA and Perimenopause?
For a deep dive into using bioidentical hormones safely during perimenopause, see my blog here.
But in addition to sex hormone replacement therapy, supplementing with hormones like DHEA can be an option too.
When used appropriately - and well monitored - DHEA is a safe way to help increase low testosterone in peri-and menopausal women. (It’s especially great for women with some types of hair loss, too!)
But, DHEA needs to be used carefully. Androgen dominance (too much testosterone) can be a main driver for the development or worsening of insulin resistance in perimenopause.
That’s why I always recommend testing before starting DHEA (even if it is available over the counter where you live) and on-going monitoring. I recommend a comprehensive hormone panel like the DUTCH test.
In the clinic, we also use pregnenolone supplementation when using DHEA. This helps with two main problems with DHEA supplementation. First, it can help offset the tendency of DHEA to lower cortisol levels, which can be a problem if someone is already dealing with low HPA output.
Secondly, DHEA has a tendency to put weight on some people, or cause water retention. Adding pregnenolone can prevent this tendency.
Active Stress Management and Supplements
Supplementing with hormones is just one part of the puzzle - just as, if not more, important are complementary lifestyle practices that help manage stress.
I make a custom plan for each of my clients, but some of the techniques we use include:
- Optimizing sleep hygiene (no blue light before bed, etc.)
- Introducing movement (finding an exercise you actually enjoy– and prioritizing muscle building over cardio)
- Circadian alignment (going to bed and rising with the sunset/sunrise)
- Balancing blood sugar and increasing protein intake
- Eliminating/reducing alcohol and processed sugar
Active stress management - like qi gong, walks in nature, meditation in any form, making time for art, getting involved in your community, and spending time with friends and loved ones - are also key.
And then of course there are the issues that you can control - like your relationships, overall task burden, time management, ability to delegate and ask for support, and cutting out toxic people or activities.
These steps can help you eliminate what stress you can and better tolerate the stress you have to live with.
A final piece of the puzzle are adaptogenic herbs and herbs for supplement symptoms. As a long-time Traditional Chinese Medicine practitioner, I’ve seen the incredible power of herbs for transforming health. But, as with all powerful tools, they should only be used after adequate testing or practitioner diagnosis has identified the imbalances that exist.
Look and Feel Your Best in Perimenopause
Perimenopause has a reputation as the worst time in a woman's life… but it doesn’t have to be that way!
With the right support, you can not just survive perimenopause - but actually enjoy the transition and step confidently into a new chapter in your life.
You don’t have to accept weight gain, low sex drive and lack of pleasure, hot flashes, mood swings, cravings, irritability, and all the other common symptoms of perimenopause.
My passion is guiding women through this change, helping to support their body’s unique needs, and watching them thrive in this phase of life!
If you’re interested in learning more, schedule a free 15 minute call by clicking here. We offer different programs for every need and budget, and would love to help you find the support that’s a perfect fit for you.
