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Cortisol’s Effects On the Menstrual Cycle: The Hidden Culprit Behind Irregular Periods

Cortisol’s Effects On the Menstrual Cycle: The Hidden Culprit Behind Irregular Periods

Cortisol’s effects on the menstrual cycle can be profound and often go under the radar when trying to determine root causes of period irregularity. As the body’s primary stress hormone, cortisol directly influences our hormonal balance, which is essential to maintain regular menstrual cycles. Let’s delve into the different ways cortisol levels, whether high or low, can contribute to irregular menstrual cycles. 

 

Cortisol’s Effects On the Body

Cortisol is produced by the adrenal glands about 30-60 minutes after we wake up as part of our daily cortisol awakening response (CAR). Circadian rhythms, or our internal body clocks, strongly drive this response. Cortisol also rises during times of stress, when we are in an activated or heightened nervous system state. In addition, cortisol increases as a protective mechanism when our blood sugar dips too low, in order to release glucose into our bloodstream.

Cortisol plays a vital role in helping regulate the production of other hormones and even has an anti-inflammatory effect during times of acute or short-term increases. That being said, problems arise when cortisol levels are chronically elevated. 

Chronically high cortisol levels reflect a constantly activated nervous system. Signs of chronically elevated cortisol levels include mid-section weight gain, acne, hair loss, trouble sleeping, anxiety, and mood changes. On the flip side, low cortisol levels are often seen after long periods of high cortisol levels. To protect us from the oxidative stress caused by chronically high cortisol, the adrenal glands downregulate their function. 

Both chronically high or low cortisol levels indicate dysfunction within the HPA axis, or the connection between hypothalamus, pituitary gland, and adrenal glands. The HPA axis is a hormone signaling highway in charge of our body’s stress response system. 

HPA axis dysfunction can lead to significant problems with blood sugar regulation, low mood and depression, increased inflammation and oxidative stress, and negative repercussions for reproductive hormones and thyroid function. 

 

How Cortisol Affects Menstrual Regularity

The Effect on Regulatory Hormones

The messages sent along the HPA axis strongly influence our reproductive hormones. At the top of this cascade is the hypothalamus, a portion of the brain. However, signals don’t just go down this cascade. The HPA axis acts on a negative feedback loop. This means that downstream, the cortisol produced by our adrenal glands signals all the way back upstream to our hypothalamus to shut off or pause hormone production.

In addition to hormones involved in our stress response, the hypothalamus also produces important hormones that are key regulators of our reproductive system. Two of these are gonadotropin-releasing hormone (GnRH) and thyrotropin-releasing hormone (TRH).

GnRH production signals to the pituitary gland to produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH then work downstream to stimulate estrogen and progesterone production in the ovaries. TRH directly influences brain signaling to the thyroid gland, by triggering thyroid-stimulating hormone (TSH) production and thyroid hormone production.

Cortisol dysregulation impacts signaling of these regulatory hormones beginning at the top of the reproduction and thyroid hormone cascades. Disruption to hormone signaling and thyroid function both can result in irregular periods.

 

The Effect on Ovulation

Adequate FSH and LH production are required for ovulation during the menstrual cycle. FSH triggers the follicles in the ovaries to grow. This helps us prepare for ovulation and potential egg fertilization. These follicles also release estrogen, leading to a steady increase in estrogen levels during the follicular phase.

Around mid-cycle, a sharp rise in LH stimulates the release of the egg (aka ovulation). Once these levels come back down, our ovaries begin producing progesterone. Chronically elevated cortisol levels blunt optimal FSH and LH production, so we don’t get the brain-ovary signaling needed for follicle development and successful ovulation. Without this, our ovaries don’t get the correct triggers to produce estrogen and progesterone.

This can result in anovulatory cycles, in which you menstruate but do not ovulate. This can also result in abnormal cycles, in which cycles are shorter than 28 days or longer than 32 days. All of these factors affect fertility and overall reproductive health. 

 

The Effect on Estrogen and Progesterone

As you can see, cortisol and HPA axis dysfunction significantly impact estrogen and progesterone. Without the proper signaling, our ovaries are not able to make adequate progesterone and estrogen. 

Our adrenal glands also produce estrogen and progesterone, although not nearly as much as the ovaries during the reproductive years. Cholesterol is the main precursor needed to produce these hormones, as well as cortisol. In order to keep up with high cortisol production, the adrenal glands will utilize resources (cholesterol and minerals like sodium and potassium) first and foremost to produce cortisol versus estrogen or progesterone.

Symptoms of low estrogen include irregular periods, with cycles typically being longer than 32 days. In the case of low progesterone, cycles are typically shorter than 28 days. Other symptoms of low estrogen and low progesterone are similar, including headaches, hot flashes, mood changes, depression, anxiety, and more.

Both estrogen and progesterone are so critically important for reproductive health, in addition to brain health, bone health, and thyroid function. 

 

Assessing if Cortisol May be Impacting Your Menstrual Cycle

Along all aspects of the reproductive hormone cascade, cortisol levels significantly impact period regularity. Irregular periods are a good indicator of reproductive health, and overall health as a whole! 

Assessing cortisol levels is key to help better understand the role of the nervous system as a potential root cause of irregular periods. This is not limited to psychological or mental and emotional stressors. Physiological stressors such as blood sugar imbalances, excessive exercise, energy or nutrient deficiencies, poor sleep, gut microbiome imbalances, viral infections, mycotoxin or mold exposure, all can be underlying drivers of chronically elevated cortisol. 

We address all of these factors according to your individual needs in our 1:1 coaching program. After assessing your symptoms, we use advanced functional medicine testing to gather data that provides insight into your hormones and daily cortisol levels, called the diurnal cortisol pattern. Apply for our waitlist today to be the first to know when new 1:1 coaching spots become available!

If you believe that cortisol disruption could be impacting your health, and you don’t want to wait to test your hormones, be sure to check out our DUTCH Test Package! With this insight, we can get you on an individualized path forward and begin to uncover the hidden culprits behind your irregular periods.

 

 

Written by Romana Brennan, MS, RD

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