If you’ve heard of cortisol, you probably know it as “the stress hormone.” In many ways this is an apt description of cortisol––its primary job is to regulate your body’s stress response. There’s a lot more to cortisol than that, however, and that’s what we’re going to explore today.

First, we’ll give you a rundown of what cortisol is, how it works, and why we have it in the first place. Then you’ll learn how this hormone works in the female body, specifically, and why it’s something you need to be aware of.

Finally, we’ll go over a few strategies for keeping your cortisol levels where they need to be. This actionable advice will help you in more ways than the physical ones. We’ve spoken with experts in the field of women’s health and endocrinology to make sure you get the insight and perspective you need to manage your body’s cortisol response for the long term.

Hello, Cortisol, My Name Is…

Your body is not a monolith. In fact, it’s one of the most complex systems on earth, and it’s kind of incredible that it works at all. With so many parts and pieces working in harmony, it seems like an impossible task to get through even one day without a catastrophe.

But here we are! And as it happens, a big part of our ancestors’ ability to survive was (you guessed it) cortisol. 

Most of us have heard about cortisol’s role as the stress regulator. And in a nutshell, yes, that is this hormone’s primary function. But limiting that role to our modern idea of “stress” keeps us from understanding the bigger role this chemical plays in our day-to-day lives. 

Stress to us might mean our job, kids, families, and fiscal situations. To our ancestors it meant a lot of other things. Stress wasn’t just about lions and bears, and it wasn’t always a negative thing. Stress was the sense that it was time to migrate to a new foraging ground, or to keep an extra eye on our kid because there’s something a little off about their color right now, and maybe they’re getting sick or need a certain kind of food…

It was more of a motivator, an alert-system, than a stressor. And in a sense, it still plays that role. Cortisol plays a big role in regulating our fight or flight response, but it’s also a major reason we’re able to notice certain things and filter out others. Think of it as a manager, and a bunch of specific organs and body parts look to it for guidance on what to do in a given situation.

Your cortisol levels help your body determine whether you’re in a time of plenty or famine. Your metabolism looks to it for guidance, then speeds up or slows down based on the information it gets. 

Cortisol helps your body decide which bodily functions are important and which one can be relegated to the “background” at a given time. If cortisol levels are elevated, your body decides that there are important, possibly threatening things going on––it dials down non-urgent functions like white blood cell production and blood flow to your extremities.

This is why, when cortisol becomes a micromanager, we run into problems. If you’re producing too much cortisol, everything starts to look like a stressor requiring a response. That response is all-encompassing yet subtle.

We spoke with Dr. Susan B. Hurson, an experienced OB-GYN who practices Functional Medicine located in Washington, DC. She takes a holistic approach to women’s health. She had some valuable insight on the roles cortisol plays in that health.

“At any given time cortisol levels will be determined by a given individual’s unique circumstances,” she told us. “Cortisol is a hormone with a huge role in regulating metabolism, immune function, and stress response; levels are controlled by the adrenal gland as a result of complex interactions between the hypothalamus, pituitary, and ovarian axis in response to any of many factors, such as sleep, nutrition, exercise, illness and emotional stress.”

Those factors are hard to quantify, sometimes, but the stakes are high. Our bodies are adapted for stress. Cortisol is a big part of that adaptation.

“The body is supremely capable of adapting to a changing milieu, but [it’s] particularly adept at managing short-term elevations in stress,” Dr. Hurson noted. Even so, “Prolonged chronic stress can result in impaired adrenal function and disordered hormone production which can be interpreted as ‘adrenal fatigue’ manifested by exhaustion, impaired immunity, altered metabolism and mood changes, such as feeling ‘tired and wired.’”  

Most of us haven’t really learned to pay attention to the reactions our bodies have beyond the obvious ones. This is especially true for women. In fact, we’re often told to purposely ignore our bodies’ signals. That ‘tired and wired’ feeling is important, but we’re used to ignoring it. We rarely consider the possibility that it’s genuinely worth noticing.

And guess what? Cortisol doesn’t like that. Your body doesn’t like that. Let’s talk about what, exactly, both of them do when you ignore them.

Excuse Me, But Are You Listening?––The Awkward Relationship Between Women And Cortisol

You know that feeling you get when you’re in a meeting and you introduce an idea, only to get ignored? And then the guy next to you rephrases that idea five minutes later, and everyone nods and writes it down like it’s the most original thing they’ve ever heard?

Well, cortisol is usually us in that situation, and we’re the room full of dudes.

Let me explain. Say there’s some kind of wildly inappropriate power imbalance at work. Crazy, I know. Or hey, let’s imagine a hypothetical situation where you somehow come home from work every day and proceed to spend hours doing…well, more work. Your partner and kids––not so much.

Cortisol shows up to say, “hey, this is NOT right, and your environment is super unhealthy.” Instead of listening to that voice, you say that you’re stressed. That’s it. It’s normal to be stressed! Maybe you even say that stress is a good thing! It’s silly to be anxious about “normal life stuff.” The problem is definitely you, not the people, events, and systems around you.

Cortisol says, “excuse me, are you even listening? I SAID THERE’S SOMETHING WRONG WITH THIS PICTURE.” And the cycle begins again.

There are a number of issues with women’s typical response to elevated cortisol levels, number one being the common habit of a) not knowing how our body works or why it reacts to things and b) not taking the time to actually feel our physical sensations or connect them to our mental processes (such as anxiety, frustration, irritability, etc).

In their book Burnout: The Secret To Unlocking The Stress Cycle, Drs. Emily and Amelia Nagoski talk about the way our bodies process stress on both a physical and mental level. Most of us fail to listen to our bodies. We try to reason away the stress, or treat the symptoms in short bursts without admitting that the underlying problems are much larger than that.

Dr. Hurson gave us a good summary of how high cortisol levels can impact our health. It’s a summary that’s worth reviewing. When cortisol levels are continually elevated, the results include things like:

• Seemingly inexplicable weight gain or “bloating” around the abdomen
• Mood swings, irritability, and a reduced capacity for empathy or compassion
• Higher blood pressure and an increased resting heart rate
• Insomnia, including a reduction in the quality of sleep (not just less of it)
• Consistent, noticeable fatigue
• Headaches, sometimes in the form of migraines
• Random and frequent bruising
• Reduced immune response, resulting in your getting sick more often
• Reduced ability to concentrate, even on things you normally enjoy doing
• Muscle weakness, tremors, and/or loss of coordination

There are many other calling cards that indicate elevated cortisol levels, but the principle is this: if you ignore the environmental stressors your cortisol is trying to draw your attention to, it will simply shout louder. It’s as if, rather than seething in the background, you jumped up in the middle of that meeting and started beating the people over the head with your notepad. 

Cortisol doesn’t take anyone’s excuses. Not even yours. And for most women, there’s plenty of excuses coming our way. Until you address the environmental problems and handle that instinct for change, guess what? Your cortisol will continue to shout. It’s trying to protect you and make sure you are in a healthy, reasonably secure place.

You may notice your periods stopping or changing schedule. You might get acne long after your awkward teenage phase ended, or you may notice your skin suddenly getting thinner. Your body will feel like it’s aging at an accelerated pace, and this kind of thing only adds to the tension and stress you’re feeling each day.

And for women, with our notoriously complex endocrine system, cortisol is really, really loud. So, how do we listen to it?

Okay, I’m Listening––Strategies For Addressing Cortisol’s Complaints

Keeping your cortisol levels in balance is about more than mere stress management. In fact, it might be more useful to think of the goal as self-management, or environmental management.

Now, it may not be realistic for you to quit your job, hire a nanny, and fly off to live in the Maldives. So when we say “environmental management,” we’re usually talking about more subtle changes. And yet these subtle changes are at the heart of true progress, and that progress goes beyond stress.

If cortisol is our built-in alarm system, maybe we need to start playing the role of heroic fireman rather than the damsel in distress. That heroism usually involves confrontation, whether it’s with ourselves or with the people around us. 

The usual advice for lowering cortisol levels usually sounds something like this:

• Eat better
• Exercise more
• Write in a journal
• Go outside
• Take vitamins
• Get more sleep
• Meditate
• Take deep breaths (yes, really)

These tips are fine, in and of themselves. All of these techniques are great ways to achieve some temporary relaxation.

Long-term, though? They’re like slapping a band-aid on a knife wound. If your environment causes you constant stress, the problem probably isn’t you. Did your ancestors blame themselves for a sudden lions-and-bears population boom? Did they meditate when they noticed the signs of an impending hurricane?

Considering the fact that you’re alive, and said ancestors were also alive long enough to pass on their genes, we’re going to guess that they handled the situation instead of ignoring it. If that sounds like tough love, that’s because it is! 

Over time, elevated cortisol levels can cause more than minor problems. It’s linked to a higher likelihood of cancer, heart attack, and stroke. It shortens our lifespans and eats away at our health. Women should take their stress seriously, along with all the signals their bodies are sending them about what is causing that stress.

So, our advice for managing your cortisol levels is this: be courageous. Cortisol might not be asking for much, after all. Usually our modern lions and bears aren’t really lions or bears. Or hurricanes. You don’t need to migrate, you need to set boundaries. Enforce the rights you have over your time, your labor, your emotional giving. 

And yes, if you’re in an overwhelming situation where your boundaries aren’t being respected, you may need to consider drastic action. Cortisol tells us when something is wrong. It isn’t our enemy. It’s our ally (most of the time). Even when our cortisol levels go a bit haywire due to normal menopausal changes or, disorders like anxiety, depression, or PTSD, they’re still telling us that something needs to be addressed.

These things aren’t easy, but neither was running away from a lion-infested savannah, or facing a food shortage that necessitated a big change of scenery. You don’t address stressors because it’s merely the right thing to do, or an act of self-care. You do it as a matter of survival. Only then can you benefit from stress-release tactics like cardio or mindfulness.

Next time cortisol is shouting, stop and say, “okay, I’m listening.” It might just save your life (and your career, and your relationships, and your marriage…you get the idea).