Stress and Menopause

You’re holding it all together – kids, ageing parents, work, home, social life, finances, staying healthy. For some women, perimenopause itself can be stressful! There’s ALOT going on, so it’s no wonder you’re feeling stressed, right?

“Stress can be defined as the response of the body to internal and external threat factors and the consequences of this response.” (1) Stress travels through our bodies via hormones in the nervous system and places pressure on our organs. This allows our bodies to adapt to those stressful changes in the environment.

Minor or short stressors may cause rapid changes, but chronic stress can cause a variety of mental and physical problems. Stress has been linked to conditions such as diabetes, high blood pressure, high cholesterol, cardiovascular diseases, cognitive disorders, depression, digestive diseases and chronic fatigue. (1)

So how does stress manifest in our bodies, and what effect can it have on menopause?

Stress in the body

Our bodies produce specific hormones to help us cope with stress – cortisol, adrenaline and noradrenaline. These are all produced in the adrenal glands, which sit nicely on top of our kidneys.

Adrenaline and noradrenaline (also known as epinephrine and norepinephrine) are the hormones that initiate the flight or fight response when we are faced with a stressful situation. They are activated when our body needs to respond quickly to a situation – the heart rate increases, as does the force of the heart contractions, which increases blood flow to the muscles and brain; the muscles around our airways relax and blood pressure increases, which helps the stress response. They also help with glucose metabolism, thus increasing energy quickly.

Cortisol is responsible for controlling the body’s use of fats, proteins and carbohydrates; it helps with inflammation in the body, regulates blood pressure and increases blood sugar. It helps with circadian rhythm (the sleep/wake cycle) and is released during stress to help boost energy.

The adrenal glands are also responsible for making androgenic steroids, which travel to the ovaries to be converted to oestrogen. (2) When we are stressed, and the adrenal glands are making lots of cortisol, it is unable to make these steroids, leaving a hormonal imbalance in the body. (3)

Similarly, oestrogen helps to regulate cortisol and keep the levels from getting too high. During perimenopause, oestrogen levels fluctuate and so cortisol is unable to be regulated as effectively as it once was. For this reason, we often experience stress more readily (4).

Is it Stress or is it Perimenopause?

Some symptoms of stress and menopause are very similar. They include:

• Pain
• Irritability
• Reduced interest in sex
• Depression
• Trouble sleeping
• Forgetfulness
• Mood swings
• Anxiety
• Weight gain

Stress comes in the form of physical stress, as well as emotional, or psychological stress. Both can play havoc with hormones, and in some cases, can even stop menstruation (for example in female athletes and women with anorexia). (5) A 2015 study found a correlation between excessive stress levels and a reduced age of natural menopause. (1)

There is still ongoing research to determine if stress contributes to early menopause.

What can we do?

If possible, the best thing we can do to cope with stress, is to remove ourselves from the stressful situation. This is not always possible, however, but there are many ways that we can help to reduce stress, including:

• Exercise – exercising promotes the release of endorphins, reducing pain and boosting pleasure, resulting in a feeling of wellbeing.
• Eat well – eat a wide variety of fruit and vegetables and keep your intake of processed foods to a minimum.
• Sleep well – make sure you get adequate sleep so that you feel refreshed during the day.
• Relax – make sure that you include regular relaxing activities to help reduce stress. Enjoy a yoga class, practice some meditation, pamper yourself with a massage, get your nails done, or sit down with a cup of herbal tea and a good book.
• Breathe – practise some deep-breathing techniques.
• Enjoy company of others – relax with friends or family and talk through anything that is worrying you.

Conclusion

Stress can be a result of menopause, or it can be a contributing factor to menopausal symptoms. Stress can affect what hormones are produced in our bodies and can present similar symptoms to perimenopause.

References

1. Choi B et al, 2015, ‘The Association between Stress Level in Daily Life and Age at Natural Menopause in Korean Women: Outcomes of the Korean National Health and Nutrition Examination Survey in 2010-2012’, Korean Journal of Family Medicine, 36(6): 305–309, viewed 18 January 2021, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666866/>
2. Johns Hopkins Medicine, 2021, Adrenal Glands, viewed 18 January 2021, <https://www.hopkinsmedicine.org/health/conditions-and-diseases/adrenal-glands#:~:text=Adrenal%20glands%2C%20also%20known%20as,stress%20and%20other%20essential%20functions.>
3. The Compounding Lab, 2004-2012, Cortisol: The Cortisol-Stress Connection & Pregnenolone Steel, viewed 18 January 2021, <https://compoundinglab.com.au/hormone-cortisol-the-cortisol-stress-connection-and-pregnenolone-steel.html>
4. Durward E, Stress and menopause: Is the menopause causing you to feel stressed?, viewed 18 January 2021https://www.avogel.co.uk/health/menopause/symptoms/stress/
5. Iliades C, 2012, The Link Between Stress and Early Menopause, Everyday Health, viewed 18 January 2021, <https://www.everydayhealth.com/menopause/stress-and-early-menopause.aspx>