Cortisol is a hormone produced naturally by our bodies, is essential to our health, and is often called the “stress hormone.” Chronic cortisol elevation can wreak havoc on the delicate balance of our hormones, and the adverse effects of excess cortisol can be far-reaching.

Long-term stress can cause too much cortisol to be released, increasing your risk for high blood pressure, type 2 diabetes, high blood pressure, weight gain, especially around the belly, osteoporosis, and many other chronic diseases.  It is critical to balance cortisol levels throughout our lives, especially during menopause.

When estrogen and progesterone decline in menopause, that can lead to chronic high cortisol levels (hypercortisolism). The yoyoing of hormones during menopause can contribute to anxiety and increase the risk of many chronic health conditions if hormone deficiencies are not corrected.

This article will help identify how chronic cortisol levels can be related to the drop in menopausal hormones and can worsen menopause symptoms.

What is Cortisol

Simply put, cortisol is the hormone that gets us up in the morning. It is at its highest levels in the morning and motivates us to get out of bed. Cortisol drops in the evening, and we start to slow down.

Cortisol is produced by the adrenal glands and affects most parts of our body, including muscles, bones, heart and blood vessels, lungs, and even your brain. Almost every cell in the body contains receptors for cortisol, and as a result, changing cortisol levels can impact how all body systems operate.

Cortisol plays a vital role in the body’s stress response and is often called the stress hormone. Glands release very high cortisol levels when you are threatened or if you perceive a threat. In order to keep yourself safe, your body releases cortisol. This rush of cortisol release is the “fight or flight response.”

An example of the fight or flight response would be when your cortisol levels skyrocket if a bear is chasing you. Interestingly, if someone cuts you off in traffic, cortisol can start to climb then too. In either situation, cortisol jumps to prepare you to stay and deal with the problem (fight) or escape (flight).

Cortisol is a powerful hormone that needs to stay properly balanced. When cortisol levels are too high and too high for a long time (chronically), we can have serious side effects. Chronic stress can cause a persistent elevation of cortisol and can lead to health problems.

Cortisol and Menopause

When you feel stressed, even just a little, your body naturally releases cortisol. Menopause symptoms can trigger that same stress response that signals an increase in circulating cortisol levels. The more stressed you are, the more symptoms you have, the more cortisol is released, and on goes the cycle ’round and ’round.

As we age, starting at about 35 years of age, we women produce smaller quantities of estrogen, progesterone, and testosterone, leading to loads of menopause symptoms. These symptoms can put women in a constant state of stress. The menopause symptoms that cause the most significant increase in stress include weight gain, hot flashes, night sweats, and poor sleep.

Before menopause, our bodies were typically pretty good at buffering cortisol and stress because we had the proper progesterone levels. Progesterone is often called the “feel good” hormone, and it helps to keep our cortisol levels under control. Once progesterone levels decrease with perimenopause, cortisol is less ‘buffered,’ and we feel the stressful effects.

When cortisol levels jump, this can decrease progesterone’s positive impacts on the body and lead to a whole host of symptoms. High cortisol can cause what some people call ‘adrenal fatigue.’ Adrenal fatigue isn’t a disease, and it’s a group of symptoms that are also symptoms of perimenopause:

  • Fatigue & low energy
  • Weight gain – especially storing fat on the belly.
  • Brain fog
  • Anxiety, depression & low mood
  • Insomnia
  • Hot flashes and night sweats
  • Cravings for unhealthy foods
  • Digestion problems like bloating
  • Low sex drive
  • More aches and pains

Worsening Menopause Symptoms

Cortisol levels increase with age, specifically from a woman’s 40s onward. Menopause symptoms may cause this increase in cortisol, worsening menopause symptoms.

Our hormones have to work together and balance one another to maintain balance. If one hormone is too high, it can throw off the whole system. During menopause, our bodies are doing their best to adapt. However, our hormones cannot always keep up with this array of changes.

Menopause causes the yoyoing of estrogen, progesterone, and testosterone levels, but the additional change in cortisol levels can affect cognitive function, heighten depression and anxiety, and lead to panic attacks. Often described by women as “brain fog,” these mental changes can make it disturbingly difficult to remember even the simplest things.

One of the women’s main concerns with peri- and menopause is weight gain. Cortisol manages how your body uses (metabolizes) carbohydrates, fats and proteins, and controls your sleep-wake cycle. We know without enough sleep, people gain weight steadily.

Raised cortisol causes increased blood sugar and can lead to comfort-eating and weight gain. The increased incidence of Type 2 Diabetes and heart disease with menopause is associated with these excess cortisol levels and increased weight and cholesterol levels.

Does HRT Help Treat High Cortisol Levels in Menopause?

While we all have high cortisol from time to time, having high cortisol over a long period can have lasting effects on your health. High cortisol levels don’t just make you feel stressed out or cause symptoms like fatigue; they can significantly impact your health and be a vicious cycle.

Hormone Replacement Therapy (HRT) can play a crucial role in increasing progesterone, reducing cortisol levels, and alleviating stress, so those menopause symptoms don’t get out of control.

Beginning HRT can help reduce symptoms of menopause AND keep cortisol levels in control. Built-up chronic stress can further deplete the already decreasing levels of estrogen, progesterone, and testosterone that generally occur during menopause.

The good news is that you can reduce unwanted menopause symptoms like weight gain, hot flashes, and mood changes by reducing your stress levels. Conversely, when you have untreated menopause symptoms, they can impact your health by increasing stress levels. And again, here goes the cycle.

Studies show how critical cortisol levels are in sleep-wake patterns, eating, physical activity, and basically how a person adapts to challenges in life. When women are on HRT, they have lower cortisol levels, react more calmly to stress during and after menopause, and have improved quality of life.

How to Normalize Cortisol Levels

  1. HRT – HRT is available as an oral tablet, a topical lotion, or a patch and can counteract the effects of excess cortisol.
  2. Healthy Sleep – Keep your sleeping and waking time the same each day, try to get at least 7 hours of uninterrupted rest, and limit electronics use before bedtime.
  3. Exercise – Regardless of which kind of exercise you choose, exercising throughout menopause reduces stress and helps improve cortisol levels.
  4. Diet – Focus on a diet that doesn’t cause spikes in your blood sugar. Spikes in sugar can cause cortisol spikes too.
  5. Relaxation – Relaxation practices can reduce cortisol and stress levels. Try deep breathing exercises and meditation.
  6. Cut Back On – You don’t have to get rid of them completely, but reducing alcohol and caffeine can significantly reduce cortisol levels.


Your cortisol level, if not balanced, can adversely impact your life, but effective menopause treatments like hormone replacement therapy (HRT) are available to help you. With support from Winona, you have the opportunity to take preventive action against health risks as we age.

Hormone replacement therapy is a safe and natural way to regain your vitality and restore proper hormone levels using bioidentical hormones identical to those produced by your own body. Winona’s healthcare platform is a place to connect with a healthcare provider to receive the quality care you deserve.

Winona is dedicated to women’s wellness. Our providers take the time to listen closely and understand what you’re experiencing. They collaborate with you to design a personalized treatment plan. Go online now and interact with our doctors about your symptoms. Winona is here for you!

Safe, natural, bio-identical HRT is available to everyone with Winona if prescribed. Women created Winona for women and their partners and families. Reach out to our Winona physicians for your free consultation today at


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