Polycystic ovary syndrome (PCOS) is a condition marked mostly by hormonal imbalances. One noteworthy hormone that has a big effect on PCOS symptoms is cortisol.
What is cortisol? It’s a stress hormone! Our bodies produce cortisol to keep us alert and awake, while it produces melatonin to keep us calm and focused. When these two are balanced, life is good! You feel energized but relaxed. However, if one is out of whack, you can immediately feel “off” and the imbalance can domino into other issues.
When cortisol levels are high, we feel wired, anxious, fatigued, and, of course, stressed-out! Cortisol can disrupt SO much. Luckily, there are lots of ways to naturally heal your high cortisol levels (and other hormonal imbalances) and find symptom relief.
Note: PCOS recently had a name change! It’s now called periendocrine metabolic ovarian syndrome (PMOS.) I am a full supporter of this name change, so you’ll see me use both terms as I transition over to the new name.
Here’s what you need to know about stress hormones and PCOS:
How To Reduce Cortisol: PCOS Symptom Relief
Chronic stress feels almost inevitable with PCOS. Why? Because you’re stuck in an exhausting cycle where your PCOS symptoms contribute to higher cortisol levels and those higher cortisol levels worsen symptoms. Healthy cortisol levels will keep your alert and focused, but when they spike, it triggers a fight-or-flight response that wreaks havoc on the body! Not on’y can high stress and anxiety impact symptoms, but long term they can lead to high blood pressure, heart attacks, strokes, and hypertension. Needless to say, it’s important to learn how to manage stress and improve your mindset!
How Does PCOS Cause High Cortisol Levels?
11beta-HSD 1
Polycystic ovarian syndrome (PCOS) can cause high cortisol in several ways! First of all, studies show that women with PCOS may just naturally produce more cortisol due to changes in an enzyme called 11beta-hydroxysteroid aminotransferase type 1. (Yes, a mouthful!) This means women with PCOS as a baseline just make more stress hormones if the hormonal imbalance goes unmanaged.
HPA Axis Dysfunction
Another reason Cysters have high cortisol is because of communication issues between three organs essential for the regulation of cortisol. It’s called hypothalamic-pituitary-adrenal (HPA) axis dysfunction (another mouthful) and it prompts your system to consistently produce excess cortisol. This dysfunction can worsen because of autoimmunity, mental health problems, metabolic conditions, and heart disease.
High Androgens
Androgens are male sex hormones, and when levels are too high in a woman’s body, it can cause a number of problems, including high cortisol. This is because elevated testosterone levels disrupt the feedback loop between the hypothalamus, pituitary gland, and adrenal glands . . . meaning it can worsen HPA axis dysfunction!
Insulin Resistance
Insulin resistance occurs when our bodies struggle to convert glucose to energy, which can lead to weight gain and elevated blood sugar levels. The cell’s poor response to glucose and the rise in insulin levels alert the body that we’re in distress, triggering the production of cortisol. With more glucose circulating our bloodstream, the more our insulin-resistant cells struggle to utilize it for energy conversion. Consequently, excess glucose can be stored as fat. So, it’s a vicious cycle that has to be broken! Luckily, you can do it using natural healing methods we’ll get into next.
Progesterone Depletion
Low progesterone, which is common in women with PCOS, can also increase stress hormones. Progesterone helps the HPA axis communicate properly, so low progesterone contributes to its dysfunction and allows for uncontrolled cortisol production. Additionally, progesterone has anti-inflammatory effects, and high cortisol can also come from inflammation. Without enough progesterone to help keep inflammation at bay, your body may produce even more cortisol!
Symptoms of High Cortisol in Females with PCOS
- Anxiety
- Irritability and Mood Swings
- Depression
- Brain Fog
- Fatigue
- GI Issues
- Headaches
- Weight Gain
- Acne
- Hirsutism
- Irregular Menstrual Cycles
- Fertility Problems
- Weakened Immune System
How To Lower Cortisol: PCOS Edition
Cut caffeine.
Caffeine intake is a contributor to high stress levels! When you drink caffeine, it triggers your body to produce adrenaline and cortisol. Remember, some cortisol is good to balance out that melatonin and keep you alert but calm, especially when you are first waking up. However, things get problematic when those stress levels are too high. So, drinking tons of caffeine is not only potentially worsening your PCOS symptoms it could actually be making you more tired because of adrenal fatigue! So, reduce cortisol levels by finding alternatives to caffeine, such as setting up a morning routine, getting quality rest the night before, and taking a walk to absorb vitamin D in the morning.
Practice self-care.
Do you know what’s great for reducing stress? Doing things you love and taking care of yourself! Take time to consider how you can practice better self-care for better management of stressful situations. This one looks different for everyone, but you could try meditating, practicing deep breathing, getting creative, spending time with loved ones, or carving out time for your hobbies!
Get better sleep.
Sleep plays a huge role in hormone regulation. If you’re not getting good sleep, your body will struggle to keep hormones balanced, including cortisol. I know this can be a lot more difficult for some of us, because women with PCOS are way more likely to experience sleep disturbances than others. But, there are ways you can improve your sleep hygiene and hopefully get a better night’s rest! Here’s how to improve sleep with PCOS.
Do slow-weighted workouts.
Slow-weighted workouts and low-intensity exercises (weight lifting, yoga, pilates) are great for PCOS symptom relief and hormone balance! They allow you to keep your cortisol levels from going too high too quickly, which in turn can help to target insulin resistance and inflammation. If you’re not sure what slow-weighted workouts are, download The Cysterhood app for exercise routines specifically curated for women with PCOS!
Eat a balanced diet.
Eating a balanced diet isn’t just good for weight loss, but it’s great for hormone balance too! Getting on an anti-inflammatory gluten- and dairy-free diet can improve insulin sensitivity and reduce inflammation, which both contribute to high cortisol levels. And, don’t worry, you can still eat delicious foods while on a PCOS-friendly diet. The right foods will help you not only lower cortisol levels but eating well can help reverse a LOT of your PCOS symptoms! You can find my favorite PCOS recipes and meal plans on The Cysterhood app!
Try acupuncture.
Acupuncture isn’t just a fad or an old-timey procedure that works using only the placebo effect. There’s actually tons of studies that show that acupuncture is actually great for you in a number of ways, including reducing stress levels by activating your parasympathetic nervous system! It can also help balance hormones that contribute to stress (like insulin). Give it a try and see how you feel!
Here’s more on acupuncture for PCOS.
Take the right supplements.
Getting on a balanced diet is great for filling your body with the vitamins and minerals it needs to thrive. However, it’s hard to get EVERY nutrient your body needs in a given day. Supplements can fill in those gaps to ensure all your body functions can be carried out as usual. Two supplements are super helpful for stress hormones: omega-3 fatty acids and vitamin D!
Studies show that omega-3 fatty acids and vitamin D help by preventing 11beta-HSD 1 from converting cortisone into active cortisol, keeping stress hormones low. It also improves the functioning of the HPA axis I discussed earlier! Oh, and it’s anti-inflammatory so all the good stuff for stress. So, getting a supplement that includes omega-3 fatty acids and vitamin D can be a smart choice for Cysters!
The best supplements for PCOS are ones specifically made for your body. As a PCOS dietitian and a Cyster myself, I created Ovafit supplements with our unique needs in mind. Each supplement is NSF-certified and formulated with the highest quality ingredients! My Metabolism Plus bundle has the 4 staple supplements you need to support your PCOS goals, including vitamin D in the MetaMulti (the ultimate PCOS multivitamin) and omega-3 fatty acids.
How to Reduce Cortisol While Fasting with PMOS
Don’t fast for more than 14 hours.
I don’t recommend fasting for more than 12-14 hours. When you limit the length of your fast, you get the [words] benefits without stressing your system. Going too long without eating can make your blood sugar dip, which your body sees as an emergency. The result? A sudden spike in cortisol. Cut the fast short, and do a majority of it while you’re sleeping, if you can.
Prioritize protein with every snack and meal.
Blood sugar stability is one of the key components to keeping stress under control inside your body. To maintain balance, ensure you build every meal around lean protein. Even make sure your snacks have protein (think a hard-boiled egg or scoop of nut butter.) This helps because protein slows digestion, which allows your body to better manage blood sugar.
Stay hydrated (and add electrolytes.)
Even mild dehydration can cause your body to release more cortisol. Make it a habit to sip water throughout the day, and consider adding electrolytes if you’re sweating, exercising, or simply struggling to stay hydrated. Electrolytes help your body absorb and retain fluids more effectively, supporting healthy energy levels and helping your nervous system stay calm and balanced.
Avoid intense workouts.
Not all workouts affect our body the same. In fact, some workouts can actually do more harm than good in a PMOS body. Cortisol plays a part in how your body responds to perceived physical stress. So, intense exercises like HIIT or even sprinting can trigger your body to release cortisol and go into emergency mode. Combine that with fast? Your cortisol levels will probably be through the roof! Instead, opt for slow-weighted workouts that allow you to work out your whole body and build muscle without the stress.
Know the signs that you’re overdoing it.
Fasting should leave you feeling better, not worse. While a little hunger is normal, constantly feeling stressed, exhausted, or miserable is not. If fasting is pushing your body beyond what it can comfortably handle, cortisol can start to rise and work against many of the benefits you’re trying to achieve. Remember, the goal isn’t to fast as long as possible. It’s to improve insulin sensitivity without stressing your body out even more.
Some signs you may be overdoing it include:
- Increased anxiety or feeling on edge
- Trouble falling or staying asleep
- Waking up in the middle of the night
- Intense hunger, cravings, or food obsession
- Irritability or mood swings
- Energy crashes throughout the day
- Feeling wired but exhausted
- Difficulty recovering from workouts
- Worsening PMOS symptoms
For more information, listen to the A Cyster and Her Mister episode about intermittent fasting with PMOS.
How to Reduce Cortisol in the Morning with PMOS
Get sunlight as soon as you can.
Sunlight is one of the main regulators of the body’s stress response. So, rather than simply trying to lower cortisol, think about supporting healthy cortisol rhythms. Your endocrine system is designed to release the most cortisol in the morning and then gradually lower levels throughout the day. But if your body isn’t getting the signals it needs to know what time of day it is, that rhythm can become disrupted. Getting sunlight shortly after waking helps keep everything balanced and functioning the way it’s supposed to.
Eat at least 30 grams of protein at breakfast.
What you eat first thing in the morning can set the tone for your blood sugar and cortisol levels all day long. A protein-rich breakfast helps stabilize blood sugar, preventing the spikes and crashes that can trigger the release of additional stress hormones. Aim for at least 30 grams of protein from foods like eggs, protein smoothies, turkey sausage, or other high-protein options.
Hydrate before you drink caffeine.
After several hours of sleep, your body naturally wakes up a little dehydrated. Reaching for coffee immediately can sometimes amplify feelings of stress, anxiety, or jitteriness, especially if you’re already struggling with cortisol regulation. Instead, start your day with a large glass of water and consider adding electrolytes for extra hydration support. Giving your body the fluids it needs first can help support healthy energy levels and create a calmer foundation for the rest of the day.
Stay away from notifications for at least 30 minutes.
Whether you think so or not, all the notifications from your phone, computer, watch, and other decisions are extremely stressful. So, when your cortisol levels are at their highest first thing in the morning, don’t put gasoline on the fire with emails, text messages, news alerts, bank notifications, and all the rest. Keep it all put away for at least 30 minutes while your cortisol rhythms regulate.
How to Reduce Cortisol Levels During Pregnancy with PMOS
Keep your blood sugar stable.
Let’s be honest: eating well during pregnancy isn’t always easy. Between nausea, food aversions, cravings, and exhaustion, sometimes you’re just trying to get through the day. But whenever possible, try to build your meals and snacks around protein, healthy fats, and fiber-rich carbohydrates. Following a diet rich in whole foods while limiting processed foods can help keep blood sugar more stable, which may reduce stress on the body and support healthier cortisol levels throughout pregnancy.
Get your sleep and prioritize comfort.
When you’re expecting, expect to be more tired. There’s no shame in that. Your body really does need more sleep! Ensure you’re getting 8-10 hours of quality sleep. To make sure it’s quality, do things like stick to a consistent sleep schedule, cut electronics 30 minutes before bed, get yourself some quality sheets, and blackout those windows. However, when you’re pregnant, don’t be afraid to take it a step further. Consider getting a maternity pillow if you struggle to get comfortable (even if it feels too early.) Your sleep matters so much to your cortisol balance!
Keep gently exercising.
Movement can be a great way to manage stress during pregnancy, but now isn’t the time for intense workouts or trying to set personal records. Instead, focus on gentle forms of exercise that feel good for your body. Activities like walking, swimming, prenatal yoga, and light strength training can support healthy cortisol levels, improve circulation, and help you feel your best without placing unnecessary stress on your system.
Get outside for a walk or stretch.
Fresh air, sunshine, and gentle movement are a powerful combination when it comes to stress management. Even a short walk around the neighborhood or a few minutes of stretching on the patio can help calm your nervous system and support healthy cortisol rhythms. As a bonus, getting outside can also boost your mood and help you sleep better at night.
Read, journal, or do other stress-relieving activities.
Pregnancy comes with a lot of excitement, but it can also come with a lot of worries. That’s why it’s important to create intentional moments of calm throughout your day. Whether that’s reading a book, journaling, praying, meditating, crafting, or simply sitting quietly with a cup of tea, find activities that help you slow down and give your mind a break.
Build a strong support system.
You were never meant to do pregnancy alone. Lean on your partner, family, friends, healthcare providers, or other moms when you need encouragement or help. Having people you can talk to, vent to, and rely on can make a huge difference in how supported and less stressed you feel throughout your pregnancy journey. A strong support network can also help reduce feelings of anxiety and depression, which are common challenges for many expecting moms.
You can naturally reduce cortisol levels and relieve PCOS symptoms!
PCOS can be stressful on its own. There are a lot of symptoms that make day-to-day life with PCOS very difficult, but you can naturally reverse your symptoms by balancing hormones, reducing insulin resistance, and lowering inflammation. Talk to your doctor about taking supplements and make a plan to heal your body and finally be symptom-free with PCOS! Check out the Ovafit blog for more advice on living and thriving with PCOS!
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