Do you frequently feel exhausted or notice unexpected weight gain without any clear cause? Everyday stress might be to blame, indicating an increase in cortisol levels. Constantly high cortisol can result in serious health issues, particularly in women. Recognizing the signs of elevated cortisol in women can facilitate early identification and appropriate treatment.

Let’s explore the key symptoms, causes, and potential long-term effects of high cortisol in females.

What Is Cortisol and Why Does It Matter?

Cortisol is a hormone secreted by the adrenal glands that aids the body in handling stress, thus earning the nickname “stress hormone.” It is an essential ‘fight or flight’ hormone released during stressful situations or other demands. Beyond managing stress, cortisol plays a pivotal role in the following essential functions of the body:

• Metabolism
• Blood sugar levels
• Blood pressure
• Circadian rhythm (sleep-wake cycle)
• Anti-inflammation
• Heart rate

Symptoms of High Cortisol in Females

Because women experience hormonal variations throughout their lives, they are more susceptible to the effects of increased cortisol levels on their physical, emotional, and reproductive health. This can lead to various symptoms of high cortisol in women, which may include:

Physical Symptoms 

• Weight Gain: Especially around the abdomen, face (moon face), and upper back.
• Skin Changes: Easy bruising, skin thinning, and slow wound healing.
• Muscle Weakness: Particularly visible in the thighs and arms.
• Fatigue: Persistent fatigue or tiredness that does not resolve with rest.
• High Blood Pressure: Constant hypertension (high blood pressure levels) over time.
• Bone Loss: High chances of osteoporosis (weakening of bones) and bone fractures.
• Facial Hair: Unwanted growth of hair on the face or body.

Emotional and Psychological Symptoms

• Mood Swings: Irritability and emotional instability.
• Anxiety Disorders: Increased anxiety, restlessness, and panic attacks.
• Depression: Prolonged exposure can result in “anxious depression”.
• Memory and Concentration Problems: Difficulty focusing and keeping information.
• Sleep Disturbances: Insomnia (difficulty falling or staying asleep) or disturbed sleep patterns.

These symptoms can make every activity challenging and can be mistaken for other mental health conditions, delaying effective diagnosis and treatment.

Reproductive and Hormonal Symptoms

• Irregular or no menstrual cycles:
• Low libido (sexual desire)
• Infertility or challenges in conceiving
• Excessive hair growth on the face, neck, and other body parts (called hirsutism)

These symptoms are particularly bothersome for females of reproductive age and can be misinterpreted as “polycystic ovary syndrome”.

Metabolic and Digestive Symptoms

• Blood Sugar Imbalances: High risk of developing insulin resistance & type 2 diabetes.
• Digestive Problems: Indigestion, bloating, stomach pain, or irritable bowel syndrome (IBS).
• Food Cravings: Strong desire to eat fatty or sugary foods.

Note: All these symptoms can vary from one individual to another and might not always point to increased cortisol levels. Hence, proper diagnosis is crucial. 

Long-Term Complications Related to High Cortisol Levels

Long exposure to increased levels of cortisol can lead to complications such as:

• Cushing’s Syndrome: Marked by buffalo hump (fat depositin on the back), rounded face, and excess weight gain, especially around the abdomen.

• Cardiovascular Conditions: Increased risk of heart disease and dilated cardiomyopathy (weakening and enlargement of heart muscles) due to high blood pressure.

• Type 2 Diabetes: Due to increased insulin resistance.

• Chronic Fatigue Syndrome: Persistent fatigue or exhaustion.

Common Causes of High Cortisol in Women

These are the potential causes:

• Chronic Stress: Constant stress can lead to persistent high cortisol levels as the stress response system of the body stays activated.

• Adrenal Gland Conditions: Disorders such as Cushing’s syndrome can trigger the adrenal glands to release excessive cortisol.

• Pituitary Gland Abnormalities: Tumors developed in the pituitary gland can overstimulate the release of cortisol.

• Medications: Prolonged use of corticosteroid medications like prednisone and dexamethasone, and some antidepressants, can increase cortisol levels.

• Hormonal Imbalances: Hormonal disorders such as polycystic ovary syndrome (PCOS) can also impact cortisol levels.

• Poor Lifestyle Choices: Poor sleep, high caffeine and alcohol use, and unhealthy diet can stimulate high cortisol levels.

• Blood Sugar Imbalances: Frequent rise and drop in blood sugar levels can trigger cortisol release.

• Obesity: Obesity (excessive accumulation of body fat) is linked to increased cortisol levels, a study says.

• Nutritional Deficiencies: Decreased levels of vitamin D, magnesium, and omega-3 fatty acids may lead to cortisol imbalance and stress-associated problems.

• Pregnancy: Hormonal changes and the preparation of the body for childbirth can increase cortisol levels during pregnancy.

Identifying and managing the causes is key to hormonal balance.

When to See a Doctor?

If you notice symptoms of high cortisol, consult your healthcare provider. Seek emergency care if you experience:

• Broken bones without a clear cause
• Chest pain
• Sudden weakness or drooping on one side of the body
• Loss of movement, vision, or speech
• Sudden, severe headache
• Trouble breathing

Diagnosing High Cortisol Levels

Diagnoses involve recognizing physical and mental symptoms and confirming the diagnosis with some diagnostic tests.

Physical and Psychological Signs:

• Physical Signs: The healthcare providers will check for signs like unexplained weight gain, muscle weakness, persistent fatigue, easy bruising, frequent infections, etc.

• Psychological Signs: Sleep disturbances, mood swings, irritability, difficulty concentrating, depression, and anxiety. 

• Other Potential Signs: Increased appetite, irregular menstrual cycles, or low libido.

Laboratory Tests:

• Cortisol Blood Test: Performed typically in the morning to measure the cortisol levels in the blood.

• 24-hour Urine Test: Evaluates the amount of cortisol collected in the 24-hour urine sample.

• Saliva Test: Measures the levels of cortisol throughout the day, especially at the late evening (when the amount of cortisol is usually lowest.

• ACTH (Adrenocorticotropic Hormone) Stimulation Test: Check the ability of the adrenal gland to produce cortisol.

Imaging Tests:

• CT or MRI Scans: Detects tumors present in the pituitary or adrenal glands.

The proper diagnosis can help the provider determine the right treatment. 

Treatment Options for High Cortisol Levels 

The healthcare professionals can help with the following treatment options:

Medical Treatments

• Examples are ketoconazole, mitotane, and metyrapone that can lower cortisol levels by inhibiting its release by the adrenal glands.

• Mifepristone is approved for the treatment of Cushing’s syndrome who are living with type 2 diabetes, where it helps block the cortisol’s effect instead of lowering its release.

• If the cause of Cushing syndrome is prolonged use of glucocorticoids, the providers can reduce the dose while also controlling the symptoms.

Surgery

• Adrenalectomy: If an adrenal tumor is the cause, the doctors can help with adrenalectomy, involving the removal of the adrenal glands, which allows the cortisol levels to bounce back to normal levels.

• Transsphenoidal hypophysectomy: If a pituitary tumor is the cause, transsphenoidal hypophysectomy is advised, which involves the removal of the pituitary gland and is crucial when struggling with large tumors.

Radiation Therapy

• This therapy involves directing radiation beams at the adrenal or pituitary gland to destroy the tumor cells that are excessively releasing Adrenocorticotropic hormones, which are responsible for triggering the adrenal glands to produce cortisol. 

Tips to Lower High Cortisol Levels Naturally

Wondering how to reduce cortisol without medication? Try these:

• Practice stress-relieving techniques: Try deep breathing exercises, meditation, and yoga daily to manage stress.

• Get adequate sleep: Research shows that lack of sleep can contribute to high cortisol levels, so get 7 to 9 hours of good sleep every day.

• Consume a balanced diet: Eat lean proteins, healthy fats, whole grains, vegetables, and fruits, and avoid excessive processed and sugary foods.

• Consume a balanced diet: Eat lean proteins, whole grains, vegetables, fruits, and healthy fats while avoiding excessive intake of processed and sugary foods.

• Exercise regularly: Practice moderate-intensity activity like walking, cycling, or swimming.

• Limit caffeine and alcohol: Limit or avoid these substances, particularly in the late afternoon and evening.

• Stay hydrated: Drink a lot of water, as dehydration can stimulate cortisol spikes.

• Take supplements: Have vitamin C and magnesium supplements to support cortisol levels.

• Follow good sleep hygiene: Sleep and wake at the same time each day and avoid electronic devices before bedtime.

• Use adaptogens (under medical guidance): Try herbs such as ashwagandha or rhodiola to balance stress hormones.

Final Thoughts

Recognizing the symptoms of high cortisol in females early is crucial for maintaining overall health and preventing long-term complications. From physical signs like unexplained weight gain and muscle weakness to emotional symptoms such as anxiety and mood swings, these warning signs should never be ignored. If you experience any of these symptoms, consult your healthcare provider promptly for accurate diagnosis and effective treatment. Alongside medical care, adopting stress management techniques and a healthy lifestyle can help keep cortisol levels balanced and support your well-being.

Frequently Asked Questions