Cortisol, also known as the "stress hormone," is a vital hormone essential for many functions in the human body that go far beyond the stress response. Here are its most important functions in the body:
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Blood sugar regulation: Cortisol supports metabolism by helping to regulate gluconeogenesis, a process in which the liver produces glucose from non-carbohydrate sources (such as proteins). This is especially important during periods of fasting or increased energy demand to ensure the body continues to have sufficient energy.
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Anti-inflammatory effect: Cortisol has potent anti-inflammatory properties and helps modulate the body's immune response. In response to inflammation, the body releases cortisol to dampen excessive immune reactions and reduce inflammation. This mechanism is crucial for controlling chronic inflammation and preventing autoimmune reactions. With chronic stress—and chronic cortisol release—the anti-inflammatory effect of cortisol decreases—the body appears to become "resistant" to cortisol, causing inflammation to flare up.
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Metabolism of fats, proteins, and carbohydrates: Cortisol is involved in regulating the metabolism of all three macronutrients. It promotes the breakdown of fats and proteins into usable forms of energy and influences the utilization and storage of carbohydrates. Through these metabolic activities, cortisol helps the body mobilize and maintain energy, especially during times of stress.
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Blood pressure regulation: Cortisol supports the maintenance of blood pressure by increasing the sensitivity of blood vessels to other hormones that regulate blood pressure. This is crucial for blood circulation and oxygen supply to the organs.
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Stress response: Cortisol is fundamental to the body's ability to respond to stress. In a stressful situation, whether physical or emotional, the body increases cortisol production. This hormone then activates a series of bodily reactions that are part of the "fight-or-flight" response. It mobilizes energy by releasing sugar (glucose) into the bloodstream, improves the brain's utilization of glucose, and shuts down functions that are less important in a survival scenario, such as the digestive system.
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Sleep-wake rhythm regulation: Cortisol also has a rhythmic secretion cycle that is closely linked to our circadian rhythm. Cortisol levels are typically highest in the morning, which helps us wake up and be active. They decline throughout the day and reach their lowest levels at night, which supports sleep. Therefore, evening stressors such as workouts or too short rest periods before bedtime are counterproductive for restful sleep.
Although cortisol is necessary and beneficial in reasonable amounts, persistently high cortisol levels can cause various health problems, especially for women with PCOS.
The role of cortisol in PCOS
PCOS, polycystic ovary syndrome, affects many women of childbearing age and leads to problems such as irregular menstrual cycles, elevated levels of androgens (male hormones), and difficulty ovulating.
- Insulin resistance and cortisol
Many women with PCOS suffer from insulin resistance. This means that cells don't respond properly to insulin, leading to elevated insulin and blood sugar levels. Studies show that high cortisol levels can further exacerbate insulin resistance, which in turn increases androgen production and worsens PCOS symptoms, creating a vicious cycle.
- Adrenal androgen excess
In addition to cortisol, the adrenal glands also produce androgens. Some studies suggest that in women with PCOS, the adrenal glands may produce excessive androgens. This further exacerbates PCOS symptoms.
- Belly fat
Women with PCOS often struggle with disproportionate amounts of belly fat, despite exercise and diet. This phenomenon is partly due to hormonal imbalances associated with PCOS, including elevated androgen levels. Cortisol, produced in response to stress, among other things, can actually influence fat distribution. High cortisol levels promote the storage of visceral fat, fat that accumulates around internal organs in the abdomen. This visceral fat is metabolically more active and more harmful to health than subcutaneous fat, which is stored beneath the skin. The precise mechanism by which cortisol contributes to fat accumulation in the abdominal area is complex and involves multiple pathways. Cortisol stimulates lipoprotein lipase activity, an enzyme involved in fat storage, while also affecting appetite and cravings for energy-dense foods. Additionally, cortisol inhibits lipase activity in adipose tissue, which slows the breakdown of fat.
- Hormonal imbalance and menstrual disorders
Cortisol has a far-reaching influence on the hormonal balance in every woman. In women with PCOS, elevated cortisol levels can trigger or further exacerbate hormonal imbalance, and lead to anovulation (lack of ovulation) and cycle irregularities, which are typical symptoms of PCOS.
Symptoms of high cortisol levels in PCOS
Too much cortisol can cause various symptoms in women with PCOS, including:
- Increased hair growth and hair loss
- Acne and oily skin
- Irregular menstrual cycles
- Mood swings
- Weight gain, especially around the middle
- Sleep disorders and exhaustion
How can you lower cortisol levels in PCOS?
Reducing cortisol levels can help better manage the challenges of PCOS:
- Dietary change (not a diet!)
A balanced, protein-rich diet and limited caffeine and sugar intake can help regulate cortisol levels.
- Regular exercise
Thirty minutes a day is an absolutely sufficient level of activity that's easily achievable. Whether it's YouTube home workouts, a short run or walk, fitness classes, or independent training at the gym—any form of moderate activity helps lower cortisol and improve insulin sensitivity.
- Mindfulness practices
Techniques such as meditation and deep breathing – especially in the evening before bedtime – can effectively reduce cortisol levels.
- Sleep priority
Good sleep should be your number one priority. A consistent bedtime and a quiet sleeping environment are beneficial.
- Dietary supplements
Certain herbal supplements can help promote hormonal balance and lower cortisol levels. Active ingredients such as ashwagandha, myo-inositol, and L-glycine/N-acetyl-cysteine are particularly noteworthy.
Understanding the role of cortisol levels in hormonal issues and PCOS is the foundation for restoring hormonal balance. Evaluating, analyzing, and effectively addressing all stressors is the beginning of your journey to hormonal balance.