Understanding the Link Between Stress and Perimenopause

by Brie Wieselman, LAc, MTCM |

Understanding the Link Between Stress and Perimenopause

Stress – we’re all living with it, and you don’t need me to tell you stress isn’t great for your health.  Women in or near perimenopause need to pay a special attention to stress. Research proves that chronic stress triggers the hormonal symptoms of perimenopause such as hot flashes, PMS, weight gain, lowered sex drive, and general well-being

But it’s not simple to get rid of stress. As a long-time health practitioner, my goal isn’t to help my clients eliminate stress, but rather teach them strategies to better manage stress. 

This is highly important when we switch to the perimenopause and we are already coping up with hormonal shift. Nobody is ready for managing stress, blood sugar imbalances, and inflammation at this phase.

I’m not going to request you to join a yoga class or lower your workload. Targeted use of the correct bioidentical hormones, herbs, and adrenal support supplements regulates your body’s response to stress so you can enjoy a smooth transition through menopause.

Today, let’s explore what stress and menopause do to the body on a hormonal level, and what we can do to better support the body for more energy, fewer hormonal symptoms, and a better life. 

How Stress Impacts Your Hormones

When I say “hormones” I don’t just mean your sex hormones like testosterone, estrogen, and progesterone. Adrenal hormones like cortisol and DHEA have a significant role in management of sex hormones.

During perimenopause, hormone levels fluctuate, and it’s fluctuating hormones that can cause symptoms like hot flashes, mood swings, and weight gain. Research claims that stress only aggravates it.

Stress triggers the release of cortisol. This is helpful as cortisol is the “fight or flight” hormone that prepares us for stress. However when stress is ongoing, it can lead to an ongoing state of elevated cortisol. Elevated cortisol in turn depletes the hormone DHEA, which is already in a natural state of decline as we age. 

Low DHEA is a problem for anyone, but especially for perimenopausal women because DHEA is a precursor to both testosterone and estrogen. Low levels of DHEA can therefore cause low levels of both testosterone and estrogen, intensifying the already changing hormone levels during this time. 

Low DHEA & The Pregnenolone Steal

Until now, we have explored how stress increases the levels of cortisol and lowers the levels of DHEA in our body. Since DHEA is a precursor for testosterone and estrogen, it affects sex hormones.

But why does elevated cortisol deplete DHEA? The “Pregnenolone Steal” process is the reason behind this.

The basic premise of the pregnenolone steal is that pregnenolone  – a hormone produced by the adrenal gland – is a precursor for both cortisol and DHEA. When body is in high stress, it produces more cortisol, “stealing” all pregnenolone and saving none for the production of DHEA.

That’s a bit of an oversimplification, though. There are more than one pools of pregnenolone that are depleted. In reality, pregnenolone is in the mitochondria of each of the cells. Rather than thinking about pregnenolone being stolen, it’s more that the body prioritizes some pathways of hormone production that are about survival (cortisol), over reproductive hormones.

Irrespective of how it happens, the reduced release of sex hormone is inconvenient in perimenopause when we are already dealing with the hormonal shift. It makes us highly vulnerable to stress or just a little stress can make huge changes in our appearance and emotions. Issues that go simultaneously like blood sugar imbalances or some underlying infections can be a bigger problem as they are responsible for release of cortisol too.

Perimenopause and Low DHEA Symptoms

If you’re dealing with stress-related hormone dysfunction on top of perimenopause symptoms, you might feel like you’ve got the worst perimenopause of anyone you know. It can cause an intensification of already-known symptoms like:

  • Hot flashes
  • Night sweats
  • Decreased sex drive (low libido)
  • Decreased sexual pleasure
  • Weight gain/ weight loss resistance
  • Poor sleep
  • Increased cravings
  • Mood disturbances (depression, anxiety, etc.)
  • Low energy
  • Overall lack of wellbeing

So that’s the “bad news.” Now let’s talk about the good news – all the things you can do to help rebalance hormones, support your body’s stress response, and get back to feeling like yourself. 

In fact, after 1-2 months on a customized plan based on your hormone test results, most of my clients see a 75% or more reduction in symptoms. 

Can Hormone Therapy Help Low DHEA and Perimenopause? 

Visit our blog to better understand the use of bioidentical hormones during perimenopause. But in addition to sex hormone replacement therapy, supplementing with hormones like DHEA can be an option too. 

When the usage of DHEA is accurate and monitored, it becomes a safe way to lower the levels of testosterone in peri and menopausal women (women with problem of hair loss can benefit from it, too!).  But, DHEA needs to be used carefully. Androgen dominance (too much testosterone) can be a main driver for the development or worsening of insulin resistance in perimenopause. 

That’s why I always recommend testing before starting DHEA (even if it is available over the counter where you live) and on-going monitoring. I recommend a comprehensive hormone panel like the DUTCH test. 

In our clinic, use pregnenolone supplementation is complemented with DHEA. This tackles the two main problems that occur with DHEA supplementation. First, it can help offset the tendency of DHEA to lower cortisol levels, which can be a problem if someone is already dealing with low HPA output. 

Secondly, DHEA has a tendency to put weight on some people or cause water retention. Adding pregnenolone can prevent this tendency. 

Active Stress Management and Supplements

Supplementing with hormones is just one part of the puzzle – just as important, if not more, important are complementary lifestyle practices that help manage stress. 

Every client gets a bespoke plan based on some of our techniques that include:

  • Optimizing sleep hygiene (no blue light before bed, etc.)
  • Introducing movement (finding an exercise you actually enjoy– and prioritizing muscle building over cardio)
  • Circadian alignment (going to bed and rising with the sunset/sunrise)
  • Balancing blood sugar and increasing protein intake
  • Eliminating/reducing alcohol and processed sugar 

Many activities such as qi gong walks in nature, all kinds of meditation, art & drawing, community interactions, and quality time with friends and loved ones manage stress actively. 

Many issues are fully under your control like your relationships, overall workload, time management, assigns tasks and get support, and putting an end to toxic people or activities. 

These steps can help you eliminate what stress you can and better tolerate the stress you have to live with. 

A final piece of the puzzle is adaptogenic herbs and herbs for supplement symptoms. As a long-time Traditional Chinese Medicine practitioner, I’ve seen the incredible power of herbs for transforming health. Just like other potent treatment plans, they shall only be used after proper testing, diagnosis, and prescription from a licensed practitioner.

Look and Feel Your Best in Perimenopause

Perimenopause is marked as the worst phase of a women’s life… but it can be made seamless if you want it to!

If you get the perfect support around you, you will not only tackle perimenopause but also enjoy your smooth hormonal shift.

You really don’t need to deal with weight gain, poor sex drive and pleasure, hot flashes, mood swings, cravings, irritability, and various other common symptoms of perimenopause. 

Counseling women through this huge change is my interest. I am enthusiastic to help them in their life-changing phase and watch them excel in it.

If you’re interested in learning more, schedule a free 15 minute call by clicking here. We offer different programs for every need and budget, and would love to help you find the support that’s a perfect fit for you. 

Care Consideration: Just a reminder that the above information is not a substitute for medical care and is not a substitute for medical advice or recommendations from a healthcare provider.  This information is not intended to treat, mitigate, or cure any disease. That said, we encourage you to connect with an Acupuncturist in your community to learn more about this and other Traditional Chinese Medicine options. If you’ve got questions about Chinese herbal medicine or getting started with an Acupuncturist, feel free to connect with us on hello@mydaolabs.com.

California-based Acupuncturist Brie Wieselman, LAc, MTCM offers coaching services focussing on hormone and digestive needs. More information about Brie, her team, and their coaching services can be found at https://briewieselman.com.

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