Chronic stress is a prevalent and common issue that impacts both mental and physical health. One of the most significant impacts of chronic stress is it can change a person’s hormonal balance. Hormones are the body’s chemical messengers, which tell various parts and systems of the body to work properly or perform other functions. These levels can reach imbalance under stress. Chronic stress is different than an immediate stress such as being frightened which can spike adrenal, it’s a long-term condition that can drive several hormonal disorders.  

When the body is under stress, it activates a system that controls the release of stress hormones such as cortisol and adrenaline. While this response is beneficial in short-term situations, such as if the person is in danger and needs to flee, chronic stress can lead to prolonged activation of these hormones which can create longer-term elevated cortisol. This can disrupt the balance of other hormones and contribute to several health conditions. 

Four Common Hormonal Conditions Affected by Chronic Stress 

  1. Thyroid Disorders: Stress can affect thyroid function by altering the levels of thyroid hormones. Hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can both be exacerbated by chronic stress. Patients with either condition might show various symptoms like weight changes, fatigue, and mood disturbances. 
  1. Diabetes: Chronic stress influences blood glucose levels through the release of cortisol and adrenaline. These hormones increase blood sugar levels, which can worsen diabetes control and increase the risk of complications. Doctors will closely monitor a patient’s reported stress levels in addition to their insulin levels and propose lifestyle changes that can reduce stress. 
  1. Polycystic Ovary Syndrome (PCOS): Stress can exacerbate the symptoms of PCOS by increasing insulin resistance and androgen levels. This can present in the form of weight gain, irregular menstrual cycles, and fertility issues that might prevent pregnancy unless they are properly addressed, and stress reduced.  
  1. Menopause: Stress can worsen menopausal symptoms such as hot flashes, sleep disturbances, and mood swings by affecting the balance of estrogen and progesterone. 

Endocrinologists are medical specialists who diagnose and treat hormone-related disorders. Their expertise is vital in managing conditions that are worsened by chronic stress. Endocrinologists use a combination of medical history, physical examinations, and laboratory tests to diagnose hormonal imbalances accurately. They will also talk to their patients to better understand their daily routines and uncover common stressors, whether that is family dynamics, work frustrations, or a lack of exercise. Armed with clinical data and context from talking to their patients, endocrinologists can then distinguish between primary hormonal disorders and those influenced by stress. 

Treatment of stress-related hormonal conditions requires a personalized approach. Endocrinologists create tailored treatment plans based on the individual’s specific hormonal imbalances, overall health, and lifestyle factors. This may include medication and lifestyle modifications. Endocrinologists often work with patients to develop effective stress management strategies, which can include mindfulness practices, exercise, and cognitive-behavioral therapy. 

Hormonal conditions often require ongoing management and adjustment of treatment plans. Endocrinologists provide continuous monitoring to ensure they adjust treatments based on the patient’s progress and they also employ the latest innovations and medications. Monitoring effectively requires doctors to communicate with and educate patients about their condition and the treatment regimens. This empowers and engages patients, so they gain some control over their health and develop a partnership relationship with their doctor and care team.  

Dr. Brian Fertig, a noted endocrinologist and Founder and President of the Diabetes & Osteoporosis Center in Piscataway, New Jersey, is an expert in managing hormonal conditions, including those caused by or made worse by chronic stress. Dr. Fertig explores stress in his two-part book series titled “Metabolism & Medicine,” that explores the relationship between metabolic processes and overall health. He discusses how stress impacts hormone levels and can lead to chronic diseases.  

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