Why Your Stress Feels Different When Your Hormones Change

If the holidays feel heavier than they used to, you are not imagining it, and you are not failing at self-care. For many women in their 40s, 50s and beyond, the same to-do list lands differently than it did a few years ago. Sleep breaks more easily. A small thing feels big. Your usual ways of unwinding take longer to work.

One piece of that story sits in your hormones. Here is what researchers have found so far, what they have not figured out yet, and a few simple ways to support your nervous system this season.

Your hormones and your stress system talk to each other

Estrogen and progesterone do more than run your cycle. They also influence the nervous system and brain pathways that shape how strongly you react to a hard day, and how quickly you settle afterward [1]. In the years before menopause, called perimenopause, hormone levels can swing up and down. When that conversation changes, your stress response can feel different too.

What the research suggests

• In one study of 52 women in the menopause transition, women whose estradiol swung more over 14 months reported more depressive symptoms at the end, but only if they had also been through several very stressful life events recently. In the lab, the women with bigger swings also felt more rejection during a speech and math stress task [2].
• A small pilot study of 15 perimenopausal women found that weekly estradiol swings went along with a higher heart rate during a standard stress test, plus more sadness, anger and rejection. Blood pressure and cortisol did not change in step [3].
• It is also personal. In 101 perimenopausal women, how closely a woman’s mood followed her estradiol varied a lot from one woman to the next [4].

Your body’s calming system can shift, too

Your parasympathetic system, the part often called “rest and digest,” works like a brake after stress. One way researchers measure it is heart rate variability, the small beat-to-beat changes in your pulse.

In 215 midlife women wearing monitors for 24 hours, that calming signal dipped during hot flashes, most of all during sleep, even when the women did not notice the hot flash [5]. In another study of 101 perimenopausal women, those with more frequent and more bothersome hot flashes had a blunted rise in cortisol after waking, a sign that the stress hormone system may work a little differently [6].

What this does not mean

This research is early, and many of the studies are small. It does not say that menopause makes every woman more stressed. In a large U.S. study that followed women through midlife, most women did not have high depressive symptoms, though those who did were more likely to have them during perimenopause or after menopause than before [7]. In the same large study group, perceived stress went down for most women as they moved through midlife, and menopausal status on its own did not predict it [8].

The honest takeaway: your hormones are one of several things that shape how stress feels, and the effect is different for each woman.

What helps your nervous system settle

• Slow breathing. A review of 223 studies found that slowing your breath raises heart rate variability, the same calming signal, during practice and after regular practice [9]. For sleep, slow breathing before bed improved self-reported sleep in the studies reviewed, though results measured in sleep labs were not conclusive yet [10].
• Mindfulness and yoga. In a randomized trial of 104 women in the menopause transition, an 8-week mindfulness and yoga program led to fewer depressive symptoms, less perceived stress, less anxiety, more resilience and better sleep than a waitlist group [11]. A broader review found that yoga-based practices may help mood and sleep in menopause, but it also noted that many studies were small and more research is needed [12].

Three small things to try this season

1. Breathe in for four counts and out for six, for five minutes before bed.
2. Give big days a soft landing. Keep the morning after a holiday event light, and protect your sleep window the night before.
3. Notice your patterns. Jot down your sleep, mood and (if you still have one) your cycle for two weeks. It is useful information to bring to a provider.

What comes next

At WORTHY, we have always looked at health through the nervous system. Something new is coming in January. Stay tuned for more details.

With care,
Meliza + The WORTHY Team

General education, not medical advice. Hormone, sleep and mood changes have many causes. If your symptoms affect your daily life, talk with a licensed provider.

References

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