Understanding the Impact of Stress on Women’sHormonal Health.

By Julia Haimovich, Accredited Practicing Dietitian.

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Let’s explore how stress drives hormonal imbalances and provide a comprehensive solution
to improve hormonal health in women. Many women are busy, tired, and stressed. You might
see these women as patients, friends, family members, or even experience it yourself. The
Deloitte Women at Work survey found that women globally are struggling with high daily
stress levels, leading to significant health consequences.1 For instance, female students
experiencing high stress are almost three times more likely to experience PMS and twice as
likely to suffer from dysmenorrhea.2

Stress impacts a woman’s hormonal health through several mechanisms. The hypothalamic-
pituitary-adrenal (HPA) axis, the hypothalamic-pituitary-ovarian (HPO) axis, and the
hypothalamic-pituitary-thyroid (HPT) axis are interconnected pathways influenced by stress.
Prolonged stress increases HPA axis activity, affecting hormone synthesis in the brain and
ovaries and leading to pathological inflammation within the myometrium. Elevated
glucocorticoids, like cortisol, promote neurotransmitter imbalances linked with mood
changes, cognitive function, and pain processing, influencing conditions such as PMS,
PMDD, PCOS, perimenopause, and dysmenorrhea.3

Elevated cortisol can increase prostaglandin synthesis within the myometrium, heightening
pain perception. To address this, targeting stress response is crucial. Magnesium regulates the
HPA axis and cortisol secretion, along with nutrients like pyridoxal 5-phosphate (Vitamin B6),

Inadequate magnesium intake is prevalent among women, and oral contraceptives can deplete
magnesium levels. Magnesium deficiency is linked with PCOS, PMS, and worsening
perimenopausal symptoms. Supplementing magnesium has shown significant improvements
in symptoms. For example, 250 mg of magnesium daily, alone or with Vitamin B6,
significantly improves PMS symptoms. Vitamin B6, essential for neurotransmitter synthesis,
works with magnesium to maintain healthy intracellular magnesium levels.5

Zinc is also crucial for hormonal health. Women with PMS have lower serum zinc levels, and
zinc deficiency leads to dysregulated glucocorticoid secretion and HPO axis disturbances.
Administering 30 mg of zinc daily over 12 weeks improves PMS symptoms and promotes
healthy central nervous system activity.6

Thyroid health significantly influences hormonal balance. Thyroid hormones affect
reproductive tissues and sex hormone availability. Stress-induced HPA axis overactivity can
disturb thyroid hormones, altering cycle length and blood flow. Supporting thyroid function
with nutrients like myoinositol, iodine, magnesium, and selenium. These nutrients
support thyroid hormone synthesis, secretion, and activity.7

Endocrine-disrupting chemicals (EDCs), like BPA, further complicate hormonal health. BPA
disrupts glucose metabolism and insulin sensitivity, contributing to PCOS development.
Enhancing liver detoxification of estrogen and EDCs is crucial. This requires optimal thyroid
function and nutrients like Vitamin B6, Vitamin B12, folate, and magnesium. 8

Insulin resistance and hyperinsulinemia are prominent in PCOS, driving hyperandrogenism
and metabolic abnormalities. Nutrients like chromium and magnesium support insulin
receptor function, signalling, and glucose uptake. Myoinositol, found in grains, seeds, and
beans, enhances insulin sensitivity and supports ovarian function. Studies show that 4 grams
of myoinositol daily, combined with 400 mcg of folic acid, improves fertility outcomes in
PCOS patients.7

This strategic approach incorporates stress management, thyroid support, liver
detoxification, and nutrient supplementation, promotes hormonal balance and overall well-
being in women.

References:

1. https://www.deloitte.com/global/en/about/press-room/women-work-report-shows-
   stagnating-progress-outside-workplace.html
2. Rafique N, Al-Sheikh MH. Prevalence of menstrual problems and their association
   with psychological stress in young female students studying health sciences. Saudi
   Med J. 2018;39(1):67-73. doi:10.15537/smj.2018.1.21438
3. KR N, R N. Hormones of HPG-axis and their Active Role during Chronic Stress and
   PCOS Induction: A Review. Int J Sci Basic Appl Res. Published online 2022.
4. Shahmoradi S, Chiti H, Tavakolizadeh M, Hatami R, Motamed N, Ghaemi M. The
   Effect of Magnesium Supplementation on Insulin Resistance and Metabolic Profiles
   in Women with Polycystic Ovary Syndrome: a Randomized Clinical Trial. Biol
   Trace Elem Res. Published online 2023:1-6. doi:10.1007/s12011-023-03744-7
5. Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of
   magnesium and magnesium plus vitamin B6 supplement on the severity of
   premenstrual syndrome. Iran J Nurs midwifery Res. 2010;15(Suppl 1):401-405.
6. Siahbazi S, Behboudi‐Gandevani S, Moghaddam‐Banaem L, Montazeri A. Effect
   of zinc sulfate supplementation on premenstrual syndrome and health‐related
   quality of life: Clinical randomized controlled trial. J Obstet Gynaecol Re.
   2017;43(5):887-894. doi:10.1111/jog.13299
7. Payer J, Jackuliak P, Kužma M, Džupon M, Vaňuga P. Supplementation with myo-
   inositol and Selenium improves the clinical conditions and biochemical features of
   women with or at risk for subclinical hypothyroidism. Front Endocrinol.
   2022;13:1067029. doi:10.3389/fendo.2022.1067029
8. Fowler, P. A., Bellingham, M., Sinclair, K. D., Evans, N. P., Pocar, P., Fischer, B., … &
   O’Shaughnessy, P. J. (2012). Impact of endocrine-disrupting compounds (EDCs) on female
   reproductive health. Molecular and cellular endocrinology, 355(2), 231-239