The stress response is the body’s natural reaction to situations that may be overwhelming, frustrating, or nerve-wracking. Stress begins with the brain, as it identifies stress as well as the behavioral and physiological response to take. (9) Hormones, such as adrenaline and cortisol, are released as a part of the stress response. (5)
Changes in hormone levels can impact many body systems, including the immune system and reproductive system. (7) Keep reading below to learn more about stress and female hormones and its role in hormone imbalance.
3 stages of stress
In response to stress, the brain triggers the fight or flight response, which causes the adrenal glands to release several hormones. The adrenals sit atop of the kidneys and are only the size of a sugar cube; weighing as much as three to four paper clips, but they can dramatically affect how we feel. (13) Generally the stress response has three stages, with different hormones and hormone levels impacting each stage. Acute stress is represented by stage one, while stages two and three develop after prolonged stress.
1. Alarm
This is the initial stage of the stress response that triggers fight or flight-related body changes. Hormones that increase adrenaline (epinephrine and norepinephrine) are released as an immediate response to a stressor. These hormones put the body in fight or flight mode by:
- Increasing blood pressure and blood sugar (glucose)
- Increasing heart rate
- Increasing oxygen consumption
- Redirecting energy use to support the stress response
- Sending more blood and oxygen to muscles (5)(19)
These bodily changes make you feel alarmed, alert, and reactive, and allow you to perform more strenuous activity than normal. (5)
At the same time as adrenaline kicks in, cortisol release is being triggered at a slower, yet timely, rate. Cortisol supports the effects of adrenaline by signaling the body to conserve energy and dedicate resources to the stress response. Cortisol suppresses the immune system, which restricts the growth and healing of cells and wounds. (5)
When the brain communicates that the stressor is gone, cortisol release should stop and the effects of stress hormones should begin to subside. (13)
2. Adaptation
If stress is repeated or ongoing, your body adapts to sustain its heightened state. The immune system remains suppressed and other organ systems begin to adapt to stress too. The digestive system will adapt to this high-stress state by decreasing hunger cues and using less energy for digestion, for example. This can speed up digestion time and limit nutrient absorption.
Remaining in a constantly stressed state can cause fatigue and negatively affect focus, memory, and mood. (5)
3. Exhaustion
Long-term hormonal imbalances related to cortisol and other stress hormones are exhausting on the body. Other functional and chemical changes occur to help maintain this stressed state. Body systems that rely on hormones, such as the reproductive system, begin to lose optimal function. (5)(19) Increased anxiety, depression, hunger, and fatigue may occur. (5)(20)

Stress and hormonal health
Hormones from the endocrine system are involved in necessary processes related to virtually every organ in the body. Endocrine glands, such as the adrenal gland, ovaries, and thyroid glands, produce and release hormones into the bloodstream. (11) From digestive hormones to sex hormones like testosterone and estrogen, stress can impact hormonal balance. This can interrupt normal body functions and cause emotional, mental, and physical symptoms. (17)
Ghrelin
Ghrelin is a hormone that regulates our appetite by stimulating hunger. Ghrelin levels increase when the body is in an energy loss or during extended periods of stress. (6)(20)
Ghrelin increases hunger frequency, reduces the use of body fat for energy, and increases the use of carbohydrates (sugars). Ghrelin also promotes the secretion of other metabolic hormones, including growth hormone and insulin. Extended periods of high ghrelin levels increases food intake and fat accumulation, which may lead to weight gain. (3)(6)(17)
Insulin
After eating, food and beverages are broken down in the digestive tract and enter the bloodstream as glucose (sugar) to be used as energy by tissues and organs. The hormone insulin is secreted by the pancreas to facilitate this process. (4) During periods of stress, insulin secretion is reduced, which can leave blood sugar levels high. This may contribute to the development of type 2 diabetes or worsen symptoms in those already with the condition. (19)(22)
Did you know? Chronic (long-term) stress can make the body insulin resistant. Insulin resistance occurs when cells lose their sensitivity to insulin, which leads to higher blood sugar levels. (23)
Thyroid hormones
Maintaining thyroid hormonal balance is important for metabolism and childhood growth and development. Thyroid hormone increases the resting metabolic rate, which is the amount of energy needed only for the body’s basic functions, such as maintaining an adequate core body temperature. The thyroid’s influence on energy storage and use supports growth in youth and the maintenance of good health in adulthood. A thyroid that is excessively active or not active enough can lead to hormonal imbalances. (8)
Research indicates that during stress, thyroid activation is decreased, as more energy is being directed to the stress response. (7)(8)(21) This may negatively impact the thyroid long-term, triggering or worsening thyroid-related autoimmune conditions such as Grave’s disease or Hashimoto’s thyroiditis. (8) Suppressing thyroid production long-term may lead to symptoms such as fatigue, fertility difficulties, and weight gain. (12)

Gonadotropin hormones
Gonadotropin (reproductive) hormones act on the gonads (reproductive glands) to induce sex hormone production. During the stress response, the release of gonadotropins is suppressed. (17) This can disrupt normal reproductive function and hormone production, potentially causing a variety of symptoms, including:
- Anxiety and/or depression
- Lower bone mass
- Lower libido (sex drive)
- Menstrual cycle changes, including irregular periods and more severe premenstrual syndrome (PMS)
- Poor eating habits
- Reduced fertility (difficulty getting pregnant)
- Weight gain (15)(19)
Addressing stress and hormonal imbalances
Healthy lifestyle habits, including eating a balanced diet, staying active, and maintaining your weight, are effective strategies for balancing hormones. It’s also important to practice healthy stress management techniques to reduce cortisol levels and sensitivity to stress. (17) Meditation, physical activity, and social support may help reduce the symptoms of stress. (1)
There are also many supplements that may help with stress. Adaptogens like ashwagandha and rhodiola may have the ability to improve stress tolerance and reduce major functional changes related to stress. (16)
The bottom line
Stress has a significant impact on hormones, which need to be balanced for optimal health. Chronic stress can wreak havoc throughout the body, including the immune and reproductive systems. Hormonal imbalances can impact many functions, including your ability to maintain a healthy weight, conceive a baby, and tolerate stress. Reducing stress levels with healthy lifestyle habits such as meditation and regular physical activity may help reduce hormonal imbalances caused by stress.
- American Psychological Association. (2019). 11 healthy ways to handle life’s stressors. https://www.apa.org/topics/stress/tips
- Abizaid, A. (2019). Stress and obesity: The ghrelin connection. Journal of Neuroendocrinology, 31(7).
- Campbell M, Jialal I. Physiology, Endocrine Hormones. . In: StatPearls . Treasure Island (FL): StatPearls Publishing; 2022 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK538498/
- Centers for Disease Control and Prevention (2019, August 12). The Insulin Resistance–Diabetes Connection. https://www.cdc.gov/diabetes/basics/insulin-resistance.html
- Chu B, Marwaha K, Sanvictores T, et al. Physiology, Stress Reaction. . In: StatPearls . Treasure Island (FL): StatPearls Publishing; 2022 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK541120/
- Chuang, J. C., & Zigman, J. M. (2010). Ghrelin’s roles in stress, mood, and anxiety regulation. International Journal of Peptides, 2010, 1–5.
- Frick, L. R., Rapanelli, M., Bussmann, U. A., Klecha, A. J., Arcos, M. L. B., Genaro, A. M., & Cremaschi, G. A. (2009). Involvement of thyroid hormones in the alterations of T-cell immunity and tumor progression induced by chronic stress. Biological Psychiatry, 65(11), 935–942.
- Helmreich, D. L., & Tylee, D. (2011). Thyroid hormone regulation by stress and behavioral differences in adult male rats. Hormones and Behavior, 60(3), 284–291.
- McEwen, B. S. (2008). Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. European Journal of Pharmacology, 583(2–3), 174–185.
- Mullur, R., Liu, Y. Y., & Brent, G. A. (2014). Thyroid hormone regulation of metabolism. Physiological Reviews, 94(2), 355–382.
- National Cancer Institute. (n.d.). NCI Dictionary of Cancer Terms. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/endocrine-system
- National Institute of Diabetes and Digestive and Kidney Diseases. (2022, November 16). Hypothyroidism (Underactive Thyroid). https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism
- National Institutes of Health. (2002). Stress system malfunction could lead to serious, life threatening disease. https://www.nichd.nih.gov/newsroom/releases/stress
- National Library of Medicine. (n.d.). Benefits of Exercise. https://medlineplus.gov/benefitsofexercise.html
- Office on Women’s Health. (n.d.). Stress and your health. https://www.womenshealth.gov/mental-health/good-mental-health/stress-and-your-health
- Panossian, A., Wikman, G., Kaur, P., & Asea, A. (2009). Adaptogens exert a stress-protective effect by modulation of expression of molecular chaperones. Phytomedicine, 16(6–7), 617–622.
- Ranabir, S., & Reetu, K. (2011). Stress and hormones. Indian Journal of Endocrinology and Metabolism, 15(1), 18.
- Tsatsoulis, A. (2006). The role of stress in the clinical expression of thyroid autoimmunity. Annals of the New York Academy of Sciences, 1088(1), 382–395.
- Tsigos C, Kyrou I, Kassi E, et al. Stress: Endocrine Physiology and Pathophysiology. . In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext . South Dartmouth (MA): MDText.com, Inc.; 2000-. https://www.ncbi.nlm.nih.gov/books/NBK278995/
- van Loenen, M. R., Geenen, B., Arnoldussen, I. A. C., & Kiliaan, A. J. (2020). Ghrelin as a prominent endocrine factor in stress-induced obesity. Nutritional Neuroscience, 25(7), 1413–1424.
- Walter, K. N., Corwin, E. J., Ulbrecht, J., Demers, L. M., Bennett, J. M., Whetzel, C. A., & Klein, L. C. (2012). Elevated thyroid stimulating hormone is associated with elevated cortisol in healthy young men and women. Thyroid Research, 5(1).
- Wong, H., Singh, J., Go, R. M., Ahluwalia, N., & Guerrero-Go, M. A. (2019). The Effects of mental stress on non-insulin-dependent diabetes: Determining the relationship between catecholamine and adrenergic signals from stress, anxiety, and depression on the physiological changes in the pancreatic hormone secretion. Cureus.
- Yan, Y. X., Xiao, H. B., Wang, S. S., Zhao, J., He, Y., Wang, W., & Dong, J. (2016). Investigation of the relationship between chronic stress and insulin resistance in a Chinese population. Journal of epidemiology, 26(7), 355–360.