Stress and PCOS

I am stressed. Sitting here writing this blog and there are a million other things running through my mind. It makes it hard to focus sometimes as it ramps up my anxiety and just makes things worse for me. It has been a while since my last post not because I was busy. In fact I wish I was busy with work, but my business is not doing well and I have been going through a downward spiral because of it. There's nothing I can do right now, or there might be but I have lost all motivation and energy to move on. I blame the stress. In the past year I have put my mind and body through a lot of stress by starting a new business and having a baby in the same year. It has taken its toll on me. I am pretty certain it is also one of the reasons I have a hard time breastfeeding my baby.

Today I want to delve into how stress can make matters worse when you have PCOS. Stress has a way of making hormones unbalanced and the body/mind miserable. For example, I should be happy. I should be grateful for a lot of things in my life, but I can't see past the things that are causing me immense stress and anxiety right now. It has a way of shutting everything down. I want to touch on this topic right now is because I recently had someone close to me say that no matter what they do- diet change, exercise, counting calories, nothing is shifting the weight. I thought her hormones might not be OK but she chimed in saying she is so stressed, she is certain that it is Cortisol (stress hormone) that is keeping her from achieving her weight loss goals. As it were I have been reading up on stress and chronic stress and stumbled on a site that explained the following:

If you’re breaking your back trying to follow the perfect low-carb Paleo diet, going to CrossFit five to six days per week, and finding yourself gaining weight, losing your menstrual function, growing hair in weird places, developing adult acne when you had clear skin as a teen, or simply feeling like a truck hit you every morning you wake up, it may be chronic stress causing your physical symptoms and hormonal imbalances.

Chronic stress is the keyword here. With Chronic stress, there are VERY high levels of Cortisol in the system ALL the time. Over exerting and under eating can do this to the body as well. It puts the body under stress so the body believes it needs to retain energy to survive and pushes our hormones over the edge again, making PCOS symptoms worse.

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Unfortunately, for us to understand how this happens I need to give a small lesson in Anatomy and Physiology.

As shown, the Adrenal glands are two small triangular shaped glands that are situated on top of the Kidneys.

These glands have a special job to do: they release hormones in response to stress. A small part of the Adrenal glands, particularly the outer part is called the Cortex. The Cortex secretes CORTISOL and Androgens (male hormones) i.e. DHEA

It is also important to know that the Adrenal glands are controlled by the Pituitary gland in the brain. The Pituitary gland controls all the hormones in the body. The particular pathway for the adrenal glands with the Pituitary gland is called the hypothalamic pituitary adrenal axis (HPA axis). You will probably hear or read a lot of things that refer to the HPA axis, but the pathway is a complicated one and will cause confusion so I won't dive deep with that one.

So why is stress bad for Women with PCOS??

Stress "Steals" Progesterone.

From my earlier posts, I explained that women who have PCOS are always low in Progesterone as they do not Ovulate, so the progesterone levels are lower in comparison to Estrogen levels. The first part of the menstrual cycle is dominated by Estrogen before it drops and allows Progesterone levels to rise and dominate the second half of the cycle. However, with PCOS this does not happen as Ovulation does not take place so Progesterone levels remain at low levels

When under stress, the body "steals" whatever Progesterone is available in order to make Cortisol as shown below.

This can only mean one thing for women with PCOS. If you are stressed, the body will take what little Progesterone you have left floating in the body to make Cortisol.

This will cause further disruption of your cycles, a decrease in fertility as embryos will not be able to implant, and miscarriage.

Natural progesterone is also a mild anti-androgen, so low levels of Progesterone means that the body has no way of counteracting the effects of the high amount of male hormones in the body. This means that testosterone related symptoms of PCOS such as facial hair and acne will get worse.

From the pathway above, it shows that the Adrenal gland will also continue to secrete male hormones as well when the body is under chronic stress. So this can mean only one thing. Male hormones and Estrogen levels will continue to climb, while progesterone levels will drop.

Now don't get me wrong, Cortisol is not ALL bad. When Cortisol is in the system due to a correct response to a stressful event i.e. not Chronic stress or Anxiety, then Cortisol works positively in the following ways:

• Manages how your body uses carbohydrates, fats, and proteins.

• Keeps inflammation down.

• Regulates your blood pressure.

• Increases your blood sugar (glucose).

• Controls your sleep/wake cycle.

• Boosts energy so you can handle stress and restores balance afterward.

However, if you are under constant stress high levels of Cortisol are pumped into the system, which leads to the OPPOSITE EFFECTS as what I have listed above.

High constant levels of Cortisol will cause:

• You to get sick more often.

• It decreases Insulin Sensitivity and Increases blood sugar thus exacerbating Insulin Resistance.

• Weight gain due to Insulin resistance.

• It decreases Serotonin which can make to anxiety and Depression worse.

• Increases Blood pressure.

• Increase in Cholesterol.

So, think of this way. Let's take my case for example, I have Insulin Resistance due to genetic traits and so it is something I can not cure but can only try to keep my Insulin levels low as it is known as the "fat storing hormone". Now add on to the fact that I am extremely stressed, sleep deprived and suffer from anxiety. Well of course I am not losing that baby weight, my skin is oilier than usual with acne and some days I do feel depressed. Stress.

Now I need to make this very clear. When I speak of stress, I mean as a whole. Most women do not realise that stress could also mean physical stress. It is very possible that your change in diet, vigorous workouts and changes in bedtime routines can put your body under immense strain. You might wonder why you feel tired all the time and blame that intense workout you had the other day not knowing that your workout to lose weight is making your symptoms worse. You might wonder how you eat nothing throughout the day and still gain weight. Cortisol coupled with Insulin Resistance and male hormones floating in the blood will make sure you do not lose any weight.

The body believes it is in danger, so it will do anything in its power to reserve energy in case you need to "Fight or take Flight". It is a Primitive response when humans needed to either fight or run away from that Lion that was coming right at them. We don't have Lions around us anymore. We don't hunt or gather like we used to. We sit in offices and look at our screens forever anxious of whether or not we will meet those deadlines, cortisol coursing through our veins and creating havoc in our bodies. Add on the anxiety that you're not losing weight and the physical strain of intense workouts/under eating makes a wonderful cocktail to throw you off balance.

This is why you will see many websites that claim they can heal your PCOS by helping you reduce stress. In my experience, yes it works. The less stressed I am, the better my body feels and PCOS symptoms are less.

But isn't that everyone at the end of the day? We all want to feel happier and less stressed out. Try and relax (I know, easier said than done). Ditch the restrictive diet and the really intense workouts for a while and opt for something that will bring balance to your life and slow down your breathing, like Yoga or Pilates.

Make it a habit and it will make a big difference to your body.

Now, If only I would take my own advice! :)

References:

How Insulin and Cortisol affect your body compostion: https://www.girlsgonestrong.com/blog/hormones/insulin-cortisol/

Adrenal PCOS: Surprising Ways Stress Affects Your Hormones: https://chriskresser.com/adrenal-pcos-surprising-ways-stress-affects-your-hormones/

What is Cortisol:https://www.webmd.com/a-to-z-guides/what-is-cortisol