Cortisol Awakening: Navigating Hormonal Changes During Menopause

As a nutritionist, I not only look at food and your behaviors around it. As a nutritionist, I am also concerned with everything related to the health of my clients. That involves all of the input on you, not just food. This blog addresses cortisol levels and the connection to mid life for women. Yes, there are Real Food recommendations and also lifestyle changes and some education to help understand the “why” behind it all.

What is cortisol?

,Cortisol, let’s call it the body’s multitasker, is a hormone our adrenal glands, (on top of our kidneys), produce. It’s like our built-in stress manager. When we’re facing a stressful situation or have low blood sugar, cortisol jumps into action. Think of it as our body’s alarm system, preparing us to tackle whatever life throws our way. It has its own daily rhythm, peaking in the morning to wake us up and winding down as the day goes on. But, here’s the catch: while cortisol is a handy helper, too much of it, especially from prolonged stress, can be a bit of a troublemaker, impacting both our physical and mental health. So, it’s a balancing act we all need to manage.

Perimenopause, Menopause and Cortisol.

In my practice as a nutritionist, we can’t have a conversation without addressing hormones and changes in our body. Something many of us are intimately familiar with?—menopause. It’s a rollercoaster ride of hormonal changes that can leave us feeling like we’re on a never-ending emotional journey. And in the midst of it all, there’s one hormone that often goes overlooked: cortisol.

Ever found yourself waking up at the crack of dawn, heart racing as if you’ve just been chased by a wild animal? Well, you can thank cortisol for that! In this blog, we’re going to dive deep into the world of menopause and cortisol. We’ll explore how this sneaky hormone can leave us feeling frazzled, sweaty, and moody, and, more importantly, what we can do about it!

Whether you’re in perimenopause-hormone levels, especially estrogen, start fluctuating, leading to various symptoms like irregular periods, hot flashes, and mood swings or full-blown menopause-the end of the reproductive years occurring when a woman has not had a menstrual period for 12 consecutive months, your body is likely sending you signals that it’s undergoing some significant changes. Cortisol, our stress hormone, can also come into play, often waking us up with a start in the early hours.

Hot Flashes: Feeling the Heat of Cortisol

In my practice as a nutritionist, we talk about hot flashes as much as we talk about avocados! Hot flashes are like sudden firestorms that can strike at any moment, leaving you drenched in sweat and red-faced. But what’s the connection between these fiery episodes and cortisol, the stress hormone? Well, it turns out cortisol can play a role in heating things up. When your cortisol levels fluctuate, it can trigger hot flashes, making them a common symptom during menopause. Read more about this ,here.

Understanding Sleep and Cortisol

As women journey through midlife, their bodies undergo a complex series of physiological changes that profoundly affect their sleep patterns and cortisol levels. In this educational section, let’s delve into the precise mechanisms at play within the bodies of midlife women, shedding light on the intricate relationship between sleep and cortisol.

Sleep Disruptions in Menopause

Menopause, often regarded as the hallmark of midlife, initiates a cascade of hormonal shifts, and one of the key players in this hormonal symphony is cortisol, frequently referred to as the “stress hormone.” During the menopausal transition, cortisol’s nightly performance can become particularly pronounced. Many women undergoing menopause find themselves grappling with a range of sleep disturbances, including insomnia, frequent awakenings, and night sweats.

Elevated cortisol levels at night significantly contribute to these disturbances. This hormone, released in response to stress, essentially acts as an alert system, potentially rendering the attainment of restful and uninterrupted sleep a challenging endeavor. It’s no exaggeration to say that a good night’s sleep is pivotal for overall well-being.

Cortisol’s Role in Menopausal Sleep Challenges

Comprehending the impact of cortisol on sleep is pivotal for midlife women. Cortisol typically adheres to a daily pattern, peaking in the morning to facilitate the waking process and gradually declining throughout the day. However, during the menopausal phase, this natural rhythm can become disrupted. Elevated cortisol levels at night can lead to prolonged periods of wakefulness, heightened anxiety, and difficulties in falling asleep.

Moreover, the relationship between cortisol and other hormones, such as estrogen and progesterone, is intricate and multi-faceted. As these hormone levels fluctuate during menopause, they can further influence sleep patterns. For instance, a drop in estrogen can give rise to night sweats and hot flashes, which, when combined with elevated cortisol levels, can create an environment that is far from conducive to a good night’s sleep.

Understanding the intricate connection between cortisol and sleep disruptions during menopause is of paramount importance for midlife women. This insight underscores the significance of prioritizing sleep as an integral part of their overall health strategy. Seeking professional guidance from a nutritionist to navigate the hormonal changes affecting sleep quality is a proactive step toward ensuring restful and rejuvenating sleep.

Mood Swings and Anxiety: Cortisol’s Emotional Roller Coaster

Ever feel like your emotions are on a wild roller coaster ride during menopause? You can thank cortisol for some of those ups and downs. Fluctuating cortisol levels can contribute to mood swings and increased anxiety, making this a challenging aspect of the menopausal journey.

Here’s how:

  1. Stress Response: Cortisol is often referred to as the “stress hormone” because it is released in response to stress, whether it’s physical, emotional, or psychological. During menopause, when hormone levels are fluctuating, the body can interpret these hormonal changes as stressors. Elevated cortisol levels in response to these perceived stressors can exacerbate feelings of anxiety and mood swings.
  2. Neurotransmitters: Cortisol affects the balance of neurotransmitters in the brain, including serotonin and dopamine, which play key roles in regulating mood. Elevated cortisol levels can disrupt this balance, potentially leading to mood swings and increased susceptibility to anxiety. Read more about this fascinating subject ,here.
  3. Sleep Disruption: As mentioned earlier, cortisol can cause sleep disturbances, including waking up in the middle of the night. Poor sleep quality and disrupted sleep patterns can lead to mood swings and increased anxiety.
  4. Hormonal Fluctuations: Cortisol’s interactions with sex hormones, such as estrogen and progesterone, can further influence mood. The hormonal fluctuations during menopause can impact how cortisol is regulated and can contribute to mood swings.
  5. Inflammation: High cortisol levels can promote inflammation in the body. Chronic inflammation has been linked to mood disorders and anxiety.

Estrogen, Progesterone, Cortisol and The HPA Axis Dysregulation

Hormonal changes during menopause can significantly affect cortisol levels, and understanding this interaction helps shed light on how they can make a midlife woman feel. Here’s a closer look:

  1. Estrogen and Cortisol: Estrogen plays a role in regulating cortisol levels. During menopause, estrogen levels decline, which can lead to changes in cortisol regulation. Lower estrogen levels can result in cortisol spikes, making a woman more susceptible to stress and anxiety.
  2. Progesterone and Cortisol: Progesterone also influences cortisol levels. As progesterone declines during menopause, it can disrupt the balance between cortisol and progesterone, potentially leading to an increase in stress and cortisol-related symptoms.
  3. HPA Axis Dysregulation: The hypothalamic-pituitary-adrenal (HPA) axis, responsible for regulating cortisol, can become dysregulated during menopause. The complex interactions between sex hormones, including estrogen and progesterone, and the HPA axis can lead to irregular cortisol patterns. This dysregulation may contribute to mood swings, irritability, and increased stress.

Overall, these hormonal changes can create a challenging landscape for midlife women, affecting both our physical and emotional well-being.

Emotional Well-being and Cortisol

Emotional well-being is a cornerstone of a fulfilling and balanced life, especially during the transformative phase of midlife. Understanding the intricate relationship between cortisol, cognitive health, mood disorders, and effective coping strategies can empower midlife women to navigate their emotional landscape with resilience and grace.

Cognitive Health

Cortisol can have a profound impact on cognitive health, particularly as women transition through midlife. Elevated cortisol levels, whether due to chronic stress or hormonal fluctuations, can affect memory, concentration, and cognitive function. It’s not uncommon for midlife women to experience moments of forgetfulness or difficulty focusing, which can be attributed, in part, to cortisol’s influence.

Mood Disorders

Midlife is a time of emotional ups and downs, partly influenced by hormonal changes and cortisol fluctuations. Mood disorders such as anxiety and depression can become more prevalent during this phase. Cortisol’s role in regulating neurotransmitters in the brain, such as serotonin and dopamine, can contribute to mood swings and increased susceptibility to mood disorders.

The key to addressing mood disorders lies in understanding that they are not a sign of weakness but a natural response to hormonal changes. Seeking support from mental health professionals, participating in therapy or support groups, and considering medication under the guidance of a healthcare provider can be effective strategies for managing mood disorders.

Coping Strategies

Effective coping strategies are essential for managing the emotional challenges that midlife can bring. Cortisol’s impact on stress response underscores the importance of adopting healthy coping mechanisms. Engaging in relaxation techniques such as deep breathing, meditation, or mindfulness can help regulate cortisol levels and reduce stress.

Emotional well-being during midlife is a multifaceted journey influenced by cortisol, cognitive health, mood disorders, and coping strategies. By recognizing the interconnectedness of these factors, midlife women can take proactive steps to nurture their emotional health, fostering resilience and embracing this transformative phase with a sense of empowerment and equilibrium.

Physical Health and Cortisol

Physical well-being is a fundamental pillar of overall health, and during midlife, it’s crucial to grasp the profound influence of cortisol on various aspects of our physical health. This encompasses cardiovascular health, bone health, as well as shifts in the condition of our skin and hair.

Cardiovascular Health

Cortisol can influence cardiovascular health in complex ways. While short-term cortisol spikes are a natural part of our stress response, chronic elevated cortisol levels can have adverse effects on the heart and blood vessels. It can lead to increased blood pressure, inflammation, and a higher risk of heart disease.

Bone Health

Cortisol also plays a role in bone health. Prolonged exposure to high cortisol levels can lead to bone loss and increase the risk of osteoporosis. During midlife, when hormonal fluctuations are already affecting bone density, it’s essential to manage cortisol levels effectively.

To support bone health, midlife women can incorporate weight-bearing exercises into their fitness routines to strengthen bones. Ensuring an adequate intake of calcium and vitamin D through diet or supplements is crucial.

Skin and Hair Changes

As midlife approaches, many women notice changes in their skin and hair, which can also be influenced by cortisol. Elevated cortisol levels can lead to skin issues such as increased dryness, sensitivity, and the appearance of fine lines and wrinkles. Hair changes, including thinning or loss, can also be linked to hormonal fluctuations and cortisol.

Maintaining healthy skin and hair during midlife involves a combination of good skincare practices, a balanced diet rich in nutrients like antioxidants and collagen-boosting vitamins, and stress management. Staying hydrated, and adopting a skincare routine tailored to your skin’s changing needs can help counteract some of these effects. For hair health, talk to your ,stylist, they are a wealth of knowledge and it’s probably they know your hair better than you do.

SO WHAT DO WE DO ABOUT ALL OF THIS??? (Managing Cortisol During Midlife)


Stress Reduction Techniques

I 100% understand that your reaction might be, “oh sure, I’ll just slow down in my already jammed packed life. That is me to a T. I’m aware that I need meditation and a slower pace in my life but I get on the track of getting things done and multitasking and it all takes a back seat.

In my practice as a nutritionist it is all about small sustainable steps and stress reduction is not different. Take small steps to lean into at least one of these ideas. You don’t have to have a yoga or meditation practice but maybe you can stretch in the morning and take deep breaths at a stop light??

  1. Mindfulness and Meditation: Practice mindfulness and meditation to stay present and reduce anxiety. Even just a few minutes of deep breathing and focused awareness can make a significant difference in managing stress.
  2. Yoga and Tai Chi: Engage in gentle forms of exercise like yoga or tai chi, which not only improve physical health but also promote relaxation and stress reduction.
  3. Deep Breathing Exercises: Incorporate deep breathing exercises into your daily routine. Slow, deep breaths can calm the nervous system and reduce stress levels. This can be done in your day, without finding a separate time. Think about a nice deep breath before you eat or take a drink of water; what do you already routinely do that you can add a deep breath too. Before you walk out the door, when you get off a Zoom call?
  4. Regular Exercise: Maintain a regular exercise routine. Physical activity releases endorphins, which can improve mood and reduce stress. Aim for at least 30 minutes of moderate exercise most days of the week. For starters? Take a walk after lunch for 5 to 10 one day…every new habit has a start!
  5. Journaling: Keep a journal to express your thoughts and feelings. This can help you process emotions and gain insight into sources of stress. This doesn’t have to start as an everyday practice. When thoughts enter your mind, if you have time, write them down.
  6. Social Support: Connect with friends and family for emotional support. Especially as women! We have the unique connection of going through this change together. Unfortunately there isn’t much research and resources out there for us. But we do have each other and we can share experiences, frustrations and solutions.
  7. Adequate Sleep: Prioritize sleep hygiene to ensure you get quality rest. Create a relaxing bedtime routine, keep a consistent sleep schedule, and make your sleep environment comfortable and conducive to rest. Maybe we have all heard these techniques before and you might be screaming at me right now because you are so sleep deprived that a cup of chamomile tea isn’t the drink you had in mind! I get it.
  8. Stress Management Apps: Explore stress management apps and resources designed to guide you through relaxation techniques, mindfulness, and meditation.
  9. Professional Help: Don’t hesitate to seek professional help if you find that stress is significantly impacting your daily life. A therapist or counselor can provide valuable support and coping strategies.
  10. Time Management: Organize your time effectively, setting priorities and allowing for breaks to reduce stress associated with overwhelming schedules. Say no when you can and when you just want to!
  11. What is Causing Stress: Look for small moments in your day where you can adjust for less stress. The other day, my teen daughter was saying how she leaves our neighborhood at the traffic light versus another exit where you have to cross two lanes of traffic then merge into oncoming traffic. I always took the latter option but I HEARD what she was saying…duh. (I had even taught her to take the traffic light option…do as I say, I suppose) But this is one of those opportunities where you can save your cortisol response from taking over. Now, I take the light, I leave our neighborhood with less stress. I’ll continue to look for more opportunities like this.


As a nutritionist, I feel strongly about how Real Food can have a significant impact on cortisol levels, both directly and indirectly. Here’s how different dietary choices can affect cortisol and some foods that may help support healthy cortisol regulation:

1. Caffeine and Sugary Foods: High caffeine intake and foods loaded with refined sugars can trigger the release of cortisol as part of the body’s stress response. Consuming these in excess can lead to cortisol spikes, making stress worse. This doesn’t mean you’ll NEVER have these foods. Perhaps you can wean yourself off of a second cup of coffee or one less dessert a week. Nutrition shouldn’t be an all or nothing game. We’ve all been there – extreme diets, followed by a return to square one.

2. High Glycemic Index (GI) Foods: Foods with a high GI, like white bread, rice, and sugary cereals, can cause rapid spikes and crashes in blood sugar levels. These fluctuations can stimulate cortisol release as the body works to stabilize blood sugar. Again, it doesn’t mean to NEVER have these foods again, but when you do have these foods add some protein and/or fat with these options to have a less drastic effect on your blood sugar. Such a good resource here.

3. Omega-3 Fatty Acids: Omega-3 fatty acids, found in fatty fish like salmon, walnuts, and flaxseeds, have anti-inflammatory properties that can help regulate cortisol levels and reduce inflammation associated with stress. Experiment with these foods to see how YOU feel. Flaxseeds have plant estrogens and can possibly be rancid depending on their quality. Either of these things could have a negative effect on your hormones. For me, I’m better off having animal options (fish) or using supplements (omega 3 supplements).

4. Complex Carbohydrates: Complex carbohydrates found in whole grains like oats, quinoa, and brown rice can help stabilize blood sugar levels, reducing the need for cortisol to regulate fluctuations. Still, pair these with fat and protein. Think about adding protein powder and peanut butter to your oatmeal…yum.

5. Magnesium-Rich Foods: Magnesium plays a role in cortisol regulation. Foods rich in magnesium, such as leafy greens, nuts, seeds, and whole grains, can support healthy cortisol levels. If you have ever had a conversation with me, I’ve mentioned magnesium as a powerhouse for just about EVERYTHING. Dark chocolate is one way to get magnesium and ,here are some of my thoughts on dark chocolate and magnesium.

6. Vitamin C: Vitamin C is an antioxidant that may help reduce cortisol levels. Citrus fruits, bell peppers, strawberries, and kiwi are good sources of vitamin C.

7. Adaptogenic Herbs: Certain herbs, known as adaptogens, may help the body adapt to stress and regulate cortisol levels. Examples include ashwagandha, rhodiola, and ginseng. These are often available as supplements or can be brewed into teas. As always, pay attention to how these additions make you feel. Try one at a time so you know which option is giving you which effect. For me, ashwagandha contributes to brain fog…we are all different.

8. Balanced Diet: Eating a well-balanced diet that includes a variety of nutrients and food groups can support overall health, which in turn can help regulate cortisol levels. Fat, protein and carbohydrates on each plate will give you balance. Eating regular, balanced meals can help maintain stable cortisol levels.

10. Hydration: Dehydration can increase cortisol production. Staying well-hydrated with water and herbal teas can support healthy cortisol regulation.

,Medical News Today supports the above suggestions as well as offering a few different ideas.

It’s always important to note that individual responses to food can vary, and what works best for one person may not be the same for another. If you suspect that your cortisol levels are consistently elevated due to dietary factors, it may be helpful to consult with a nutritionist or registered dietitian who can provide personalized guidance and recommendations based on your specific needs and circumstances.

Exercise and Physical Activity

As a nutritionist, exercise as movement goes hand in hand. I highly promote ,Prodigy Fitness for their dedication to men and women in midlife. They are supporting our need to keep moving and remain independent. I’m far from needing assistance but the present is the time to support my strength, not when I hit an age where I start to fail in my everyday movements! The owner of Prodigy, ,Andrew Hamel shares my intention on the strengths of the basic tried and true knowledge we have about health and fitness.

For recovery, restoration and strength as well check out ,The Well Studio. For those of you who are not local, they also offer quality online options. What I always say about The Well Studio: I feel like I can do the yoga, it’s not a situation where the teacher is the expert and I can only hope to do as well as they do. In every class I’ve taken, I have felt like it’s my practice at that moment on that day. TWS is also committed to strength and ,nutrition.

The Midlife Fitness Revolution

Midlife is a pivotal time to embrace fitness because it offers numerous benefits. It’s not just about weight management; it’s about enhancing your overall well-being. Regular exercise can boost your energy levels, improve mood, reduce stress, and increase your physical strength, helping you navigate the unique challenges and changes that come with midlife.

Start by setting realistic fitness goals that align with your midlife needs and lifestyle. Explore various forms of exercise, such as strength training, yoga, or cardio workouts, to find what suits you best. Create a balanced fitness routine that includes both cardiovascular and strength-building exercises. Seek guidance from fitness professionals or join fitness classes to stay motivated and accountable.

2. Finding Your Fitness Passion

Exercise should be enjoyable, especially during midlife. Finding a fitness passion is essential because it not only keeps you fit but also brings joy and fulfillment. Engaging in activities you love makes staying active sustainable and inspiring.

Experiment with different types of physical activities to discover what resonates with you. Attend classes or workshops, explore local parks for outdoor activities, or try new fitness trends. Listen to your body and choose activities that align with your interests and goals. Make fitness a social experience by exercising with friends or joining a local sports club.

3. Navigating Hormonal Changes Through Exercise

Hormonal fluctuations, particularly during menopause, can bring discomfort and challenges. Exercise can be a powerful tool for balancing hormones and alleviating symptoms such as hot flashes, mood swings, and sleep disturbances.

Engage in a combination of aerobic exercises, strength training, and flexibility workouts. Cardiovascular exercises like brisk walking or swimming can help with mood swings and sleep quality. Strength training supports bone health, and flexibility exercises like yoga can reduce stress and improve sleep. Consult with a fitness professional or a healthcare provider for personalized advice on tailoring your exercise routine to hormonal needs.

4. Beyond the Gym: Incorporating Daily Movement

Daily movement is crucial because it complements structured workouts and contributes to overall health. It helps counteract the effects of prolonged sitting and keeps you energized throughout the day.

Look for opportunities to incorporate physical activity into your daily routine. Take short walks during breaks, use a standing desk, do bodyweight exercises at home, or choose active transportation when possible. Set reminders to move regularly, and consider tracking your daily steps using a fitness tracker or smartphone app.

5. Overcoming Fitness Challenges

Challenges like time constraints or physical discomfort can hinder fitness efforts. Overcoming these obstacles is essential to maintain a consistent exercise routine.

Prioritize exercise by scheduling it in your calendar and treating it as an important commitment. Find time-efficient workouts or break longer sessions into shorter intervals. Address physical discomfort with appropriate modifications or by seeking guidance from a healthcare professional or ,physical therapist. Join fitness classes or enlist a workout buddy to stay motivated and accountable.

6. The Mind-Body Connection

The mental and emotional benefits of exercise are profound. Physical activity reduces stress, boosts mood, enhances cognitive function, and promotes overall mental well-being.

Incorporate mindfulness practices, such as ,meditation or deep breathing exercises, into your fitness routine to amplify the stress-reducing effects of exercise. Focus on the positive emotions and sense of accomplishment that come with each workout. Engage in activities you enjoy to make exercise a pleasurable experience that contributes to your mental and emotional health.

7. Aging Gracefully: Exercise for Longevity

Aging gracefully involves maintaining physical health and function as you grow older. Exercise plays a pivotal role in preserving bone density, joint health, and cardiovascular fitness, ensuring you continue to thrive as you age.

Include weight-bearing exercises, such as lifting weights or bodyweight exercises, to support bone density. Prioritize joint health by practicing proper form and technique during workouts. Engage in regular cardiovascular exercise to maintain heart health and overall fitness. Consult with a healthcare provider or fitness professional for exercise programs tailored to your age and specific needs.

Conclusion: Empowering Women Through Cortisol Awareness in Menopause

In the evolution through midlife, menopause emerges as a transformative phase accompanied by a myriad of changes. Among these changes, the role of cortisol, the “stress hormone,” takes center stage, significantly impacting various aspects of women’s health. As we conclude our exploration of cortisol in menopause, it becomes evident that awareness and understanding are the pillars of empowerment for women during this pivotal period.

From sleep disturbances to mood swings and beyond, cortisol’s influence extends across the spectrum of menopausal experiences. By shedding light on the intricate connection between cortisol and the challenges women face, we aim to provide knowledge as a source of empowerment.

Armed with this understanding, women can embark on a journey of self-care and well-being. We can navigate the highs and lows of menopause with resilience, armed with strategies and solutions to address the disruptions caused by cortisol. This awareness enables us to take charge of our health, seeking a nutritionist when needed and implementing lifestyle changes that support our overall well-being.

Empowerment, in the context of menopause and cortisol, means embracing this transformative phase with grace and confidence. It means acknowledging that while menopause brings its unique set of challenges, it also offers an opportunity for growth, self-discovery, and renewed vitality. By arming ourselves with knowledge and understanding, we can approach menopause not as a hurdle but as a journey toward greater well-being and fulfillment.

As we wrap up this intriguing exploration of cortisol in menopause, may every one of us find the strength to not only embrace this phase armed with the power to thrive, even in the face of hot flashes and cortisol-induced mood swings. And with a deep understanding of the intricacies of midlife, we can navigate its complexities with the grace of a seasoned sailor, and the resilience of someone who’s seen it all.

So, here’s to the wisdom that comes with age, the humor that keeps us sane, and the camaraderie of women who, like fine wine, only get better with time. Cheers to embracing midlife with style, grace, and a hearty chuckle or two!