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What are Some Symptoms of High Cortisol in Females?
Updated on July 25, 2023
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What are Some Symptoms of High Cortisol in Females?
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If you are feeling tired in the morning, too awake in the evening, and tense throughout the day, it is possible that you have high cortisol levels.

What is Cortisol and How Does It Affect Women's Health?

Cortisol is commonly known as the “stress” hormone because of its role in the body’s response to stress

The Role of Cortisol in the Body

When your body is in “fight or flight” mode, cortisol tells your body to burn stored sugars for extra energy while also keeping your mind alert for danger.

Cortisol, however, is not just used in such situations. 

It is a type of steroid hormone called glucocorticoids. “Gluco” refers to their role as a primary regulator of glucose metabolism or the conversion of sugars to energy. “Corti” refers to the adrenal cortex, which is a part of the adrenal glands that produce cortisol and other glucocorticoids.1

All glucocorticoids play a role in managing the body’s metabolism, stress response, and blood pressure. Cortisol, in particular, has a large effect on the sleep cycle and how your body responds to stress.

“Cortisol is responsible for a wide range of metabolism and processes that involve the immune responses,” explains our in-house medical expert, Dr. Rizza Mira.

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What Are the Symptoms of High Cortisol in Females?

Some of the most common symptoms include fluctuating/unpredictable energy levels, tension, and headaches, among others. They can vary in terms of frequency and severity, depending on your levels.

Cortisol levels in both men and women naturally fluctuate throughout the day. For example, cortisol is typically at its lowest at night so that the body can achieve a calm state for sleep, and increases during the day.

Cortisol also spikes in response to acute stress such as in response to immediate danger. These sharp increases in cortisol are part of the body’s natural response to threats and should return to normal levels after the threat has passed.

In general, people assigned female at birth tend to produce less cortisol in response to stress than biological men.2,5 A comparatively very high cortisol response for women is potentially unnatural or a sign of medical concern.

Physical Symptoms of High Cortisol Levels

When cortisol is unnaturally high regularly, it can cause several negative effects on the body. These effects include:

  • Insomnia
  • Palpitations
  • Lowered sex drive
  • Brain fog and lowered alertness
  • Susceptibility to infections (due to disrupted inflammation response in the body)
  • Mood swings
  • Feelings of constant anxiety or restlessness
  • Other hormonal imbalances

Overly high cortisol production means that your body is perpetually maintaining some level of alertness and stress. And yet, because of a disrupted sleep cycle and metabolism, you may still feel tired.

“This is true when the levels of cortisol are at their lowest point but are still at a high level for a normal individual,” says Dr. Mira.

Emotional and Mental Symptoms of High Cortisol Levels

The constant sensation of being in a fight-or-flight response can also take a toll on your mental health. This can produce a sensation of anxiety which may or may not have a clear trigger. 

“Too much stimulation of this response can also cause behavioral disorders, that, overtime can cause a vicious cycle of mood disorders,” explains Dr. MIra.

Cortisol also affects mental health. Too much cortisol may act as a sign of the onset or increased severity of a mental illness such as anxiety disorder or depression.3 A mental health professional will consider the role of elevated cortisol production in any such symptoms.

Reproductive Health Implications

Too much cortisol also affects reproductive health. Libido can decrease significantly while the body is in a high-cortisol state. Other symptoms of increased cortisol levels may also affect libido, such as insufficient sleep.

Stress can have a negative impact on both the ability to conceive and maintain a healthy pregnancy.4

Whether there is a stimulus for stress or not, as cortisol levels rise, so does the body’s stress response. Levels constantly being out of the norm may contribute to infertility.

The increased or abnormal production of any hormone also disrupts the production of other hormones. Any disrupted production of estrogen and progesterone can disrupt the menstrual cycle or affect fertility.

“High cortisol is the number one inhibitor of the hormone responsible for ovulation, sperm production and release, and other sex hormones,” says Dr. Mira.

What Causes High Cortisol Levels in Females?

Several factors can cause high cortisol levels, but chief among them may be chronic stress.

Chronic Stress and High Cortisol

Chronic stress is when you experience an amount of stress regularly, typically due to your day-to-day situation. Unlike acute stress, which is an effect of sudden and unexpected danger, chronic stress results in prolonged stimulation of the fight-or-flight response. 

Some factors that commonly cause chronic stress are a stressful job, persistent financial or romantic issues, some medications and medical conditions, and other frustrating environments.

Chronic stress causes the body to produce a higher-than-normal amount of cortisol over a prolonged period. As this becomes the norm, several symptoms mentioned above may begin to appear or worsen. 

This can also cause “adrenal fatigue,” a currently non-medical term6 to describe a feeling of fatigue due to adrenal glands not being able to keep up with the demand of a constant fight-or-flight response.

This is especially true for biological women whose baseline cortisol response is already lower than that of men.2,5

Medical Conditions Associated with High Cortisol

Adrenal tumors or an enlarged adrenal gland (hyperplasia) could be one cause of elevated levels of cortisol.

An overactive pituitary gland can also have the same effect, as this gland produces adrenocorticotropic hormone (ACTH), which tells the adrenal gland how much cortisol to create.

Hormones in the body operate in a check-and-balance mechanism. Adequate signals should be sent to the pituitary gland so that just enough hormones can be produced. In adrenal hyperplasia, for example, the adrenals provide excess amounts of cortisol that are not sensed by the pituitary gland.

Dr. Rizza Mira

High levels of cortisol for an extended amount of time may also cause Cushing syndrome.7 Cushing syndrome is a set of symptoms that include:

  • A fatty lump between the shoulders
  • Weight gain producing a rounded face
  • Weight gain producing a larger torso in comparison to arms and legs
  • Stretch marks
  • Bruises or easy-to-bruise skin
  • Acne breakouts
  • Hirsutism or dark, coarse hair growth around the body
  • Irregular or stopped periods

Cushing syndrome is rare but may occur as a result of glucocorticoid treatments.

How to Diagnose High Cortisol Levels

Cortisol tests are uncommon, but they may be necessary if you or your doctor believe that you may have abnormal cortisol levels.

Medical Tests for Cortisol Levels

Cortisol tests may also be called free cortisol, salivary cortisol, or urinary cortisol tests. This is because these tests may require a sample of your blood, saliva, urine, or any combination of the three to be more accurate.8

The nature of your symptoms may influence what type of test your healthcare provider recommends. You may also be instructed to take certain samples during a specific time of day.

  • A blood-based cortisol test requires a blood sample extracted via a needle. 
  • A salivary test is done via swab and may be administered by a nurse or by yourself at home with a special kit. 
  • A urine test will typically require all of a patient’s urine over a 24-hour period, unlike other urine tests, which may only collect one sample.

Cortisol tests do not require fasting but may be done multiple times in a day or over several days for a more accurate reading. This is because cortisol level can fluctuate widely based on the time of day and immediate circumstances, such as when you are at work or at home resting.

What Are Normal Cortisol Levels?

Cortisol levels in the morning normally range from 5 to 25 micrograms per deciliter (mcg/dL), but this can still vary based on other factors.8 This is why taking multiple tests is sometimes important so your doctor or healthcare team can determine your normal range. 

“Cortisol levels follow a circadian rhythm: highest in the morning and lowest at night,” explains Dr. Mira.

The results of a cortisol test may require taking other tests if your doctor thinks you have too much cortisol or too little.8 These tests include an ACTH stimulation test to check your adrenal gland health, a dexamethasone suppression test, or an MRI or CT scan to locate potential tumors and enlarged glands.

How to Lower Cortisol Levels Naturally

Apart from medical interventions, such as when cortisol levels are high due to adrenal gland tumors or other diseases, there are also ways to lower cortisol naturally.

“The first step to managing high levels of cortisol is determining the exact source of excess cortisol,” instructs Dr. Mira.

Stress Management Techniques

As the production of cortisol is the body’s response to stress, managing stress effectively can reduce it.

  • Engaging in calming hobbies such as yoga or art are great ways to release stress without entering a high-adrenaline state.
  • Practicing meditation and mindfulness can help create mental habits that make one more stress-resilient.
  • Consciously avoiding stressful situations may help reduce anxiety.
  • Stressful circumstances (such as financial or family situations) that cannot be easily avoided may require a shift in perspective or attitude toward them. Perception of stress plays a large role in the body’s response to it.9
  • Laughter may be one of the best medicines. Laughter suppresses cortisol production and increases endorphins, the anti-stress hormone.
  • Avoidance of medications that might contain steroids.

Therapy or consulting with a mental health professional may give you additional stress management techniques.

Addressing Sleep Issues

While cortisol affects sleep, achieving better sleep also, in turn, helps regulate levels of cortisol.

  • Decreasing screen time from phones or computers at least 30 to 60 minutes before attempting to sleep may help achieve better sleep.
  • Air-conditioning or lowering a room’s temperature helps the body cool down for sleep.
  • Regular exercise can also improve sleep quality.
  • Building a sleeping routine can condition your body to activate sleep-aiding processes more consistently.
  • Maintaining a consistent sleep schedule by attempting to sleep and wake up at the same time every day also helps the body prepare for sleep easier.
  • Avoiding caffeine also helps the body regulate sleep better.

When to Seek Medical Help for High Cortisol Symptoms

If any of the above-listed symptoms of high cortisol are persistent (chronic) or high intensity (acute), then this may be a sign to consult a medical professional and get tested.

If you also have multiple symptoms of Cushing syndrome, this may be a clear sign of too much cortisol.

In particular, if fatigue, insomnia, or other symptoms begin to drastically impede your daily lifestyle, consider reaching out to your doctor.

Increased cortisol levels over a long period of time lead to other health complications such as high blood pressure, rapid weight gain, and worsening mental health. Diagnosing glandular problems and tumors early is important so they may still be effectively treated.

Treatment Options for High Cortisol Levels

Treatment will depend on the source of increased cortisol levels. 

Tumors in the adrenal gland are potential signs of adrenal cancer and require treatments such as radiation therapy and surgery. Chemotherapy may also be an option if the cancer has spread from the adrenal gland to other parts of the body.

There are also medications for the regulation of cortisol production. Your doctor will advise you to slowly stop taking these medications.

Other medications are metyrapone, levoketoconazole, osilodrostat, mitotane, or ketoconazole. These are antiglucocorticoid medications that suppress the production of cortisol and other glucocorticoids. Consult your doctor for the best treatment option for your case.

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Updated on July 25, 2023
Will Hunter
Will Hunter
Content Contributor
Will is a content writer for KnowYourDNA. He received his B.A. in Psychology from the University of California, Los Angeles. Will has 7 years of experience writing health-related content, with an emphasis on nutrition, alternative medicine, and longevity.
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