In my practice, I see a large number of women who have either gone through or are going through menopause who are suffering from hot flashes and night sweats, sometimes for years after their last menstrual period. It is often assumed that this is purely due to estrogen levels dropping. However, many women are surprised to discover (after coming to see me) that a huge factor in alleviating these symptoms is addressing cortisol imbalance (aka adrenal fatigue).
Cortisol is a hormone released by the adrenal glands in response to stress. It is often released after a stressful situation (where the more immediate players are epinephrine and norepinephrine-aka adrenaline). When the adrenal glands are functioning optimally, it is released in the right amount for a limited time and then levels return to baseline. Under chronic stress, levels can be quite elevated for longer periods of time and this can start to cause symptoms such as anxiety, trouble sleeping, palpitations, and weight gain. If the stress continues long enough, the adrenal glands get fatigued and you can then have a significant deficit in cortisol levels leading to low cortisol symptoms – fatigue, feeling cold, hair loss, palpitations, exercise intolerance, and several symptoms that look like hypothyroidism. The best way to figure out if cortisol is playing a role in your menopausal symptoms is for us to test your levels. This can be accomplished with a saliva kit, a urine sample, or in some cases a blood draw.
Why am I writing so much about adrenal health in an article about menopause? Because if the adrenal glands are already having trouble when the ovaries start reducing their output of estrogen and progesterone, menopause is a lot rougher. The best things that women can do to treat cortisol imbalances/adrenal fatigue is to get adequate amounts of sleep daily, eat regular meals, practice stress reduction regularly (yoga, meditation, deep breathing, regular vacations, camping etc), and see your local licensed naturopathic doctor for testing and an evaluation.