Managing high cortisol levels during menopause

Published on 08 July 2025

What is cortisol? 

Cortisol is known as the ‘stress’ hormone. If you experience a stressful or anxiety inducing situation, your body releases adrenaline and cortisol in response. Adrenaline increases heart rate, blood pressure and energy, while cortisol raises blood sugar levels and affects the immune, digestive, and reproductive systems. The effects of cortisol aren’t all bad; it helps to control the sleep-wake cycle, regulates metabolism, manages inflammation, supports the immune system and much more.

After the stressful situation has passed, adrenaline and cortisol hormone levels drop, returning the body to normal. However, chronic stress can disrupt this process, leading to high cortisol levels.

How menopause affects cortisol levels

During menopause, fluctuating oestrogen and progesterone levels can potentially lead to higher baseline levels or prolonged cortisol response to stress. If you’re going through the menopause, you’ll know that it can be a stressful and anxious time, and these hormonal shifts can increase stress responses, leading to higher cortisol levels.

Symptoms of high cortisol levels in female menopause

Many of the symptoms of high cortisol levels during menopause are very similar to menopausal symptoms so it’s important to keep track of them if you’re experiencing pre-existing symptoms that worsen, or don’t improve with treatment.

Difficulty sleeping

Despite getting adequate sleep, many women experience persistent tiredness. Cortisol typically peaks in the morning and declines throughout the day, often being at the lowest point in the late evening to promote sleep. However, elevated cortisol levels, especially at night, can interfere with sleep and increase feelings of anxiety and stress. This, combined with lower levels of oestrogen and progesterone during menopause, can lead to hot flushes and night sweats for many women, further disrupting sleep patterns, leading to fatigue and low energy.

Weight gain

Hormonal and metabolic changes can play a big role in weight gain. For example, the decline in oestrogen in menopause affects how fat is stored, with more fat being often being stored around the abdomen. Having high levels of cortisol further affects this by disrupting metabolism and also storing fat around the tummy area, hence why this type of weight gain is often referred to as ‘cortisol belly’ or ‘stress belly’. Other factors such as stress-induced cravings, increased insulin resistance and age-related changes can all lead to weight gain.

Mood changes and brain fog

Increased sleep disturbances, sensitivity to stress and hormonal fluctuations experienced during menopause can impact your mood by heightening feelings of anxiety and depression. High cortisol is also closely linked to mood changes so they’re hard to separate from each other.

The drop in oestrogen during menopause and chronically high cortisol levels can affect brain function, leading to difficulty concentrating, memory problems, and brain fog. Our guide to mental health during menopause looks at some of the warning signs that you could need help and support.

Digestive issues

Menopause and high cortisol levels can significantly impact your gut health. Understanding the symptoms of digestive issues and learning how to manage or mitigate them is essential to improving wellbeing during this phase of life. If you’re struggling with bloating, abdominal cramps, changes in bowel habits, indigestion or IBS, you’re not alone. Read on to discover the links between digestive issues and menopause.

Immune system suppression

The decline in oestrogen and progesterone during menopause, combined with the stress-induced elevation of cortisol, can significantly impact your immune system’s function. These hormones play a role in regulating inflammation, promoting immune cell development, and protecting against infections. Some studies have shown that women are more at risk of developing autoimmune diseases during and after menopause, potentially due to the changes in hormonal balance and immune responses.

Other symptoms

High cortisol during menopause can impact your health by heightening your blood pressure and blood sugar. This could lead to the development of type 2 diabetes so it’s important to begin making positive lifestyle changes to reduce your risk.

Strategies for managing high cortisol levels during menopause

Improve sleep hygiene

• Aim for regular sleep and wake times to regulate your body’s natural cortisol rhythm
• Create a relaxing bedtime routine to signal to your body that it’s time to rest and ensure it’s the optimum environment for sleep – cool, dark and quiet

Regular exercise

• It’s important to remain active throughout menopause and it can have a positive effect on reducing stress levels too. It’s recommended to aim for 150 minutes of exercise per week. This should also include at least two sessions of strength training each week to build and maintain muscle mass, which reduces as oestrogen declines
• Exercise can also help to maintain good pelvic health – read our article here.

Dietary adjustments

• Magnesium – Foods rich in magnesium such as seeds, nuts, beans, dark chocolate and dark leafy greens like kale, can help to regulate cortisol levels, blood sugar, boost energy and aid with stress reduction during menopause. Magnesium is a powerful vitamin that helps maintain other essential minerals too like calcium, zinc and potassium
• Omega-3 fatty acids – High amounts of omega-3 fatty acids are found in oily fish, nuts and seed. This helps to support hormone balance which will help cope with high cortisol and menopausal changes
• Anti-inflammatories – Cortisol, if heightened, can lead to inflammation in the body. Choosing foods with anti-inflammatory properties such as vegetables, fruits and whole grains can support with a healthy cortisol response
• Limit caffeine and alcohol – Caffeine can trigger anxiety if consumed in large amounts, disrupting sleep, mood and exacerbating menopausal and high cortisol symptoms. Maybe you could limit yourself to one coffee a day and stick to the recommended maximum alcohol intake for women, including those experiencing menopause, which is no more than 14 units per week

Stress management techniques

There are many ways to reduce stress in your life to ensure you feel empowered through menopause. Below are just a few activities you could try until you find the right fit for you. If you notice no improvement in your symptoms or anxiety and low mood is starting to impact your ability to carry out everyday tasks, please do talk to someone you trust. Don’t suffer in silence through menopause and high cortisol.

• Yoga/meditation
• Deep breathing
• Time in nature
• Journaling
• CBT – cognitive behavioural therapy
• Holistic therapies – aromatherapy, massage or acupuncture

Speak to our experts

If you're struggling with the symptoms of high cortisol levels, you can request a cortisol test by booking an appointment with our Private GPs.

You can also book an Advanced female health assessment with Dr Fiona Warner, which includes comprehensive pathology biomarkers and is suitable for women that may be concerned with various stages of menopause and/or are 50 years old and over.

Contact our Private Patient team via Livechat, by completing our online enquiry form or by calling 01580 363158.