It’s no mystery that the past few years have been…a lot. More than ever before, I’ve noticed female stress symptoms in my practice, often plaguing a very puzzled and sometimes scared client.
Have you noticed this in your practice, too? Or maybe even your own body?
As clinicians, we know that stress is detrimental. It’s on every list of possible underlying contributors and covered in every CEU course we take.
But stress is a strange element to account for, and female stress symptoms, specifically, can throw multiple curveballs into your client’s symptom picture.
It’s critical to remember that the effects of stress aren’t amorphous. Yes, stress is a feeling or a response, but that doesn’t mean the biological effects are any less real.
In fact, the opposite is true: the physical effects of stress are linked to almost every known pathological condition. People who live or work in stressful environments are at higher risk of many disorders, and due to physical and cultural factors, females are particularly susceptible to stress-related illness (1).
So, what do we do?
This blog will review the most common and the most concerning female stress symptoms. I’ll also offer nutrition, lifestyle, and supplement solutions that you can bio-individually implement with your clients.
Female Stress Symptoms #1: Cognition, memory, and learning
Stress wreaks havoc on the nervous system. This detrimental connection has been studied for over 50 years.
Prolonged stress can cause structural changes in the brain and atrophy of brain mass. It can negatively affect our ability to take in new information, incorporate it into our lives, and even skew our perception of situations.
Unfortunately, stress may also affect our ability to remember, as the hippocampus is particularly susceptible to stress hormones.
“…total function of memory and the conversion of short term memory to long-term memory are dependent on the hippocampus; an area of the brain that has the highest density of glucocorticosteroid receptors and also represents the highest level of response to stress (2).”
But do neurologically-based female stress symptoms differ from those experienced by men?
Amazingly, yes. But the research is complex.
One 2013 study, for instance, found that young females and males had different responses to a test of working memory performance, a part of short-term memory that influences reasoning, decision making, and responsive behaviors. While stressors led to enhanced working memory performance in males, they had the opposite effect on women—their working memory became impaired (3).
However, a 2020 study of older adults found the exact opposite effect! Higher cortisol led to impaired working memory in males, while females appeared to benefit from the stressful exposures (4).
While these findings initially seem confusing, It may be that sex-specific hormones—estrogen and testosterone—play a role in the way males versus females respond to stress (5). Younger males and females would thus have different responses than older males and females as sex hormone levels differ according to age.
Female Stress Symptom #2: Immune function
It’s commonly known that our immune system responds to stress.
Consider the physically taxed athlete who is susceptible to upper respiratory tract infections, the overworked student who gets a bad cold after exams, or the burned-out corporate exec who is finally forced to stay home because she’s too sick to get out of bed (6).
The neurotransmitters, immune cytokines, and hormones that are released when we feel stressed go right to the immune system’s control center: the brain. Many stress chemicals can cross the blood-brain barrier and act directly on glands such as the hypothalamus and pituitary and brain regions such as the hippocampus, amygdala, and prefrontal cortex.
The nervous system, in turn, communicates with the immune system via innervated lymphoid organs, such as the thymus and spleen, as well as immune-acting neurotransmitters like acetylcholine, norepinephrine, and histamine.
“In about 200 AC, Aelius Galenus (Galen of Pergamon) declared that melancholic women (who have high levels of stress and, thus, impaired immune function) are more likely to have cancer than women who were more positive and exposed to less stress (Reiche et al., 2004[88]). This may be the first recorded case about the relationship between the immune system and stress (2).”
The most well-known immune/stress interaction is the immune-suppressing action of glucocorticoids, both synthetic and natural.
Anyone with a bad case of poison ivy will fondly recall the relief offered by a steroid cream or shot, i.e., a prescription that mimics cortisol. In this acute situation, immune suppression is used for a fantastic purpose. But when we experience stress for long periods, our body’s natural (and needed) production of stress hormones can have unwanted immune-halting effects.
The short story is that stress eventually weakens the immune system. And in some studies, female stress symptoms differ from those found in men.
One such study compared the effects of stress on first-year male and female law students to a control group. Both groups reported health behaviors, emotions, and coping strategies. The researchers also gathered data on both groups’ cellular immune responses to an injected antigen (mumps or candida).
The study found that first-year male students had a significantly more robust antigen response than first-year females. However, there was no difference in response in the control group.
The researchers discuss that the lack of female antigen response may be a sign of altered cellular immunity due to stress (7).
Female Stress Symptom #3: Heart health
It’s easy to conjure up the image of a stressed-out, type-A businessman screaming into a cell phone…and his subsequent stress-induced cardiovascular risk.
But what about female stress symptoms and heart health?
A 2021 study titled “Associations of Job Strain, Stressful Life Events, and Social Strain With Coronary Heart Disease in the Women’s Health Initiative Observational Study” reports that women may experience domestic psychosocial stressors such as caregiving and family disturbances more frequently than men.
A negative synergy occurs when these are combined with career-associated stress, such as pay discrepancy or stereotype threat. Essentially, many women deal with increased stress at home and in the workplace, and it affects their hearts.
After adjustment for age, other stressors, job tenure, and socioeconomic factors, the study found that females with high rates of stressful life events could experience up to a 12% increased risk of coronary heart disease (8).
However, there is some good news: estrogen protects the heart.
“There are gender-dependent differences in the cardiovascular response to stress and, accordingly, it has been estimated that women begin to exhibit heart disease ten years later that men, which has been attributed to the protective effects of the estrogen hormone (Rozanski et al., 1999[93]) (2).”
Estradiol, specifically, may guard against oxidative damage and fibrosis while promoting mitochondrial function and positive vasculature changes such as angiogenesis and vasodilation (9).
Female Stress Symptom #4: Hormonal balance
Yes, estrogen is cardio and neuroprotective. However, imbalanced estrogen can be highly problematic.
The final female stress symptoms are those that involve hormones.
Chronic stress has a bi-directional effect on estrogen, progesterone, and testosterone.
This means that stress can disrupt our intricate hormone balance—at the same time, hormones lead to female-specific responses due to their influence on the HPA axis.
Long story short: it’s complicated. But, understanding this cross-talk allows us to consider the connections between stress and hormonal issues in our clients.
Stress may increase estrogen, for example (10, 11). However, some research shows that it may decrease it (12). One fascinating study showed that, overall, levels of estrogen were decreased in response to stress, while a specific portion of participants’ levels was elevated (13)!
Similarly, stress may increase progesterone (16), but it may also decrease it (17).
Estrogen, in turn, affects female stress symptoms. During times of prolonged stress, estrogen influences memory (13), mood disorders such as anxiety and depression (14), and may even influence the development of autoimmune disease (15).
Ultimately, remember that the primary modulator of stress—the HPA axis—directly coincides with the primary modulator of sex hormone balance—the hypothalamic-pituitary-gonad axis, or HPG axis. Your clients may experience hormonal symptoms concurrent with chronic stress, especially during times of hormonal flux like puberty, pregnancy, perimenopause, and menopause.
References
- https://www.jneurosci.org/content/27/44/11851
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/
- https://pubmed.ncbi.nlm.nih.gov/23238042/
- https://psycnet.apa.org/record/2020-57141-007
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181678/
- https://pubmed.ncbi.nlm.nih.gov/6623247
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765871/
- https://www.ahajournals.org/doi/10.1161/JAHA.120.017780
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655818/
- https://ndnr.com/endocrinology/estrogen-dominance-in-women/
- https://pubmed.ncbi.nlm.nih.gov/1529000/
- https://link.springer.com/article/10.1007/s40750-014-0004-2
- https://www.tandfonline.com/doi/full/10.1080/10253890.2021.1891220
- https://www.jneurosci.org/content/41/4/648
- https://news.harvard.edu/gazette/story/2012/08/estrogen-and-female-anxiety/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498122/
- https://www.frontiersin.org/articles/10.3389/fendo.2011.00019/full