Episode 54 - The connection between your menstrual cycle, stress, safety and cellular repair

In our productivity-obsessed world, chronic stress has become so normalized that we barely recognize it as the physiological emergency it truly is. Most discussions about stress focus on superficial management techniques—the bubble baths, breathing exercises, and meditation apps that promise relief but rarely address the underlying mechanisms of our stress response systems.

This deep dive explores the intricate physiology of your stress response, examines how modern life has hijacked our ancestrally-designed systems, and offers a framework for genuine stress repair that goes beyond mere management. Drawing from Episode 54 of the Inner Rhythms podcast, we'll explore the complex relationship between your adrenal glands, HPA axis, and hormonal health—particularly for those with menstrual cycles.

If you've been experiencing unexplained fatigue, hormonal imbalances, sleep disruptions, or that elusive feeling of being "tired but wired," understanding the physiological underpinnings of your stress response could be the missing piece in your health puzzle.

 

Topics Covered

In this comprehensive exploration of the stress response system, we'll cover:

• The anatomy and physiology of the adrenal glands
• How the HPA axis (Hypothalamic-Pituitary-Adrenal) operates during stress
• The seven-step stress response cascade in your body
• Why modern life overwhelms our ancestrally-designed stress system
• How cortisol interacts with your menstrual cycle hormones
• The concept of allostatic load and its impact on health
• Why most "stress management" techniques fail to create lasting change
• Root-level approaches to stress repair and resilience

 

Listen to the Episode

• Spotify
• Apple Podcasts
• YouTube

 

Timestamps

[00:02:49] Adrenal gland anatomy and function

[00:03:35] The HPA axis explained

[00:07:38] Seven-step stress response cascade

[00:10:26] Adrenaline vs cortisol functions

[00:12:59] Blood sugar's role in stress response

[00:15:14] Modern lifestyle vs ancestral stress patterns

[00:17:21] Cortisol's circadian rhythm

[00:19:15] Estrogen's influence on stress resilience

[00:23:10] Allostatic load concept

[00:27:14] Stages of HPA axis dysfunction

[00:30:10] Second wind phenomenon and sleep disruption

[00:32:54] Categories of stressors

[00:37:15] Problem with "managing" vs repairing stress

[00:41:21] "Your body cannot heal if it doesn't feel safe"

 

Adrenal Anatomy and Physiology: The Stress Command Centers

Your adrenal glands are small, triangular-shaped glands located directly on top of your kidneys. Despite their modest size, they're physiological powerhouses that produce hormones regulating stress, metabolism, blood pressure, fluid balance, immune function, and even aspects of reproduction and sexual development.

Each adrenal gland consists of distinct layers with specialized functions:

The Adrenal Cortex

The adrenal cortex is the outer layer constituting approximately 80-90% of the gland's mass. It synthesizes and secretes steroid hormones and is divided into three zones:

1. Zona Glomerulosa: Produces aldosterone, a mineralocorticoid that regulates electrolyte balance—particularly sodium and potassium levels in the body. Aldosterone helps maintain blood pressure by influencing fluid retention.
2. Zona Fasciculata: Produces cortisol, the primary glucocorticoid involved in metabolism, immune response, and stress adaptation. Cortisol is often called the "stress hormone" but plays numerous roles beyond stress management.
3. Zona Reticularis: Produces androgens, primarily DHEA (dehydroepiandrosterone) and androstenedione, which are precursors to testosterone and estrogen. These androgens contribute to secondary sexual characteristics and libido.

The Adrenal Medulla

The adrenal medulla forms the inner portion of the adrenal gland, comprising approximately 10-20% of its mass. This region produces catecholamines:

1. Adrenaline (Epinephrine): The primary "fight-or-flight" hormone that prepares the body for immediate action during stress.
2. Noradrenaline (Norepinephrine): Works alongside adrenaline to prepare the body for emergency response.

The adrenal medulla is innervated by sympathetic nerve fibers, and its hormone release is regulated by the sympathetic nervous system—the "action" branch of your autonomic nervous system.

 

The HPA Axis: Your Stress Response Command Chain

The Hypothalamic-Pituitary-Adrenal (HPA) axis is the central stress response system in your body. This complex neuroendocrine network connects your brain and adrenal glands through a sophisticated cascade of hormonal signals.

The HPA axis operates through a series of precise steps:

The Seven-Step Stress Response Cascade

1. Perception of stressor: When your brain perceives a threat or stressor (physical danger, work deadline, relationship conflict, etc.), sensory information is sent to the amygdala—a brain region involved in processing emotions, particularly fear and anxiety.
2. Activation of the hypothalamus: The amygdala signals the hypothalamus, a small region at the base of the brain that acts as your hormonal headquarters. In response to the perceived threat, the hypothalamus activates the sympathetic nervous system.
3. Release of CRH: The hypothalamus releases Corticotropin-Releasing Hormone (CRH) into the bloodstream. This hormone is the initial messenger in the stress response cascade.
4. Pituitary gland response: Upon receiving CRH, the pituitary gland releases Adrenocorticotropic Hormone (ACTH) into the bloodstream.
5. Adrenal gland stimulation: ACTH travels to the adrenal glands, signaling them to secrete stress hormones.
6. Hormone secretion: The adrenal glands release cortisol, adrenaline, and other hormones into the bloodstream.
7. Physiological changes: These hormones trigger body-wide changes, preparing you to confront or escape the stressor.

This elegant system evolved to keep us safe, but it was designed for acute stressors, not the chronic activation that characterizes modern life.

 

Adrenaline vs. Cortisol: Different Roles, Different Timelines

Your primary stress hormones have distinct functions in the stress response:

Adrenaline (Epinephrine)

Adrenaline is responsible for the immediate, short-term response to stress. It:

• Increases heart rate to circulate blood more efficiently
• Dilates airways to improve oxygen intake
• Redirects blood flow to vital organs such as muscles and brain
• Enhances alertness and sensory perception
• Prepares the body for physical exertion ("fight-or-flight")

Adrenaline acts within seconds and its effects dissipate relatively quickly.

Cortisol

Often called "the stress hormone," cortisol plays a more complex role in the stress response:

• Mobilizes energy stores by increasing blood sugar levels
• Suppresses non-essential functions such as digestion, reproduction, and certain immune responses
• Regulates inflammation and immune function
• Powers you through prolonged demanding situations

Cortisol takes longer to rise after a stressor (minutes rather than seconds) and its effects can last for hours. It can be considered the "long-term stress responder" compared to adrenaline's immediate action.

 

The Critical Role of Blood Sugar in Stress Response

A fascinating aspect of the stress response that doesn't receive enough attention is how it affects your blood glucose levels. When adrenaline and cortisol are released, they signal your liver to release stored glucose (glycogen) into your bloodstream.

This glucose surge serves as immediate fuel for your muscles and brain—literally providing the energy needed to fight or flee from danger. Your oxygen levels rise, blood vessels dilate, heart rate increases, and organs critical for survival (brain, lungs, heart, muscles) receive more oxygen and glucose.

Meanwhile, systems deemed non-essential for immediate survival receive less blood flow and resources:

• Digestive tract
• Skin
• Kidneys
• Reproductive system

This is why chronic stress can lead to digestive issues, skin problems, and reproductive/fertility challenges—these systems are consistently deprioritized when stress hormones are elevated.

 

Ancestral Design vs. Modern Reality: The Mismatch

Our stress response system is remarkably similar to that of our ancestors—yet our environment has transformed dramatically. This mismatch explains much of our current stress-related health crisis.

Our ancestors might have encountered a predator several times per year, triggering an appropriate stress response followed by recovery. Today, we face:

• Daily traffic commutes
• Constant digital notifications
• Work deadlines and performance pressure
• Financial stress
• Relationship challenges
• Global crisis awareness
• Environmental pollutants
• Information overload
• Social media comparison
• Poor sleep quality
• Nutritional deficiencies
• Inflammatory diets

The HPA axis constantly tries to adapt to our environment, but these chronic stressors create a system that's perpetually activated without adequate recovery time. Our bodies simply weren't designed to function in constant emergency mode.

 

The Circadian Rhythm of Cortisol

Your HPA axis operates on a 24-hour rhythm known as the circadian rhythm. In a healthy pattern:

• Cortisol levels rise significantly upon waking (cortisol awakening response)
• Levels remain relatively stable throughout the day
• Levels gradually decline in the evening as melatonin rises
• Lowest levels occur during deep sleep

This natural rhythm is crucial for energy regulation, immune function, cognitive performance, and even mood stability. The morning cortisol peak helps you wake up energized and alert, while the evening decline allows your body to prepare for rest and repair.

When chronic stress disrupts this pattern, we may see cortisol that's:

• Low in the morning (causing fatigue and "zombie-like" mornings)
• Erratic throughout the day (causing energy crashes and mood swings)
• Elevated at night (causing the "tired but wired" feeling and insomnia)

 

The Menstrual Cycle-Stress Connection

For people with menstrual cycles, there's a critical relationship between reproductive hormones and stress hormones that's rarely discussed in conventional healthcare.

The adrenocorticotropic hormone (ACTH) rises when estrogen is higher, creating a significantly stronger cortisol awakening response around ovulation compared to other phases of the menstrual cycle.

This means your body is naturally more equipped to handle stress and engage in stress repair when estrogen is elevated—typically from about day 3 of your cycle until ovulation. After ovulation, when progesterone becomes dominant and estrogen levels decline, your natural stress resilience decreases.

This partially explains why many people experience increased stress sensitivity, anxiety, and overwhelm during the luteal phase (between ovulation and menstruation). Your body simply has less physiological capacity for stress management during this time.

This isn't a design flaw—it's a feature. Historically, the luteal phase would have been a time of reduced activity and increased rest. Our modern expectation to maintain consistent productivity throughout the entire cycle ignores this biological reality.

 

DHEA and DHEA-S: The Resilience Hormones

Dehydroepiandrosterone (DHEA) and its sulfated form DHEA-S are adrenal hormones that play vital roles in stress resilience. These hormones:

• Act as precursors to sex hormones (testosterone and estrogen)
• Modulate HPA axis activity
• Help regulate cortisol levels through negative feedback
• Support immune function
• Promote brain health
• Contribute to overall vitality

DHEA and DHEA-S can counteract some of cortisol's negative effects, essentially providing a buffer against chronic stress. However, prolonged stress eventually depletes these hormones, reducing this protective capacity and accelerating the negative consequences of elevated cortisol.

 

Allostatic Load: The Cumulative Burden of Chronic Stress

Allostatic load is a crucial concept for understanding chronic stress. It refers to the cumulative physiological "wear and tear" on the body resulting from repeated or chronic stress exposure.

While our bodies are designed to adapt to stressors and maintain stability (a process called allostasis), chronic or excessive stress overwhelms these adaptive mechanisms. The resulting allostatic load represents the price our bodies pay for adaptation to challenging life circumstances.

Allostatic load affects multiple physiological systems:

• Cardiovascular: Increased blood pressure, atherosclerosis, heart disease risk
• Metabolic: Insulin resistance, abdominal fat accumulation, metabolic syndrome
• Immune: Chronic inflammation, reduced immune function, increased susceptibility to illness
• Neurological: Altered brain structure and function, cognitive impairment, mood disorders
• Endocrine: Hormonal imbalances affecting thyroid, reproductive, and stress response systems

Contributing factors include external stressors (work, relationships, finances) and internal stressors (inflammation, infection, blood sugar imbalances, gut dysfunction).

 

The Progression of HPA Axis Dysfunction

Chronic stress leads to a predictable progression of dysfunction in the HPA axis:

1. Initial adaptation: The body responds appropriately to stressors with increased cortisol and adrenaline, but maintains normal daily rhythms.
2. HPA axis resistance: With continued stress exposure, the brain's sensitivity to cortisol diminishes, disrupting the negative feedback loop that would normally reduce stress hormone production. This results in sustained high cortisol levels.
3. Compensatory adaptation: Further exposure desensitizes the hypothalamus and pituitary to hormonal signals and depletes metabolic reserves. The body's production of CRH (Corticotropin-Releasing Hormone) may escalate, but the pituitary's diminished sensitivity impairs ACTH release.
4. Secondary adrenal insufficiency: Decreased ACTH ultimately reduces cortisol production, leading to symptoms of adrenal insufficiency despite the fact that the adrenal glands themselves remain capable of producing cortisol.
5. Severe adrenal insufficiency: In advanced stages, the hypothalamus may cease producing CRH altogether, creating a cascade of hormonal deficiencies.

This progression explains why some people with chronic stress exhibit high cortisol, while others show low cortisol—they're simply at different stages of HPA axis dysfunction.

 

The Many Faces of HPA Axis Dysregulation

HPA axis dysfunction and adrenal insufficiency can manifest through various symptom patterns:

• Decreased stress resilience: Inability to handle even minor stressors
• Extreme fatigue: Particularly morning fatigue resistant to caffeine
• Cognitive impairment: Brain fog, memory issues, difficulty concentrating
• Sleep disturbances: Trouble falling asleep, staying asleep, or waking refreshed
• Orthostatic hypotension: Dizziness upon standing
• Abdominal weight gain: Even with dietary intervention
• Weakened immunity: Frequent illnesses, slow recovery
• Reduced libido: Loss of sexual desire and function
• Depression or anxiety: Often resistant to standard treatments
• Menstrual irregularities: Changes in cycle length, flow, or ovulation

The specific pattern depends on:

• Duration of chronic stress
• Individual genetic factors
• Liver function and cortisol clearance
• Nutritional status
• Sleep quality
• Existing health conditions

 

Cortisol Patterns and Their Significance

Different patterns of cortisol dysregulation create distinct symptom profiles:

High Cortisol Throughout the Day

• Anxiety, racing thoughts
• Insomnia
• Digestive disturbances
• Blood sugar imbalances
• Hypertension
• Suppressed immune function

Low Cortisol Throughout the Day

• Extreme fatigue
• Low blood pressure
• Hypoglycemia
• Salt cravings
• Increased pain sensitivity
• Poor stress tolerance

Disrupted Cortisol Rhythm

• Low morning cortisol: Difficulty waking, morning fatigue
• High evening cortisol: "Second wind" at night, insomnia
• Erratic cortisol: Unpredictable energy, mood swings

The "second wind" phenomenon—that burst of energy many experience in the evening when cortisol should be declining—is particularly problematic, as it disrupts sleep architecture and further perpetuates the cycle of HPA axis dysfunction.

The Hidden Impact of Chronic Stress on Other Systems

Chronic elevation of stress hormones creates cascading effects throughout the body:

Immune Function

Cortisol modulates immune response—initially enhancing it during acute stress, but suppressing it during chronic stress. This explains why chronically stressed individuals often experience increased susceptibility to infections, prolonged healing times, and heightened inflammatory responses.

Blood Sugar Regulation

Cortisol increases blood glucose by stimulating gluconeogenesis (the creation of new glucose) and reducing insulin sensitivity. Chronically elevated cortisol can lead to insulin resistance, metabolic syndrome, and eventually Type 2 diabetes.

Thyroid Function

The HPA axis interacts intimately with the hypothalamic-pituitary-thyroid (HPT) axis. Chronic stress can decrease the conversion of inactive thyroid hormone (T4) to active thyroid hormone (T3), creating functional hypothyroidism even when standard thyroid tests appear normal.

Reproductive Hormones

The "pregnenolone steal" phenomenon occurs when chronic stress prioritizes cortisol production over sex hormone production. Since pregnenolone is a precursor to both cortisol and progesterone, the body "steals" this precursor for cortisol production, potentially reducing progesterone levels. This can manifest as PMS, irregular cycles, luteal phase defects, and fertility challenges.

Gut Function

The gut-brain axis is bidirectional—stress affects gut function, and gut dysfunction creates stress. Chronic stress alters gut motility, decreases digestive enzyme production, changes gut microbiome composition, and increases intestinal permeability ("leaky gut")—all of which can contribute to IBS, SIBO, food sensitivities, and nutrient malabsorption.

 

Sources of Stress: Beyond the Obvious

Understanding stress requires recognizing that stressors come in multiple forms:

Emotional/Psychological Stressors

• Trauma (past or present)
• Grief
• Relationship conflict
• Work pressure
• Financial concerns

Physical Stressors

• Physical injury or trauma
• Illness
• Inadequate nutrition
• Insufficient calories
• Over-exercise
• Under-exercise

Internal Stressors

• Infections (including stealth infections)
• Autoimmune processes
• Digestive issues
• Food sensitivities
• Gut dysbiosis
• Blood sugar imbalances

External Stressors

• Environmental toxins
• Mold exposure
• Electromagnetic fields
• Light pollution
• Noise pollution
• Climate extremes

Your stress response doesn't distinguish between sources—a bacterial infection, relationship breakup, and work deadline all activate the same physiological cascade. This explains why addressing only psychological stressors often proves insufficient for complete recovery.

 

The Problem with "Stress Management"

The term "stress management" itself reveals a fundamental misconception about chronic stress. We treat stress as something to be managed with surface-level tools:

• Bubble baths
• 10-minute meditation sessions
• Productivity hacks
• Breathing exercises

Meanwhile, the root causes of stress continue burning in the background unaddressed:

• Taking adaptogens without fixing sleep
• Practicing breathwork while staying in toxic environments
• Doing morning yoga but ignoring body signals the rest of the day
• Using meditation apps while maintaining an unsustainable workload

Stress isn't just a feeling—it's a whole-body physiological state rooted in survival mechanisms. It begins deep in the brain, travels down to the adrenals, affects blood sugar, gut function, hormones, mood, and your sense of safety in the world.

When we only look at symptoms or use tools to temporarily soothe stress rather than resolve what's creating it, we stay stuck in cycles of depletion.

Root-Level Stress Repair: Beyond Management

True stress resilience requires addressing the foundations of physiological safety:

Ask Deeper Questions

• Where in your life do you feel chronically unsafe?
• What rhythms is your body craving that you're not honoring?
• What has your body been carrying for too long without support?
• Which stressors have you normalized that are actually chronic burdens?

Remember: Safety is Prerequisites for Healing

Your body cannot heal in survival mode—it heals in safety. It heals when cortisol isn't constantly overriding every other hormone, when you eat enough, rest enough, feel your emotions, connect with others, and honor your natural rhythms.

The body heals when we stop glorifying exhaustion and start honoring our design—a beautiful oscillation between activation and rest, between sympathetic and parasympathetic states, between doing and being.

When stress is addressed at the root level, benefits extend far beyond feeling calmer:

• Improved digestion
• Enhanced sleep quality
• Easier menstrual cycles
• Support for robust ovulation
• Stabilized mood
• Balanced immune function
• Restored energy and vitality

 

Building True Stress Resilience: Practical Approaches

While deep stress repair requires personalized approaches, these foundations support everyone's stress resilience:

1. Honor Circadian Rhythms

• Get morning sunlight exposure within 30 minutes of waking
• Maintain consistent sleep-wake times, even on weekends
• Create a wind-down routine 1-2 hours before bedtime
• Limit blue light exposure after sunset
• Eat main meals during daylight hours

2. Stabilize Blood Sugar

• Start the day with protein, not just carbohydrates
• Include protein, healthy fats, and fiber with every meal
• Avoid extended fasting if you're experiencing stress symptoms
• Limit caffeine, especially after noon
• Consider chromium, magnesium, and B-complex supplements to support glucose metabolism

3. Support Your Nervous System

• Practice parasympathetic activation through slow breathing, humming, or gargling
• Create boundaries around digital inputs and work hours
• Schedule regular time in nature
• Engage in gentle movement like walking or stretching
• Prioritize positive social connection

4. Honor Your Menstrual Cycle (if applicable)

• Track your cycle to understand your patterns
• Align high-performance tasks with your follicular phase
• Create more space for rest during luteal phase
• Consider seed cycling to support hormone balance
• Be mindful of cycle-specific nutritional needs

5. Address Root Causes

• Work with practitioners who understand HPA axis dysfunction
• Consider testing for hidden stressors (gut infections, nutrient deficiencies, etc.)
• Create a safe physical environment (address mold, air quality, etc.)
• Heal past trauma through somatic approaches
• Build community and support systems

 

Key Takeaways

1. The stress response is physiological, not just psychological
• Your stress response involves complex interactions between your brain, adrenal glands, and multiple hormone systems
• Stress isn't just "in your head"—it creates measurable changes throughout your entire body

 

1. Your adrenal glands produce multiple critical hormones
• The adrenal cortex produces cortisol, aldosterone, and sex hormone precursors
• The adrenal medulla produces adrenaline and noradrenaline
• These hormones affect everything from energy levels to immune function to reproductive health

 

1. Adrenaline and cortisol have different roles in stress response
• Adrenaline provides immediate, short-term emergency response
• Cortisol manages longer-term stress adaptation
• Both are necessary for survival but problematic when chronically elevated

 

1. Modern life creates unprecedented chronic stress
• Our ancestors experienced acute, infrequent stressors
• Modern humans face constant low-grade stressors with inadequate recovery time
• This mismatch overwhelms our ancestrally-designed stress response system

 

1. Your stress response follows a natural rhythm
• Cortisol should be highest in the morning and lowest at night
• Disruptions to this rhythm affect sleep, energy, mood, and metabolic health
• Respecting your circadian rhythm is fundamental to stress resilience

 

1. Menstrual cycles and stress response are interconnected
• Higher estrogen (follicular phase) enhances stress resilience
• Lower estrogen (luteal phase) reduces natural stress capacity
• This explains increased stress sensitivity before menstruation
• Honoring cycle phases can dramatically improve stress management

 

1. Chronic stress progresses through predictable stages
• From initial adaptation to resistance to insufficiency
• Different stages present different symptoms and require different approaches
• Both high and low cortisol can indicate HPA axis dysfunction

 

1. Stress affects all body systems
• Immune function: increased inflammation, reduced immunity
• Digestion: altered gut motility, microbiome changes
• Reproduction: hormonal imbalances, cycle irregularities
• Metabolism: blood sugar issues, insulin resistance
• Brain: cognitive impairment, mood disorders

 

1. "Managing" stress doesn't work—repairing it does
• Bubble baths and meditation apps don't address root causes
• True resilience comes from creating physiological safety
• Surface-level interventions create temporary relief at best

 

1. Your body heals in safety, not in survival mode
• Creating conditions for healing means addressing both obvious and hidden stressors
• Supporting foundational rhythms (sleep, nutrition, movement, connection)
• Honoring your unique biology rather than cultural expectations

 

About the Host

Iris Josephina is a functional hormone specialist, entrepreneur, and coach, passionate about cyclical living and running a business in alignment with natural rhythms.

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• 💬 Come say 'Hi' on Instagram: @cycleseeds
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