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The Effects of HRT on Cortisol

A normal level of cortisol in our body, per the University of Maryland's Medical Center, is 6 to 23 micrograms per deciliter (mcg/dL). And when we have a normal level of cortisol, we can expect our body to function as it should, regulating our blood pressure, metabolizing glucose, aiding immune system function and producing inflammation responses when needed. But some medical conditions, like menopause, decrease hormone output, prompting the use of hormone replacement therapy (HRT) to counter that negative imbalance. But in some cases, HRT can have a negative effect on cortisol too.

  1. Cortisol Explained

    • The pituitary gland produces a hormone called ACTH, which in turn prompts the adrenal gland to release a steroid hormone known as cortisol. The hormone cortisol plays an important and positive role in many functions of our body (as mentioned earlier) but can also cause negative consequences too when its level gets too low or high, which can happen due to increased and prolonged stress or other conditions (like HRT use).

    Hormone Replacement Therapy's (HRT) Positive Effects on Cortisol

    • In a study conducted by the Endocrine Research Unit at Mexico's Hospital de Especialidades, it was concluded that HRT increases DHEA and ACHT, as well as cortisol concentration in women undergoing menopause due to hypoestrogenism (too low a level of estrogen).

      Too low a level of estrogen coupled with low levels of other hormones can have many negative effects, including low blood pressure (something an increase in cortisol level can counteract). Therefore, this study shows the positive effect that can be realized in increasing cortisol levels through the use of HRT.

    Stress, Cortisol and Menopause Complications

    • Cortisol works in unison with the thyroid hormone, but as stress increases in a person's life, their cortisol levels rise, creating problems with the cortisol-thyroid relationship. Too much stress over a continued period of time--and the subsequent overabundant release of cortisol to counter it--results in thyroid resistance (the refusal of all other hormones, not just cortisol, to respond to the thyroid's signals), according to David Zava, Ph.D., the director of ZRT Laboratory in Portland, Oregon.

      When symptoms of low estrogen and other hormones occur during menopause age, or there is a cortisol-thyroid problem (resulting in menopause-like symptoms), an individual and a doctor may erroneously assume that the symptoms are related to menopause, and HRT may be recommended and started, per Zava.

    HRT's Negative Effects on Cortisol

    • Therefore, if the cortisol levels in the body are already high due to stress or other medical conditions that have not been diagnosed, starting HRT could compound the problem rather than alleviate the current symptoms as hoped. And since continued high levels of cortisol over prolonged periods can negatively impact the brain, muscles, skin and bones of an individual, it is important to make sure HRT is the solution before it is begun.

    Significance

    • Individuals who struggle with sleep problems may be experiencing the problem due to cortisol levels that are too high. Simple saliva hormone tests performed by your doctor in the afternoon when cortisol levels are usually near their lowest (they are highest in the morning) can help determine if cortisol is too high.

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