The Effects of Estrogen on Cortisol, or, Why I’m Marking My Calendar “Danger Week”
By: Jessica Hatch
I have general anxiety disorder with OCD and body dysmorphic tendencies. That’s the first thing you should know. When either my anxiety or my OCD gets out of control, I tend to get depressed, which for me manifests as general listlessness, a mental fog, and/or paralyzing doubt about all of my life choices.
Still, in a lot of ways, I am very lucky. The insurance that my office job provides its employees includes modest behavioral health coverage. Moreover, my mental health issues are, to this point, manageable through cognitive behavioral therapy (CBT), regular exercise, and journaling.
Through these management tools, I’ve made great strides in replacing negative schemas (“You’re worthless,” “Why would anyone care about you?”) with positive ones (“I am enough,” “I deserve good things,” “There is no wrong way to have a body”), especially where anxiety, body image issues, and OCD are concerned.
But every once in a while, I noticed I’d backslide. I’d beat myself up for having an extra slice of pizza. My overachiever to-do list would defeat me. I wouldn’t want to get off the couch. In short, I’d feel easily overwhelmed, panicky, and self-loathing.
And then I started to notice a pattern to this backslide. Huh. It happened about once a month. Oh, hey. It happened the same week every month. Oh, no. It always happened the week before my period.
Of course it was hormones.
As a feminist, I hated the idea of my anxiety being related to hormones. It felt so wilting flower. “Ah, I seem to get more anxious, compulsive, and depressed when I’m PMSing.” It was like the modern-day equivalent of the “wandering uterus,” a bogus theory that was used to make hysteria a gendered mental condition in the 19th century. (Seriously. Look it up.)
But, discarding the misogynist reading of PMS, the pattern was there.
I’m nothing if not an analytical person, so I considered what I already knew about hormones and the human menstrual cycle. I knew that the week before a person’s period is when that person ovulates. I also knew that, to make ovulation happen, the body produces a metric crap-ton of a hormone called estrogen.
So, I found myself wondering about another hormone, the stress hormone cortisol. Heightened levels of cortisol correspond to a feeling of stress and anxiety in the body. It exists because it was once a good thing: it helped our ancestors decide between fight and flight.
I wondered… Could estrogen levels be directly linked to cortisol levels in the body?
Turns out, I was right. An increase in estrogen has a direct correlation with increased levels of cortisol. So, when a person ovulates (or faux-ovulates, if they are on hormonal birth control), their estrogen levels peak, making cortisol levels peak, too. With little progesterone to balance it out and calm down the body system, this can be a perfect storm for stress, anxiety, and depression. This is why we feel bloated, panicky, stressed during ovulation.
(You can fact check me here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663529/).
All right, it’s great that I figured this out, but how could I harness this knowledge to empower myself?
I recently told someone that slapping a label on yourself is no good if you let the label act as a road block. It would be like Peter Parker getting bitten by a radioactive spider, then doing nothing when webbing shot out of his wrists except saying “Oops,” and cleaning it off of the ceiling.
It’s easy to say, “I have anxiety with OCD tendencies that get worse before my period, it’s hopeless,” but it’s challenging and so, so worth it to say, “I have anxiety with OCD tendencies that get worse before my period. How can I help myself in the long run?”
This, to me, would be the redeeming part of calling myself out for acting irrationally during PMS.
So, armed with this knowledge, I now label my planner DANGER WEEK every third week of the month. During Danger Week, it’s imperative that I get enough sleep, decent exercise, and reduce alcohol and caffeine intake. All of this helps me personally to reduce my environmental sources of stress.
To ensure success, I block out two lines on each day of my daily planner so that I can’t overbook myself. Then, the Friday of that week (aka “Pamper Day”), I give myself a modest treat, like an afternoon nap, manicure, or the latest best-seller I’ve been eyeing for a while. This is done in the name of self-care and to instill in me the belief that I, like everyone else, deserve good things.
On top of my regular mindfulness efforts, I’ve been practicing Danger Week for three months now. It has led to a mental landscape with far less dramatic peaks and valleys, and a more even keel daily life. My friends who have periods have even started exploring Danger Week’s impact on their lives. Yay for science leading to empowerment and improved self-care!
I would encourage any readers who are facing similar problems, labels, or diagnoses to explore their options. Do you have to let your problem or label define your experience, or can you harness what you know about it to make your life even richer?