#Hormonehealth and #cortisol are now trending on TikTok with (582.5M views), causing us to become curious about the stress hormone, taking over TikTok, the impact of our hormones, namely cortisol levels, on our mood, fatigue, weight, and overall health, especially during the summer months. However, left out of all the online chatter was the impact on our vaginas and reproduction due to stress, which can lead to several physical issues, such as a lack of libido and an increase in yeast infections and UTIs. As we head into the summer, the stress of travel, wedding season, preparing for loved ones to return to school, and daily life can easily trigger our cortisol levels.
Dr. Janelle Howell is a pelvic floor physical therapist and social media influencer, affectionately known as @vaginarehabdoctor on Instagram and TikTok, and founder of V Rehab Services LLC. This global educational company teaches women to overcome sexual pain and urinary incontinence through virtual coaching, monthly exercise classes, courses, and vaginal health ebooks. She believes unmanaged and chronic stress can impact your vagina and reproductive system in various ways.
One is when we’re stressed; our blood sugar levels can rise, to prepare for flight or fight, which would be beneficial; if we had to run away in a moment of danger, our muscles would need the energy to support all the increased movement. The issue is that when we are under stress, and our body is not fleeing or escaping, our body pumps more sugar into the bloodstream (including blood vessels in the vagina), and our immune cells are weakened. “This can make it easier to get vaginal infections like yeast infections, bacterial vaginosis, and even urinary tract infections which typically require a medical assessment to diagnose and effectively treat,” Dr. Howell says to ESSENCE.
Another primary way stress impacts our vaginal health is by tensing and restricting our pelvic floor muscles. “These muscles surround the vagina, supporting our pelvic organs like our bladder, uterus, and vagina and allowing us to either have a bowel movement or hold it in. “These are also the muscles that support our pelvis as we’re pregnant, stretch to allow the passage of the baby when we give birth vaginally, and help us not to pee our pants! These muscles are super vital but very sensitive to stress,” Howell says.
Dr. Justine Roper, owner of InHer Physique, agrees with Howell about how harmful holding tension is in your pelvic floor muscles, as it could cause serious physical issues. “That long-term tension could contribute to pelvic floor dysfunction, infertility-related problems, bladder/bowel problems, and sexual issues. To have optimal vaginal and reproductive health, we need proper blood flow and nerve conduction, flexibility/stability of our pelvic floor muscles, proper hormone production, and optimal vaginal pH,” Roper says.
Roper continues, “Cortisol plays a large role in metabolism and immune support. Having acute, chronic, or traumatic stress can impact your immune system and disrupt your entire body. Stress can cause changes in discharge and increased risk of vaginal infections, low libido, vaginal dryness, changes in the menstrual cycle, weight fluctuations, and pelvic floor tightness.”
As a pelvic floor therapist, Roper often sees many of the symptoms mentioned above in my patients and encourages them to assemble a collaborative care team that includes various providers that can address their specific needs. “A balanced care team can look like having an OB/GYN, pelvic floor therapist, endocrinologist, mental health provider, acupuncturist and a massage therapist for a person who experiences chronic stress and suffers from those symptoms,” Roper states.
As a pro tip, Roper suggests laying off the kegels, as many people don’t realize that doing too many of those exercises can cause issues. For reference, signs of a tight pelvic floor can be constipation, pain during sex, and lower back pain. Abdominal, Hip, or back pain, pelvic pressure, difficulty emptying your bladder, urinary urgency, or the need to run to the restroom often are signs of pelvic floor dysfunction.
Additional side effects of stress as it relates to your vagina:
Aside from the common side effects, unbalanced vaginal pH levels, difficulty orgasm, pelvic pain, tailbone pain, and recurrent vaginal infections. Vaginismus is another condition that can happen due to high stress and anxiety. Vaginismus is the body’s automatic reaction to the fear of some or all types of vaginal penetration. Whenever penetration is attempted, your vaginal muscles tighten up on their own. However, Howell says this condition is treatable, and the remedies may look like breathing exercises, postural training, internal pelvic floor muscle release, and other modalities that a pelvic floor physical therapist usually teaches. However, it’s important to note that while pelvic floor and physical therapists professionals can teach you ways to overcome these patterns of vaginal and pelvic floor dysfunction, it’s essential for the patient to incorporate healthy and sustainable ways to manage the stress in their life as a wellness and preventative practice.
Alice Benjamin, a nurse and founder of the popular “Ask Nurse Alice” social media platform, shares additional physical and psychological issues when experiencing chronic or prolonged stress.
Hormonal imbalance: Stress triggers the release of stress hormones like cortisol and adrenaline, which can interfere with the delicate balance of reproductive hormones such as estrogen and progesterone. This hormonal imbalance can affect menstrual cycles, ovulation, and fertility.
Menstrual irregularities: Stress can cause irregular periods, missed periods, or amenorrhea (absence of menstrual periods). This is often due to alterations in the hypothalamic-pituitary-ovarian axis, the hormonal feedback loop that regulates the menstrual cycle.
Fertility issues: Stress affects hormonal balance and menstrual irregularities, making it more challenging for couples to conceive. Stress may reduce libido and sexual desire, further impacting fertility.
Vaginal health: Stress weakens the immune system, increasing the risk of vaginal infections such as yeast infections and bacterial vaginosis. Additionally, chronic stress may contribute to pelvic muscle tension, leading to discomfort, pain during intercourse (dyspareunia), or conditions like vaginismus.
Menopause symptoms: Stress can exacerbate menopausal symptoms such as hot flashes, night sweats, and mood swings, making the transition to menopause more challenging.
Pregnancy complications: High-stress levels during pregnancy can potentially lead to complications like preterm labor or low birth weight. Additionally, stress during pregnancy may affect fetal development and have long-term consequences for the child’s health.
Polycystic ovary syndrome (PCOS): Some research suggests that stress may contribute to developing or worsening PCOS, a hormonal disorder that can affect ovulation and fertility.
Endometriosis and pelvic pain: Although the exact relationship is not fully understood, stress can exacerbate symptoms like endometriosis and other chronic pelvic pain conditions.
How should we keep our vaginas healthy during the summer months?
Because of the heat and increased demand for hydration, finding several ways to stay hydrated is critical, says Howell. She suggests drinking herbal tea, coconut water, coconut or lemon infused water, regular water, and juicy fruits like kiwi, mango, pears, and watermelon to stay hydrated and therefore aid us in immune support for managing and preventing infections, preserving vaginal lubrication, and even promoting pelvic floor muscle support for bladder control, bowel elimination, and sexual wellness.
“Another great way to support our vaginal health during summer is to opt for more outdoor activities! We can be tempted to stay indoors due to the blazing temps, but indoor air is significantly more polluted than outdoor air. Our vaginas thrive on Vitamin D. Vitamin D, and exposure to sunshine can help us with our menstrual cycles, fertility, stress levels, and vaginal health. A lack of sufficient sun exposure can contribute to depression (which typically leads to less than optimal vaginal health outcomes), so simply getting our bodies in sunlight is a free way to help cancel stress and upgrade our vaginal health,” Howell says.
Physical trainer and doula Rachel Nicks says, “Do not sleep with panties on! Wear loose clothing in the summer months and sleep without underwear. Increased heat can cause an increase in vaginal infections.”
Dr. Alice’s tips on taking care of our hormone health:
Balanced Diet: Eat a well-balanced diet that includes a variety of nutrients. Focus on whole foods, including fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid excessive consumption of processed foods, sugary snacks, and drinks.
Regular Exercise: Engage in regular physical activity. Exercise can help regulate hormone levels and improve overall health. Aim for cardiovascular conditioning, strength training, and flexibility exercises.
Stress Management: Chronic stress can disrupt hormone balance—practice stress-reduction techniques such as meditation, deep breathing, yoga, or spending time in nature.
Adequate Sleep: Get enough restful sleep each night. Lack of sleep can negatively impact hormone production and regulation.
Limit Caffeine and Alcohol: Excessive caffeine and alcohol consumption can affect hormone levels. Moderate your intake of these substances.
Stay Hydrated: Drink plenty of water daily to support proper bodily functions.
Maintain a Healthy Weight: Excess body fat can lead to hormonal imbalances, especially in insulin and sex hormones. Aim to maintain a healthy weight through a balanced diet and regular exercise.
Regular Check-ups: Visit your healthcare provider for regular check-ups and screenings, which can help identify any potential hormone-related issues early on.
Avoid Endocrine Disruptors: Avoid exposure to environmental toxins and endocrine disruptors, which can interfere with hormone function. These include certain chemicals found in plastics, pesticides, and some personal care products.
Hormonal Birth Control and Hormone Replacement Therapy: If you are using hormonal birth control or undergoing hormone replacement therapy, follow your healthcare provider’s recommendations and regularly review the appropriateness of the treatment for your needs.
Educate Yourself: Stay informed about hormone health, its importance, and any specific risks or issues relevant to your age, sex, or medical history.
What should we do if we’re experiencing symptoms of low cortisol levels?
Howell suggests decreasing our caffeine levels, alcohol intake, and even stress levels. “When we drink caffeine, this stimulates the release of cortisol. If we constantly release cortisol from stimulants like coffee and alcohol, the body can fall behind in cortisol production, eventually leading to insufficient levels. Trying to get sufficient sleep or opting for decaf coffee in the mornings is a great help,” she says.
Howell continues, “Additionally, getting more nutrients like fat, protein, magnesium, and plants can help too! Cortisol is made from cholesterol, so eating more avocados, almonds, cashews, greek yogurt, olive oil, chia seeds, salmon, and other foods with good fats helps support our production of cortisol.”