High cortisol: effects on the body and risks

A balanced cortisol level is crucial for health, pregnancy, and fertility, while a chronic excess due to stress poses significant risks.

Eat cortisol plays an important role in the body by regulating stress and metabolism, but its chronic increase can have negative effects on health, reproductive function, and the course of pregnancy, whereas a moderate level is necessary for the proper functioning of all systems.

In recent years, the measurement of cortisol level has become a common practice in private laboratories. Some medical centers have even included it in their standard health check-ups. Patients often wonder how to check their cortisol levels and what it indicates.

Cortisol is the main hormone that regulates the body's reactions to stress. Its increase is associated with chronic emotional stress, lack of sleep, excessive physical effort, and a diet rich in carbohydrates. This hormone can be both beneficial and dangerous, depending on its amount and duration of exposure.

Cortisol and pregnancy

During pregnancy, the cortisol level in a woman's body naturally increases by nearly three to four times compared to its non-pregnant values. This is a physiological process related to the need for the maternal body to adapt and ensure the proper development of the fetus. Cortisol regulates the mother's metabolism, influences blood circulation in the placenta, and contributes to the formation of the fetus's lungs.

The increase in cortisol during this period plays a positive role: it participates in the development of the fetal cardiovascular system, in the formation of the nervous system, and helps the baby adapt to post-birth conditions. Its importance is particularly high in the third trimester, when the hormone promotes the production of surfactant, a substance necessary for the newborn's respiration.

However, a cortisol level that is too high, caused by chronic stress or hormonal disorders, can have negative repercussions on the course of pregnancy. It increases the risk of developing gestational diabetes, hypertension, preeclampsia, and favors premature birth or slowed fetal growth. In the future mother, this often manifests as insomnia, fatigue, and depressive states.

Stress management during pregnancy is particularly important. Breathing techniques, prenatal yoga, walks in the fresh air, and restorative sleep are beneficial. An endocrinologist or obstetrician-gynecologist can prescribe additional cortisol testing if there is suspicion of significant hormonal disorders. Balancing this hormone is key to a healthy pregnancy and proper fetal development.

Cortisol in reproductive medicine

In reproductive medicine, cortisol is considered one of the key hormones influencing the ability to conceive and the success of assisted reproduction programs. Chronic stress and high cortisol levels disrupt the balance of sex hormones: in women, progesterone and estrogen production decreases, while in men, testosterone production diminishes. This leads to ovulation problems, poor sperm quality, and implantation issues.

In women, excess cortisol can disrupt oocyte maturation and reduce pregnancy chances, as well as increase the risk of failure in IVF and egg donation programs. In men, elevated cortisol reduces sperm concentration and motility, impairs morphology, and sometimes causes erectile dysfunction. That's why fertility treatment programs consider both partners' hormonal status.

During IVF cycles and donation programs, doctors closely monitor cortisol balance. Optimal values are important for preparing the endometrium for implantation and normal embryonic development. Patients are often advised to undergo psychotherapy, stress management, moderate physical activity, and sleep monitoring. These measures help reduce excessive cortisol levels and increase pregnancy success chances. Hormonal profile monitoring is an important part of a comprehensive approach to infertility treatment, including IVF with donor eggs and double donation.

Main functions of cortisol

Cortisol is produced by the adrenal glands and performs many functions. It regulates the body's response to stress, participates in the metabolism of fats, proteins, and carbohydrates, controls blood sugar levels, and maintains blood pressure. Its role in regulating the sleep-wake cycle is also important. However, excessive production harms the body: edema appears, skin and hair condition deteriorates, intestinal function is disturbed, and immunity is weakened. Chronic stress diminishes the body's ability to recognize and destroy tumor cells, increasing cancer risk. Disruptions in daily fluctuations of this hormone lead to insomnia and fatigue.

Stress and its phases

The classical theory distinguishes three phases of stress: acute stress, adaptation, and exhaustion. Acute stress manifests as increased heart rate, dilated pupils, elevated blood glucose, and halted digestion. It is impossible to sustain this state for long. Chronic stress causes cortisol dysfunction, depression, inflammation, and accelerated aging. To prevent exhaustion, relaxation techniques such as meditation, yoga, and moderate physical activity are used.

Sometimes, Cushing's syndrome develops, a disease associated with a adrenal tumor or prolonged corticosteroid use. In such cases, the intervention of an endocrinologist is necessary.

Effects of cortisol on the body

In moderate quantities, cortisol helps mobilize energy, improves concentration, has anti-inflammatory effects, and maintains blood pressure. However, chronic increase leads to anxiety, depression, weight gain, insomnia, weakened immune system, muscle mass loss, and reproductive function disorders. Thus, its benefits and harms depend on its balance.

Symptoms of cortisol imbalance

High levels are characterized by constant fatigue, irritability, insomnia, increased appetite, hair loss, acne, premature skin aging, decreased libido, and frequent infections. When levels are low (for example, in Addison's disease), weakness, weight loss, low blood pressure, abdominal pain, nausea, hypoglycemia, apathy, and sometimes skin darkening in certain areas are observed.

When to perform a cortisol test

The test is prescribed for rapid weight gain, stretch marks, persistent high blood pressure, chronic fatigue, depression, early osteoporosis, changes in facial contour, menstrual cycle disorders, and suspicion of endocrine diseases. Examination methods include measuring free cortisol in urine over 24 hours, evening saliva, and morning blood after a dexamethasone test. Clinical signs are often more informative than laboratory tests, which is why interpretation is always performed by a physician.

Preparation for testing

To ensure reliable results, it is important to avoid physical exertion and alcohol consumption for 24 hours, get sufficient sleep, and arrive fasting for analysis. Cortisol levels vary throughout the day, so the time of examination and the patient's general condition are taken into account. The doctor should also be informed about any hormonal medication intake.

Final cortisol value

Cortisol is an essential hormone for the normal functioning of the body. Its balance is crucial for health, especially during pregnancy and in reproductive medicine programs. Monitoring cortisol levels allows early detection of endocrine disorders and improves treatment effectiveness.

Bibliography

Yoichi Chida, Andrew Steptoe. Cortisol awakening response and psychosocial factors: a systematic review and meta‑analysis, Biological Psychology, 80(3): 265–278, 2009.

Sally S. Dickerson & Margaret E. Kemeny. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research, Psychological Bulletin, 130(3): 355-391, 2004.