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A Tangled Web: Hormones, Gut Health, Stress, and Mental Health

Updated: Oct 25, 2022

Stress can be a major contributor to depression. This seems obvious, right? You get stressed out and then your mood drops. How many of us have been through a stressful life event over the past six months? Spoiler alert: it’s all of us. For many of our patients, increased stress from financial worries, job losses, the upcoming election, or living in the middle of a global pandemic has caused new or worsening mental health issues like anxiety, insomnia, and depression.

The impacts of stress aren’t all in our minds. Stress impacts an endless number of processes in the body. Cortisol is one of our main stress hormones. This hormone is released from the adrenal glands after they are stimulated by adrenocorticotropic stimulating hormone (ACTH), another hormone sent out by the pituitary. Chronic elevated cortisol levels deplete serotonin and dopamine and may actually damage receptors for these neurotransmitters.

Stress and Hormones

Chronic stress also impacts our hormone levels. In women, high-stress levels are associated with lower estrogen levels according to some research. Stress suppresses ovarian hormone production and can lead to low levels of both estrogen and progesterone. High cortisol levels can also decrease progesterone, leading to an imbalance in hormones contributing to an estrogen-dominant state. Finally, stress can tax the liver leading to less efficient removal of estrogens from the body, possibly leading to increased levels of estrogen.

In men, chronic stress causes increases in ACTH, the hormone released from the pituitary gland that tells the adrenal glands to produce cortisol. High levels of ACTH and cortisol have been associated with decreases in circulating testosterone in men.

The Role of Gut Health

Stress can also have major impacts on gut health. Stress weakens the junctions between our intestinal cells, allowing gaps to develop. These gaps allow food particles and pathogens to enter the bloodstream, causing inflammation, inappropriate immune activation, and food reactions. This is called increased intestinal permeability or leaky gut, and it’s way more common than you think (because let's be honest, most of us are pretty stressed).

Issues with gut health and mental health are linked in a bidirectional relationship, meaning that changes in either one could lead to changes in the other. Most serotonin, one of the neurotransmitters associated with mood regulation, is produced in the gut. More inflammation and irritation in the gut can lead to changes with serotonin.

Gut health also impacts hormonal health. In a recent study, researchers looked at endotoxin-initiated inflammation and its effect on testosterone. Endotoxin-initiated inflammation is a marker for increased intestinal permeability. The study found that high endotoxin levels were correlated with lower testosterone levels and higher levels of inflammatory compounds called cytokines. Researchers think this inflammation may suppress the cells that produce testosterone.

Hormones and Mental Health

Hormonal changes can impact our mental health. For women, fluctuating estrogen levels can increase symptoms of depression including sadness, anger, and depressed mood. The effects are noticeable for many women during menopause, but women can also experience depressive symptoms during hormonal fluctuations during their menstrual cycle. For men, low testosterone levels are associated with depression, anxiety, and insomnia.

What Does It All Mean?

Like it does in our daily lives, stress tends to spread in our bodies. One little stressor can put you on edge and lead you to feel more stressed about another issue later in the day. Your nervous system gets primed to react to stress and so it feels like stressors are everywhere. Our body systems are all interconnected. Changes in one system lead to changes in other systems. Stress impacts our hormone levels which can lead to changes in mood. Stress also impairs proper gut function which can lead to lower levels of hormones and neurotransmitters.

At Opus Anti-Aging and Wellness, we work with patients to tackle the root cause of their health issues. Oftentimes, stress is a major component of this root cause. We work together to incorporate exercise, nutritional changes, botanical medicine, energetic medicine, and mind-body techniques to reduce stress levels and support a healthy gut, hormonal, and neurotransmitter function in the body.

If you're struggling with stress, call our office and make an appointment to discuss ways to support your mental and physical health.



Albert KM, Newhouse PA. Estrogen, Stress, and Depression: Cognitive and Biological Interactions. Annu Rev Clin Psychol. 2019 May 7;15:399-423.

Foster JA, Rinaman L, Cryan JF. Stress & the gut-brain axis: Regulation by the microbiome. Neurobiol Stress. 2017;7:124-136. Published 2017 Mar 19. doi:10.1016/j.ynstr.2017.03.001

Fothergill M, Wolfson S, Neave N. Testosterone and cortisol responses in male soccer players: The effect of home and away venues. Physiol Behav. 2017 Aug 1;177:215-20.

Gordon JL, Peltier A, Grummisch JA, Sykes Tottenham L. Estradiol Fluctuation, Sensitivity to Stress, and Depressive Symptoms in the Menopause Transition: A Pilot Study. Front Psychol. 2019 Jun 12;10:1319.

Rodgers S, Grosse Holtforth M, Hengartner MP, et al. Serum testosterone levels and symptom-based depression subtypes in men. Front Psychiatry. 2015;6:61. Published 2015 May 4. doi:10.3389/fpsyt.2015.00061

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