Stress, Hormones and PCOS – What’s the Link?

Lisa Smith Nutritionist
Jun 24
4 min read

Updated: 6 days ago

If you’re living with PCOS, you’ve probably noticed how your symptoms flare up at certain times, like during high-pressure periods at work or when you’re not sleeping well. Chronic stress can have a knock-on effect on your hormones, metabolism, cycle and energy levels.

Let’s explore how stress really does affect your hormones, and what you can do to start feeling more balanced again.

Cortisol: Your Stress Hormone and Its Role in PCOS

Cortisol is your body’s main stress hormone. It helps you respond to pressure, danger or blood sugar dips by raising your heart rate and blood glucose so you can act fast.

That’s helpful in the short term, but in women with PCOS, cortisol doesn’t always switch off when it should.

High or persistent cortisol can:

Increase insulin resistance
Disrupt ovulation
Drive stubborn weight gain (especially around the middle)
Worsen sugar cravings and low energy
Disrupt sleep and mood regulation
Lower progesterone, making PMS or period symptoms worse

In PCOS, this becomes a vicious cycle. You feel tired, wired, and reactive, and your body finds it harder to reset.

Is It Just ‘Stress’, or Something Deeper?

Many women I work with say they’re not even sure if they are stressed, they’ve been operating on high alert for so long it feels normal. But stress doesn’t always show up as panic or anxiety.

Here are some common signs your stress hormones are out of balance:

Feeling tired in the morning but wired at night
Poor quality sleep, even if you get 7–8 hours
Racing thoughts, especially before bed
Crashing energy around 3–4pm
Strong sugar or caffeine cravings
Feeling overwhelmed by small tasks
Irritability, low motivation or mood swings

These are often driven by underlying cortisol and blood sugar dysregulation, not just a lack of willpower or poor time management.

How High Cortisol Disrupts Hormonal Balance in PCOS

Here’s what happens when stress goes unchecked:

1. Blood Sugar Becomes Unstable

Cortisol raises blood glucose as part of your stress response. But frequent spikes can worsen insulin resistance, which is already a core driver in many types of PCOS.

2. Progesterone Drops

When your body prioritises survival, it downregulates reproduction. Cortisol can suppress ovulation and lower progesterone, leaving oestrogen unopposed, and triggering PMS-like symptoms, sore breasts, mood swings or heavier bleeds.

3. Testosterone Increases

Stress-induced insulin resistance may lead to excess androgens (like testosterone), which can worsen symptoms like acne, hair thinning and facial hair growth.

4. Thyroid Function Slows

Chronic stress can slow thyroid hormone conversion and metabolism, contributing to fatigue, poor concentration and slower weight loss, another common PCOS frustration.

What Actually Helps Beyond Just ‘Relax More’

You don’t need to become a yoga master or live on a beach to reduce the impact of stress.

Here’s what I find works best for clients with PCOS:

1. Stabilise Your Blood Sugar First

Keeping glucose steady reduces the body’s perceived stress response. Aim for protein with every meal and avoid skipping breakfast. My clients often see big improvements in energy, mood and cravings by doing this alone.

2. Build In Daily ‘Switch-Off’ Signals

Your body needs a clear signal that it’s safe.

This could be:

5–10 minutes of deep belly breathing
A morning walk outside or a short walk after meals
A relaxing routine before bed (without screens)
Gentle movement like stretching, the NHS has stretching exercises here

These may seem small, but they send a powerful message to your brain that you’re not in danger.

3. Support Your Sleep-Wake Rhythm

Try to go to bed and wake up at similar times. Dim screens and overhead lights an hour before bed to support melatonin production. Cortisol and melatonin work in a rhythm, when one is up, the other is down, so regulating your sleep can help rebalance both.

4. Adapt Your Exercise to Your Stress Load

If you’re exhausted and burnt out, high-intensity workouts may be making things worse. Walking, strength training and low-impact movement can support insulin sensitivity without adding to your stress burden.

5. Use Nutrients That Support the Stress Response

A functional nutrition approach includes food-first strategies to support adrenal balance.

Useful nutrients include:

Magnesium – especially from leafy greens, pumpkin seeds, dark chocolate
Vitamin C – found in bell peppers, berries, kiwi, citrus
B vitamins – especially B6 for hormone and mood support
Protein – to stabilise blood sugar and repair hormone receptors

PCOS Is a Whole-System Condition

Stress doesn’t cause PCOS, but it can make every symptom feel worse, from weight gain and cravings to mood swings, sleep problems and period issues.

That’s why supporting the stress response is a non-negotiable step in any PCOS programme I run. It’s not about doing more, but helping your body feel safe enough to shift into balance.

Understand Your Hormone Patterns

If stress is something you know affects your cycle, cravings or sleep, this is exactly what we explore in my 12-Week PCOS Programme, The Hormone Shift Method. We take a food-first, root-cause approach to rebalancing hormones, supporting energy, weight, and mood – with weekly guides and practical steps you can stick to.

Want to Learn More About Your Hormone Balance?

Download your free Hormone Health Snapshot – a simple self-check tool to help you spot which hormone patterns might be driving your PCOS symptoms.

Disclaimer

This blog is for informational purposes only and is not a substitute for personalised medical advice. Always speak to your GP or a registered health professional before making changes to your healthcare routine.

References

Adan R.A.H., van der Beek E.M., Buitelaar J.K., Cryan J.F., Hebebrand J., Higgs S., Schellekens H., Dickson S.L. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European Neuropsychopharmacology, 29(12), 1321–1332. https://doi.org/10.1016/j.euroneuro.2019.10.011
Grosso G. (2021). Nutritional Psychiatry: How Diet Affects Brain through Gut Microbiota. Nutrients, 13(4), 1282. https://doi.org/10.3390/nu13041282
Sarris J., Logan A.C., Akbaraly T.N., Amminger G.P., Balanzá-Martínez V., Freeman M.P., Hibbeln J., et al. (2015). Nutritional medicine as mainstream in psychiatry. The Lancet Psychiatry, 2(3), 271–274. https://doi.org/10.1016/S2215-0366(14)00051-0
Dal N., Bilici S. (2024). An Overview of the Potential Role of Nutrition in Mental Disorders in the Light of Advances in Nutripsychiatry. Current Nutrition Reports, 13(2), 69–81. https://doi.org/10.1007/s13668-024-00520-4