Are your female patients suffering from Rushing Woman’s Syndrome?

These days women are often in a permanent state of stress – juggling their family, career, finances as well as a chaotic lifestyle. There are biochemical consequences to this constant rush – resulting in imbalanced hormones, HPA axis dysfunction, sluggish thyroid glands and so on.

The term ‘Rushing Woman’s Syndrome’ was coined by Dr Libby Weaver. It evolved out of her observation of women’s health being drastically affected by the constant rush that many women now live in. “Never before have I seen the extent of reproductive system problems that I now see. Women are tired and wired. Sex-hormone based health problems such as polycystic ovarian syndrome (PCOS), endometriosis, infertility, debilitating menopauses and exhaustion have never been greater, and the role of stress in this is undeniable when you look at both the body’s chemistry and the scientific research.” (Weaver, 2011).

Body systems involved in the rush – including (but not limited to):

Reproductive System
During the body’s response to stress (whether in the alarm, resistance or exhaustion phase) the impact on the hypothalamic-pituitary-ovarian feedback loop can be sufficient to cause an interference in hormonal balance leading to disrupted menstrual cycles, temporary cessation of ovulation, enhanced PMS symptoms and various other reproductive system conditions. We have a symphony of steroid hormones. Estrogen and progesterone are made in the ovaries. Cortisol, testosterone and DHEA are made in the adrenal glands. These steroids form an interchangeable pool of hormones, which are converted one to the other as the body needs them. When conditions are right, the body allocates its precious steroid hormones to hormones such as DHEA and progesterone. These hormones promote immune balance, cancer prevention, and reproduction.

When conditions are stressful, the body allocates the same steroid building blocks  to cortisol. Cortisol is the “survive now – deal with things later” hormone. So, if stress is high, then estrogen and progesterone are depleted because the body needs cortisol instead. The result may be irregular menstrual cycles. Further more, excess cortisol suppresses thyroid hormone, which causes cycle irregularity, and excess cortisol makes the body resistant to insulin, which in turn may cause failure to ovulate.

Nervous System
Acute stress situations cause an increase in stress hormones – adrenaline, noradrenaline, and cortisol. Cortisol is important to blood pressure regulation and the normal functioning of several body systems including cardiovascular, circulatory and reproduction. During stressful times our heart rate increases and blood vessels dilate (to allow increased blood flow to the big muscle groups), increasing blood pressure. If this stress continues and therefore the release of stress hormones, this can increase the frequency of symptoms such as headaches, dizziness, and depression. For example, long-term exposure to cortisol can contribute to weight gain.

Endocrine System
The pituitary is the master switch of the endocrine system which sends signals to other endocrine system glands (adrenals, ovaries, thyroid) instructing them to make hormones. For example the adrenal glands will make stress hormones, the ovaries make sex hormones and thyroid gland makes hormones that control temperature and metabolism. None of them work in isolation, they all influence each other. When we are stressed, adrenalin is released by the adrenal glands (to escape the perceived threat), blood sugar rises, to give us more energy and blood pressure and pulse rate increase to provide more energy to the muscles. But as a result reproductive functions are down regulated as the body prioritizes its need for survival rather than its need to reproduce.

Glucocorticoids, including cortisol, are important for regulating the immune system and reducing inflammation. While this is valuable during stressful or threatening situations where injury might result in increased immune system activation, chronic stress can result in impaired communication between the immune system and the HPA axis. This impaired communication has been linked to the development of numerous physical and mental health conditions, including chronic fatigue, metabolic disorders (e.g. diabetes, obesity), depression and immune disorders.

Digestive System
The gut has millions of neurons which can function fairly independently and are in constant communication with the brain. Stress can affect this brain-gut communication, hence why we feel ‘butterflies’ in the stomach, and may trigger pain, bloating and other gut discomfort. The gut is also inhabited by millions of bacteria which can influence its health and the brain’s health. Stress is associated with changes in gut bacteria which in turn can influence mood. Thus, the gut’s nerves and bacteria strongly influence the brain and vice versa. Stress can also make pain, bloating or discomfort felt more easily in the bowels. It can affect how quickly food moves through the body, which can cause either diarrhoea or constipation.

Furthermore, stress can induce muscle spasms in the bowel, which can be painful. Digestion is affected by stress in terms of nutrients that the intestine can absorb. The intestines have a tight barrier to protect the body from (most) food related bacteria. Stress can make the intestinal barrier weaker and allow gut bacteria to enter the body. Although most of these bacteria are easily taken care of by the immune system, the constant need for inflammatory action can lead to chronic symptoms. People with chronic bowel disorders, such as Inflammatory Bowel Disease or Irritable Bowel Syndrome are particularly affected by stress. This may be due to the gut nerves being more sensitive and changes in gut microbiota, how quickly food moves through the gut, and/or changes in gut immune responses.