PCOS, stress, and how to reduce your cortisol leves
Cortisol has become a buzzword in wellness circles, with people understandably taking the steps to reduce how their bodies are impacted by stress. However, for women with PCOS, understanding cortisol is key to understanding our bodies, as hormonal imbalance is directly correlated to cortisol. So, what is cortisol?
Cortisol is a hormone produced by the adrenal glands that governs how your body responds to stress. It is responsible for key daily functions, including your sleep-wake cycle, energy levels, and how your nervous system responds to stress.
When cortisol levels remain elevated for prolonged periods, this can signal the body to produce more insulin to help meet its increased energy demands. Over time, this can eventually lead to insulin resistance or worsen existing insulin resistance. Insulin resistance occurs when the body's cells become less responsive to insulin, making it harder to regulate blood sugar levels. At the same time, the hormonal disruption of PCOS itself (such as irregular cycles, elevated androgens, metabolic stress and rapid weight gain) can keep the nervous system in a low-grade state of alert, thereby keeping cortisol levels higher.
This complex hormonal interplay is actually one of the reasons why PCOS has now been renamed PMOS (Polyendocrine Metabolic Ovarian Syndrome), in order to more accurately reflect the very nature of the syndrome.
Insulin, cortisol, and androgens are all deeply intertwined, when one is disrupted, the others follow.
This is why PCOS has now been renamed PMOS ((Polyendocrine Metabolic Ovarian Syndrome).
Addressing cortisol is central to healing and reducing PCOS symptoms.
Understanding cortisol can help us understand that our ongoing symptoms are not a sign that there is something wrong or broken with our bodies, but simply that our nervous system is stuck in a response state that we are trying to slowly and gently undo.
How to reduce cortisol levels
1. Breathwork
The most direct tool we have for shifting the nervous system is the breath. Slow, extended exhalations in particular activate the vagus nerve and move us from fight or flight mode (sympathetic) to rest and digest (parasympathetic) mode. Just a few simple breaths can be enough to feel the difference. Here are a few easy and simple techniques to start with:
Double inhale, slow exhale
Inhale fully, take a second inhale on top of it, then release slowly and completely.
4-6-8 breathing
Inhale for 4 counts, hold for 6, exhale for 8.
Box breathing (4-4-4-4)
Inhale, hold, exhale, hold, each for 4 counts.
All of these breathwork exercises activate the parasympathetic nervous system almost immediately. I recommend starting with a timer for 3 minutes once a day, 3 minutes is easy to start with and it’s enough for you to feel a difference. Then you can move on to 3 minutes in the morning and 3 minutes before bed. Next thing you know, 3 minutes will become effortless and you will likely find yourself doing it for much longer, naturally gravitating towards breathwork to reduce and relieve stress.
2. Stretch every day
When we're chronically stressed, muscles tend to hold tension without us even noticing, such as tight hips, a clenched jaw, and rounded shoulders.
Gentle stretching, especially slow, intuitive movement, reduces stress and tension in the body and signals safety to the nervous system. This helps us return to being present in our bodies, if even for a moment.
Like breathwork, stretching activates the parasympathetic nervous system and helps ease tension in the mind and body. It doesn't need to be a full yoga session, studies have shown that just ten minutes in the morning or before bed is enough to make a difference over time.
3. Play, create, and explore
Our hobbies and creative outlets put us back in touch with play, joy, and simply doing things for fun.
When the body is in an elevated state of stress, chronic cortisol elevation can keep us in execution mode — moving from task to task, unable to fully rest even when we sit down. We jump from one task to another, constantly thinking about what needs to be done. If we sit down and relax, it is likely in the form of scrolling through social media, which numbs us more than it does shift our nervous system from a state of activation to a state of relaxation, even if it might feel that way.
When we engage with or reconnect to our hobbies and creativity, we are reconnecting with the part of ourselves that wants more from life than simply to just do, and instead, we connect with the part that wants to be. This is what it also means to shift the nervous system from fight-or-flight mode to rest-and-digest mode.
Take out your sketchbook. Read a book about a topic that interests you. Go for a hike with friends. Whatever it was that once brought you joy and meaning in your life, make space for it again.
4. Go for walks
Walking is gentle on the mind, body, and nervous system, and it is easy and accessible. Walking increases the production of endorphins that naturally elevate mood, while also lowering cortisol without spiking it the way intense exercise can. It also activates rest-and-digest mode as walking activates deeper breathing. A simple 20–30 minute walk outdoors is enough, and it is even better if it is in nature, as natural environments are more likely to decrease cortisol. However, if you don’t have access to outdoor spaces, then a treadmill will do.
5. Take magnesium glycinate
Magnesium is one of the most important minerals for stress regulation, and one of the most commonly depleted. Magnesium glycinate can help reduce stress levels and reduce cortisol levels, especially if you struggle with sleep or regularly wake up in the middle of the night. Research suggests women with PCOS are at higher risk of magnesium deficiency because magnesium plays a direct role in controlling how much cortisol your body produces.
Magnesium also works on a neurological level by supporting GABA, the neurotransmitter responsible for calming the brain and nervous system. Low magnesium means less GABA activity, which can result in higher anxiety levels and higher cortisol over time. It is also excellent for supporting deeper and more restful sleep, which is essential for reducing cortisol levels.
6. Don't stress about your cortisol levels
Stressing about your cortisol levels simply means giving your stressed out mind and body even more to stress about, which simply defeats the purpose.The things on this list aren’t another thing to add to your endless “to-do” list, the purpose of doing these things is so you can shift from doing to being.
If you are stressing out about doing breathwork or going for walks, it’s a bit counterintuitive. Instead, it’s about making the body feel safe again, shifting the nervous system from fight-or-flight mode to rest-and-digest mode. This is what lowering cortisol levels means, and for women with PCOS, it means shifting the body back into its natural balance.
Conclusion
Lowering cortisol levels means less pressure on the adrenal glands, increased insulin sensitivity, and a body that slowly but surely shifts from panic mode into safety mode. Chronic stress amplifies almost every symptom of PCOS, from irregular cycles to weight gain to hair loss and mood shifts. This means that addressing cortisol is an integral aspect of regulating PCOS symptoms and that owering cortisol levels creates the conditions your body needs to actually heal. But it all starts with you being kinder to yourself and being gentler with your mind and body, because that is what your body is signalling it needs from you right now.
Citations
Teede, H.J. et al. (2026). Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: A multistep global consensus process. The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext
Gerritsen, R.J.S. & Band, G.P.H. (2018). Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Frontiers in Human Neuroscience. https://www.frontiersin.org/articles/10.3389/fnhum.2018.00397
Nestor, J. et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine. https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(22)00474-8
Toda, M. et al. (2019). Combined effect of walking and forest environment on salivary cortisol concentration. Frontiers in Public Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC6920124/
Gonul, B. et al. (2011). Serum magnesium concentrations in polycystic ovary syndrome and its association with insulin resistance. PubMed. https://pubmed.ncbi.nlm.nih.gov/21696337/
Yaribeygi, H. et al. (2022). Molecular mechanisms linking stress and insulin resistance. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC8971350/
