Stress and hormone balance, Pregnenolone Steal

It’s not easy being female.

About 60-70% of all my patients are women. It’s not that men don’t need functional medicine, it’s that they think they don’t or they are too tough to need it.

Women suffer from the hormonal ups and downs each month and through puberty and then through menopause. These can range from mildly irritating to downright debilitating. Although many, if not most women suffer from some degree of premenstrual syndrome (PMS), the extreme health and mood imbalances associated with PMS and menopause are a sign your system is out of whack, often due to stress, among other issues.

Hormone balance is very sensitive to stress, inflammation, toxins, poor diet, sleep deprivation, lack of exercise, too little sunlight, and other common factors of modern life. Because the reproductive hormones play an important role in brain health, mood, and brain inflammation, when they’re imbalanced, brain function and mood suffer.

In women, imbalances are characterized by excess estrogen, insufficient progesterone, or too much testosterone. Both stress and blood sugar that is either too low (hypoglycemia) or too high (insulin resistance) are the most common culprits of PMS symptoms and a miserable menopause transition.

Symptoms of hormonal imbalances in women include:

  • Frequent or irregular menstruation

  • Mood instability

  • Depression

  • Problems sleeping

  • Changes in weight or appetite

  • Cry easily

  • Irritable

  • Poor concentration

  • Anxiety

  • Fatigue

  • Low libido

  • Migraines


Low pregnenolone/progesterone from chronic stress

One of the more common reasons for hormonal imbalance is low progesterone caused by chronic stress. This is a mechanism called “pregnenolone steal,” when chronic stress robs the compounds needed to make progesterone to make stress hormones instead. This leads to PMS and sets the stage for a miserable menopause transition.


When it comes to stress, the brain does not know whether you are angry at traffic, soaring and crashing after consuming a glazed donut and triple-shot caramel latte, or narrowly escaping being trampled by a bison, or chased by a lion. All it knows is to prepare for fight or flight and that reproduction hormones can wait until things have settled down. But for many sleep-deprived, over-stressed Americans fueled on caffeine and sugar, settling down rarely happens. This leads to an over production of cortisol and a decrease in pregnenolone and/or progesterone leading to a decrease in hormones. 


The fix isn’t necessarily in a tub of progesterone cream; first address the sources of stress. A primary stress-buster is stabilizing blood sugar. People either eat too infrequently and too sparingly, or they overeat and eat too much sugar. Both are stressful for the body.  

Here are some other common causes of chronic stress that lead to miserable PMS and menopause:

  • Sugar, sweeteners, starchy foods (rice, pasta, bread, etc.), too much caffeine

  • Food sensitivities (gluten, dairy, eggs, soy, corn, nuts, grains, etc.)

  • Leaky gut and gut inflammation symptoms — gas, bloating, indigestion, heartburn, diarrhea, constipation, stomach pain, irritable bowel

  • Sleep deprivation

  • Pain and inflammation — joint and muscle pain, skin rashes, respiratory issues, brain fog, fatigue, depression

  • Autoimmune diseases such as Hashimoto’s hypothyroidism

  • Overdoing it, over exercising, not taking time for yourself

  • Bad diet of junk foods, fast foods, processed foods


Restoring hormonal balance naturally

Ideas to halt pregnenolone steal include an anti-inflammatory diet, stabilizing blood sugar (SUPER IMPORTANT), restoring gut health, dampening pain and inflammation, and managing autoimmunity. 

These are functional medicine basics. Make sure you are eating the right amounts and kinds of essential fatty acids. Additionally, certain botanicals are effective in supporting female hormone health and the body’s stress handling systems. I have included some links to some of the more common hormone balancing supplements we use in my office. 

Go take a chill pill

I’m Dr. Craig Mortensen
Be healthy, be happy. 

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