How Stress Affects the Body: Skin, Hormones, Reproductive Health, and Digestion
Issue No. 5: Stressed Out!
Words - Aarti Patel, PA-C + Diana McDonnell, DNP + Edwina Horton, RN + María Teresa Alzuru, MA, Terri Fleming, APRN, FNP-BC, AAHIVS
Illustration - ALEXANDRA FOLINO
How does stress affect your skin, hair, and nails?
The integumentary system refers to the organ system consisting of your skin, hair, and nails, which protect your body. Many skin disorders are caused or worsened by a traumatic event or chronic stress.
Short term responses to stress, such as skin blushing and perspiration, can occur when your sympathetic nervous system is alarmed during physical or psychological stress. These responses are normal and don’t have any long-term negative effects.
Stress is both a cause and consequence of dermatological disorders also known as skin diseases. Chronic stress can cause people to develop compulsive, repetitive behaviors that can cause or worsen skin conditions. Some of these behaviors that may disrupt the integrity of your skin include scratching, compulsive hand washing, showering, hair pulling, picking compulsively, and bathing due to thoughts of contamination. These behaviors can lead to irritant contact dermatitis, which is inflammation of the skin caused by an irritant.
Two common skin disorders atopic dermatitis (eczema) and psoriasis can impact your scalp, skin, and nails. These disorders are often worse during times of high stress both emotionally and also due to injury to the skin.
Stress can also lead to increased hair loss, which can happen months after a traumatic or stressful event. Studies have found that elevated cortisol levels can disrupt hair growth, but in cases where the hair loss is an acute reaction, the hair will grow back as your cortisol levels decrease.
If you’re experiencing these behaviors or conditions and they are impacting your quality of life, speak with your health care provider or a dermatologist.
What is the impact of stress on your respiratory & cardiovascular systems?
When we normally inhale and exhale, our lungs are able to absorb and supply oxygen to our cells and remove carbon dioxide. But during times of stress, our breathing pattern changes.
In periods of stress or anxiety, you may start taking small, shallow breaths and instead of using your diaphragm, you may use your shoulders. When this happens, it can disrupt and decrease the amount of oxygen you take in.
This is not usually an issue for most of us, but for people with asthma or other chronic lung diseases, quick and shallow breathing causes minimal air to enter the body, leading to hyperventilation and flare-ups of any existing illness. Hyperventilation can also occur in people who are prone to panic attacks.
The effects of stress can take a toll on your heart as well. Moments of stress can cause increased oxygen demand on your body, leading to spasms of your coronary (heart) blood vessels and instability of your heart’s electrical system, causing abnormal heart rhythms (arrhythmias).
During moments of acute stress, a fight or flight response can occur. This is when stress hormones are released that cause responses causing things, like high heart rates and constriction of blood vessels, which can lead to causing high blood pressure. Once the stress episode is gone, your body will return to its normal state.
Chronic stress, however, can contribute to long term term cardiovascular problems. The constant elevation of blood pressure and heart rate and persistent increased levels of stress hormones increases the risk of cardiac problems like hypertension, high cholesterol, heart attacks, and strokes. The increased stress hormone levels are known to cause inflammation particularly to coronary arteries that can lead to a heart attack.
Stress on the Musculoskeletal System
The musculoskeletal system refers to the bones, muscles, joints, ligaments, and other connective tissue that supports the skeleton, and connects tissues and organs together.
Stress can cause muscle tension. As a reflex, the body attempts to protect itself from injury and pain. Chronic stress can cause chronic muscle tension. Tension in the shoulders, neck, and head is associated with headaches. Stress has also been associated with teeth grinding, which can have long-term consequences for your teeth and jaw if left untreated.
Sometimes a musculoskeletal injury can trigger a chronic pain condition, which often relates to how someone heals and responds to the original injury. Some people may avoid activity to prevent re-injury, but this can actually make their healing worse. It’s important to try to resume activity as soon as safely possible in order to prevent worsening complications, such as muscle atrophy.
How does stress affect your brain?
Stress is a biological response to demanding situations. It causes the body to release hormones. These hormones help the body to take action, fight or flight.
What you may not know is that stress can have a serious impact on your brain. Hormones released in stressful situations, such as cortisol, can affect the brain’s ability to function properly. This increased cortisol can impair your ability to form memories and engage in higher order tasks. This is part of your body’s survival response to stress, focusing as much energy as possible on staying safe and not on storing information for later.
However, chronic stress means that your brain is flooded with these hormones over much longer periods of time. This can kill brain cells, and shrink parts of the brain responsible for memory and learning. Chronic stress increases the risk of mental illnesses, such as depression, anxiety, and post-traumatic stress disorder (PTSD).
Symptoms of stress related to your brain function include:
Constant worrying
Racing thoughts
Forgetfulness and disorganization
Inability to focus
Poor judgment
Being pessimistic or seeing only the negative side
Frequent headaches, jaw clenching, or pain
Gritting, grinding teeth
Stuttering or stammering
Tremors, trembling of lips, hands
Light headedness, faintness, dizziness
Ringing, buzzing or “popping sounds
Frequent blushing, sweating
How can I manage my stress?
Improving your sleep quality and incorporating a meditation practice can help to manage the impact of stress on your body. Getting enough sleep can help to reduce the buildup of proteins and toxins in your brain that can accumulate during the day due to stress. A regular meditation practice can improve your ability to regulate your stress reactions, and help you return to a state of calm more quickly.
If you believe that you are dealing with chronic stress, are unable to manage your stress, or your stress is impacting your ability to work or complete regular household tasks, speak to a health care professional.
What are the effects of stress on the endocrine system?
The endocrine system is a network of glands in the body that produces hormones that regulate many processes such as metabolism, growth, reproduction, mood, and sleep. The endocrine glands do this by releasing hormones into your bloodstream so they can travel to other body parts.
Important parts of the endocrine system’s stress response consists of the hypothalamus and the pituitary gland, located in the brain, and the adrenal glands located right above the kidneys. Together, they make up the hypothalamic-pituitary-adrenal axis (the HPA axis).
When you’'re in a stressful situation, the brain initiates a chain reaction involving this HPA axis. The hypothalamus tells the pituitary gland to produce a hormone, which then signals to the adrenal glands to increase the production of adrenaline and cortisol. Adrenaline increases your heart rate and blood pressure. Cortisol, sometimes referred to as the “stress hormone,” increases the level of energy available in your body. Cortisol also inhibits some functions that are nonessential in a fight-or-flight situation.
Typically, when the perceived threat or stressor has passed, your hormone levels return to normal, allowing the body’s functions to return to normal as well. However, if the stressful situation persists, that fight-or-flight reaction stays turned on. Because the endocrine system controls so many processes in the body, long-term exposure to stress hormones like adrenaline and cortisol can increase your risk of:
Anxiety/Depression
Chronic fatigue
Digestive issues
Heart disease
Immune disorders
Metabolic disorders (e.g. diabetes, obesity)
Can stress affect your reproductive system?
Yes, stress can affect your reproductive system. Stress felt in the body causes the release of cortisol and impacts many different hormones in your body. Changes in the release of cortisol impacts the functioning of our reproductive systems, which include your breasts, ovaries, uterus, cervix, vagina, penis, and testes.
For people with female reproductive anatomy, chronic stress can raise cortisol levels and disrupt the menstrual cycle, leading to changes in timing and increased pain. High stress during pregnancy is also linked to a greater risk of depression, which can contribute to complications during pregnancy and birth, as well as challenges for both parent and baby after delivery. During menopause, natural hormonal changes can cause symptoms like hot flashes and mood shifts, which may increase stress. In turn, emotional distress can make physical symptoms feel more intense.
For people with male reproductive anatomy, certain infections can affect your reproductive function. Chronic stress can also lower your testosterone levels, leading to reduced sex drive, erectile dysfunction, and changes in sperm production and development, which may impact fertility.
Stress can also exacerbate or worsen any pre-existing reproductive health conditions you have. People with herpes simplex are more likely to experience outbreaks in times of increased stress, and people who have uterine fibroids or endometriosis can see a worsening of their symptoms due to increased stress. Stress also impacts your immune system, which can lead to a worsening of sexually transmitted infections caused by viruses, including HIV.
How does stress affect your gut and digestive system?
The gastrointestinal system, more commonly known as the digestive system or the gut, is made up of all the gastrointestinal organs that are connected from your mouth to your anus, including the esophagus, stomach, liver, pancreas, and intestines.
Stress can affect your digestive system in many ways. Stress can also cause decreased blood flow to your gut, affecting its functioning. When you’re stressed, your appetite can increase or decrease which can impact your overall health. Stress can cause muscle spasms, diarrhea, and constipation. It can also affect digestion and the absorption of nutrients, and cause inflammation. Individuals suffering from stress may also increase their use of alcohol and tobacco, which can cause heartburn. In severe stress, vomiting may be triggered, and chronic vomiting can damage the esophagus in the long term.
People who experience a lot of stress early in life may experience different development in their nervous systems and stress reactions. This can lead to chronic stress, and an increased risk of gut diseases or dysfunction later in life.
There are nerve cells throughout the gut that facilitate communication between the gastrointestinal system and the brain. Increased stress can impact this communication and result in additional discomfort, such as pain and bloating.
There are also millions of bacteria in your stomach and intestines, which affect the health of your digestive system and your brain. Increased stress can cause changes in your gut bacteria, which can also affect your mood.
