By Laura Norkin
Perhaps you’ve also seen the posts. “Nervous system resets,” belly-fat myth busting, face-depuffing, and guides to reversing gray hair — because of something-something cortisol! For spring, beauty site Byrdie recommends a “cortisol closet”: comfy clothes in the colors of oatmeal and moss. On a recent episode of Las Culturistas, Californian comedian Blair Socci says she’ll pass on Barry’s Bootcamp: “I’m doing low-cortisol shit, bitch!” It’s not just her; the Instagram mamas, the Substack hormone enthusiasts, and the manosphere looksmaxxers are all posting about a low-cortisol life.
It’s weird that these online subcultures are converging around the same scammy concept. But for women in midlife, there’s reason to take a closer look — with one eyebrow raised.
What is cortisol, first of all
While cortisol can spike with stress, triggering that fight-or-flight feeling, it is — contrary to now-popular belief — a normal part of our lives. Cortisol follows a daily rhythm: high in the morning, declining steeply through the day.
This rhythm connects to the brain’s central circadian system, explains Dr. Seleipiri Iboroma Akobo, MD, MPH, board-certified in obesity, family, and addiction medicine. Cortisol peaks about 30 minutes after you wake, signalling readiness for the day. It should be lowest at night, helping you go to sleep. Cortisol does not equal stress or its physical manifestations. If your body’s job is cellular repair, immune function, metabolic processing and cognition, cortisol is the alarm that says it’s time to clock in and get to work.
The story changes in midlife
“Cellular repair” is scientific jargon for things like skin health and soothing inflammation. Immune function is feeling well and fighting illness. Metabolism means what our body does with nutrients. Cognition is thinking. So, yes, this also sounds like a list of things that go haywire in perimenopause. “I want women to understand they’re not imagining things,” Dr. Akobo says. Aging is associated with a flattening of the cortisol slope that is compounded by estrogen fleeing the scene.
“Think of estrogen as a brake on the stress system. When that brake starts failing, the whole car is at risk,” she says. To continue her metaphor, symptoms like hot flashes and night sweats are a check-engine light: not always bad news, but something could be amiss under the hood. “The practical implication is the cortisol that should be low at 10 pm is still elevated, which disrupts sleep onset, disrupts sleep architecture, and then flattens the morning peak the next day, which starts the whole cycle again.”
A crap night of sleep once in a while is just life. But living under intense, unrelenting stress can cause this kind of chronically misfiring cortisol, which may contribute to increased risks of high blood pressure, high blood sugar, accumulating fat around the midsection, high cholesterol, cognitive decline, and cardiovascular disorders.
The day-to-day expression of unhealthy stress buildup also rhymes with perimenopause: feeling wired-but-tired, trouble sleeping even when you’re exhausted, weight shifting to the abdomen without diet or exercise changes, anxiety that feels new or disproportionate, brain fog, and a stressor recovery time that’s more like days than hours, Dr. Akobo explains. She has studied cortisol in high-performing executives suffering burnout and finds a direct connection, corroborated by larger research, between a disrupted “cortisol clock” and lower mental wellbeing.
In a sense, the influencers are right. Chronic stress is correlated to many maladies, from the unpleasant to the downright dangerous. “Middle-aged women are not imagining it. Their biology has genuinely shifted and they are paying for it with blood and sweat, literally.”
Why is “cortisol” trending?
For as long as there has been online discourse on women’s health and wellness, it has relied upon euphemistic language to skirt around talking about our body issues. Now, Kate Lindsay, author of Embedded and host of ICYMI, Slate’s Internet culture podcast, says “cortisol” is being used online as “a stand-in word for something much broader.” It doesn’t surprise her to see influencers from pre-aging twentysomethings to looksmaxxing young men using it. The internet tends to collectively kingmake some word or phrase — nepo babies, parasocial, dopamine — using it until it’s stripped of its actual meaning.
At the same time, Lindsay says she’s seen the language of self-care trend toward more technical and clinical: “Self care in general has been expressed recently through terms of optimization.” Cortisol works because “it sounds scientific, so it feels trustworthy,” she says. “But I don’t think the average person could tell you what it actually is or how one measures it.” (Good news: You don’t have to.)
I’m reminded of the way migraines and TMJ gave cover for getting Botox. Hacking your life to solve a self-diagnosed hormonal imbalance may just be the latest socially acceptable way to say you feel weird about your jowls. Cortisol, as a term, “is this new bogeyman in the women’s beauty space,” Lindsay says, used to gesture at a fear of the physical signs of aging that are accelerated by stress. But there’s no magic pill for that, and if there were, you wouldn’t hear about it on TikTok or by buying a PDF someone DMs you when you comment “bloat” under their Instagram post. “I think how you’re supposed to deal with [it] is very similar to the self-care behaviors that have been around for at least 15 years online,” she adds.
But seriously what do we do
Stop pathologizing normal stuff. Doctors don’t routinely check cortisol levels (it changes all day long, which is just one reason the home tests are likely useless). A cortisol-related illness called Cushing’s syndrome and prolonged corticosteroid use can cause an exaggerated face swelling delightfully referred to as “moon face”, or “cortisol face”. But Dr. Akobo suggests bad sleep, a salty diet and allergies are three more likely culprits for a puffy face. “The [‘cortisol face’] trend is medicalizing normal faces, and that is bothersome in many ways.”
Avoid any app with an algorithm. “[Algorithms] reward things that I think are counter to the responsible sharing of information about health, because it needs to be really bombastic or fear-based,” Kate Lindsay of Embedded shares. Dr. Akobo scoffs at the entire idea of managing one’s cortisol or the assumption that it should always be low. “That framing contributes to the hustle culture further creating the hamster wheel of self-optimization,” she says. Instead, “protect your stress-recovery architecture, which is worth doing for any woman in midlife.”
Stress-reduction is good. Stress can cause health issues. Sleep is very important. Poor sleep can cause health issues. The advice is easy to give even if it’s hard to take: Take walks, take baths, do yoga, limit salt, strength train, get some morning sun, prioritize sleep — just relax. A lot of this becomes harder in midlife, and changes are going to happen. But, if you’re concerned, Kate Lindsay is one Internet Person with a good idea:
“Ultimately? Just go to the doctor.”