Cortisol

Cortisol is the body's primary stress hormone, produced by the adrenal glands in response to physical and emotional stress, with important roles in regulating blood sugar, blood pressure, metabolism, and immune function. Women with PCOS frequently show dysregulation of cortisol production and the HPA axis (hypothalamic-pituitary-adrenal axis), with evidence suggesting that chronic stress and elevated cortisol worsen insulin resistance, promote abdominal fat storage, and increase androgen production from the adrenal glands. This creates a feedback loop where stress exacerbates PCOS symptoms, making stress management practices like adequate sleep, mindfulness, and moderate exercise important complementary strategies alongside medical treatment.