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By Clare Kittredge  Reviewed by Lindsey Marcellin, MD, MPH

Effects of stress on your emotional and physical health may be worse than you thought.

Although female sex hormones and brain chemistry offer some protection from stress, women are more deeply affected by the physical and emotional effects of stress than men.

Women’s reactions to stress are rooted in their body chemistry. Men have higher androgen levels, while women have higher estrogen levels, says Paul J. Rosch, MD, FACP, president of the American Institute of Stress (AIS).

“Their brains are also wired differently,” says Dr. Rosch, who is also a clinical professor of medicine and psychiatry at New York Medical College, and honorary vice president of the International Stress Management Association. “Women tend to react to stress differently than men. They don’t respond with the fight or flight response — they’re more apt to negotiate.”

Stress: How Women Are Affected

The effects of the natural anti-stress hormone oxytocin, produced during childbirth, breastfeeding, and in both sexes during orgasm, are enhanced by estrogen and reduced by testosterone.

This helps women more than men, Rosch says. And nurturing activities boost oxytocin levels in women.

The catch-22 is that women need more oxytocin than men to maintain their emotional health. For example, Rosch explains, women are more negatively affected when they’re not touched, and also feel more stress than men in relationships.

According to the American Academy of Family Physicians (AAFP), stress is an expression of the body’s natural instinct to protect itself. While this may warn a woman of immediate danger, like a fast-approaching car, prolonged stress effects can negatively affect your physical and emotional health.

“Our stress response was exquisitely honed over millions of years as a protective mechanism,” said Rosch. “That was OK for our ancestors who ran into saber-toothed tigers. The tragedy is that today, it’s not that, but hundreds of things like getting stuck in traffic jams. Our bodies respond in the same unfortunate fashion, with hypertension, strokes, and ulcers.”

Stress Effects: The Physical Side

“Your stress may vary, but if you have stress with your work, your kids, your neighbors, and marriage all at once, that’s a big deal,” said Lori Heim, MD, president-elect of the AAFP and a hospitalist (a family physician who works only in a hospital) at Scotland Memorial Hospital in Laurinburg, N.C. “In women, I see this in changes in menstrual patterns — nothing else is going on except a huge increase in stress, and all of a sudden, they may be losing their hair or having menstrual irregularities, and everything points to stress as a factor.”

The AIS reports that some surveys show 75 to 90 percent of visits to primary care physicians are for stress-related complaints. According to the National Women’s Health Information Center, the effects of stress on women’s physical and emotional health can range from headaches to irritable bowel syndrome. Specific stress effects include:

• Eating disorders. Anorexia and bulimia are 10 times more common in women than in men, says Rosch, and this may have something to do with stress levels. Like depression, this illness has been linked to low levels of serotonin and is often treated with serotonin-boosting antidepressant drugs.
• Stomach ailments. Stress can make you reach for junk or comfort foods, or upset your stomach to the point that you feel like you can’t eat. Common stress-related stomach troubles include cramps, bloating, heartburn, and even irritable bowel syndrome (IBS). Depending on how you respond, these can lead to weight loss or weight gain.
• Skin reactions. Stress can lead to breakouts and even itchy rashes and hives in some people.
• Emotional conditions. From being in a blue or irritable mood to more serious mental issues like depression, your emotional health suffers when there’s stress in your life. Women are better than men at hiding some emotions like anger and aggressiveness because the parts of their brains responsible for these emotions are larger than men’s, but depression strikes women twice as often as men, says Rosch, adding, “The emotional effects of stress on women can range from postpartum depression after pregnancy to depression after menopause.”
• Sleep problems. Trouble falling or staying asleep is common in women affected by stress, and this is particularly counterproductive since a good night’s sleep can help ease stress.
• Concentration difficulty. Stress makes it hard to focus and be effective in your responsibilities at home or work, and that can compound your problems if your stress comes from your job to begin with.
• Heart disease. The stress of competing in today’s job market has increased women’s heart disease risk, Rosch says. Stress can negatively affect the entire cardiovascular system, and lead to high blood pressure, stroke, and heart attack.
• Lowered immune response. One of the more complicated physical reactions to stress is your body’s lessened ability to fight off disease, whether it’s a cold or a flare-up of a chronic condition.
• Cancer. Some studies have suggested a link between stress and the development of breast and ovarian cancer. In one study, researchers found that the risk of breast cancer was increased by 62 percent in women who had experienced more than one highly stressful life event, like divorce or the death of a spouse.

Stress Effects: Stress-Lowering Techniques

Research presented at the most recent Western Psychological Association meeting found that 25 percent of happiness hinges on how well you handle stress. And what was the most important stress management strategy? Planning — or anticipating what’s going to stress you out — and having the tools in place to tamp down the tension. Here are some more tips for managing stress:

• Improve your diet. By eating well-balanced meals and skipping junk food, you can improve your physical well-being and, in turn, your emotional health.
• Make time for exercise. “We do know that exercise is a phenomenal way of dealing with stress and depression,” said Dr. Heim. Research shows that getting active can lift your spirits and increase the release of endorphins, a natural chemical associated with mood.
• Find fun ways to relax. Connect with family and friends and people you enjoy being around. Rediscover favorite hobbies; recent studies link a resurgence in knitting and needlepoint to their stress-reducing effects. Other popular stress-busters include yoga, meditation, and tai chi.

Finally, if you feel overwhelmed by stress and its effects, talk to your doctor about ways to deal with it. You may learn new techniques for managing stress on your own, or you may find that therapy with a mental health professional will better help you to get it all under control.