I, like many women, have been in denial about my stress levels. It’s been easy for me to be. I have a calmer state of mind than I’ve had in months. I’m eating better than ever (clean protein, carbs and fats). I’m working out more consistently (running, strength training, and pilates). I take magnesium to boost my sleep. I’m efficient at being busy. But recently, my body, and my Oura Ring, have been sending me warning signs.

The red flags are everywhere. My cycle is irregular, and my digestion is out of sync. I have gained weight around my midriff, my face is usually puffy, and, according to a Technogym body scan I took recently, I am shockingly carrying six liters of water retention. I have always associated cortisol spikes with a racing heartbeat, anxiety, overwhelm, and feeling emotional—none of which I currently align with. “If you’re doing ‘everything right’ and your body’s not responding, it’s time to look under the hood,” says Hannah Alderson, a nutritionist and hormone specialist who published her book, Everything I Know About Hormones, in May this year.

Cortisol and hormone balancing have become trendy buzzwords in health and well-being today. But there’s more connection between these two than the zeitgeist would have us believe. And the symptoms of high cortisol, the stress hormone, are also broader and more varied than we might expect. Think: fatigue, irregular or painful periods, bloating, low mood, brain fog, and PMS. “It can be salt cravings or waking up around 3 am feeling like you’ve had a double espresso,” says Alderson. (Pink Himalayan sea salt is my preference.) This means cortisol often goes unchecked.

Cortisol is the hormone that activates out of necessity during times of stress. It creates the fight-or-flight mode our ancestors relied on—survival of the fittest. Today’s predators that peak our heart rates are different, though. Stress today is pervasive rather than momentary, as our brains struggle to switch off in this constantly online era, so the spikes are prolonged throughout the day. Women in particular, used to downplaying symptoms and feeling a bit off during menstrual cycles, don’t always connect the dots.

Society has become accustomed to being high functioning through stress. “The cultural pressure to ‘do it all’ creates an impossible standard,” says Georgia Smith, a London-based nutritionist who founded Balanced Boss, a stress-reducing mentoring program aimed at high-performing women. “We carry more of the invisible labor at home, so add that to ambitious careers, and the nervous system is overloaded.” Her clients are typically executives or entrepreneurs aged between 25-45, who she sees in person or via Zoom. Typically, they are mentored for between three to six months.

The global workplace stress management market was valued at $10.6 billion in 2023, according to a report by Global Market Insights; it’s expected to double by 2032, to $20.5 billion. It’s no wonder the next generation of office buildings, like WSA in New York or Valentyns in Cologne, are designing gyms and wellness spaces into the offering. The pursuit of a work-life balance has become a need for a work-health balance. For employers, an at-work spa is an incentive to get staff back into the office.

But how do you know for sure if your cortisol is too high? It’s hard to determine as there are few medical, diagnostic tests available. “Blood tests can be helpful, but they only track a single moment,” says Alderson. She recommends functional testing, which offers a more comprehensive profile; they’re offered at upscale gyms such as Equinox across the US, and Third Space in London. “A four-point saliva test or dried urine (DUTCH) test maps out your cortisol rhythm across the day.” She recommends a saliva test every three months.

If testing is out of reach, there are other effective steps women can take to lower their overall levels. “Many of them are free,” says Alderson, who advises to eat a high-protein breakfast within 90 minutes of waking, and to avoid caffeine on an empty stomach. Personally, I have four eggs for breakfast each morning; Danimás founder Dany Garcia eats 4oz fillet steak, 4oz sweet potato, and half a cup of blueberries as a ritual. Radovan Ivanović, a nutritionist at SIRO, a fitness hotel in Montenegro, advised me a month ago to reduce my coffee intake. I decided to swear off it altogether in favor of matcha lattes. I also switched to coconut milk, which is less inflammatory, he says, than oat. I do feel better. Pre-11 pm bedtime and walks after meals are also encouraged by Alderson, while on TikTok, Gen Z women have popularized red meat for hormone regularity.

Certain supplements can help, too. I recently started taking Hormone Harmony ($59.49 per month), a thrice-daily natural pill by Happy Mammoth, which is primarily targeted at menopausal women but claims to be effective for women at any age. (I’m in my mid-thirties.) It includes ashwagandha, a popular stress reliever. I noticed a shift in water retention within a few days, and within a few weeks, it had a noticeable effect on my cycle. Erewhon sells ashwagandha in capsule or liquid form.