“Pregnenolone steal” is often the culprit behind the hormonal rollercoasters that affect so many women during PMS, perimenopause, and other female hormone imbalances. We think it’s normal because so many women are impacted, but it’s not normal. Instead, it’s a symptom of chronic stress that leads to pregnenolone steal — a mechanism in which stress robs the sex hormones to meet the high demand for stress hormones.
Chronic stress, inflammation, and pregnenolone steal are common underlying causes of PMS, a difficult perimenopause and transition into menopause, infertility, male menopause, and polycystic ovary syndrome (PCOS).
How the body is designed to cope with stress
When you experience stress, your adrenal glands produce stress hormones in a “fight or flight” response. Once the stressor is gone, the body returns to the “rest and digest” state during which tissue damage done from the physiological stress can be healed.
In an ideal world, we spend most of our time in the rest-and-digest phase; fight-or-flight is uncommon and short-lived. In the real world, however, many people stay stuck in fight-or-flight mode. This is especially common in people coping with chronic inflammatory and autoimmune disorders.
Stress is not just about worrying about money, an accident or injury, or a failure to meditate. For instance, one of the most common causes of chronic stress is unstable blood sugar from a diet that is high in processed carbohydrates, skipping meals, or relying on caffeine for energy. Other common sources of stress are a chronic infection, undiagnosed autoimmunity, food intolerances, and leaky gut. No matter the source of stress, the body responds in the same way with the stress response.
Pregnenolone steal prevents sufficient sex hormone production
Pregnenolone is a building block hormone that goes into making other hormones, including estrogen, progesterone, and the stress hormone cortisol.
In response to prolonged stress, the adrenal glands increase cortisol production to help the body cope. In order to meet this increased demand, the body steals pregnenolone that would go into making the sex hormones to make more cortisol, thus the name “pregnenolone steal.”
The problem is, the body can only make so much pregnenolone. Since the supply is not endless, cortisol takes priority over making other hormones such as estrogen and progesterone. This is because a stress response is perceived as an emergency while hormone production can resume when things return to normal. Unfortunately, for many people, things never seem to return to normal.
This sets the stage for hormone imbalances, especially progesterone deficiencies that underlie PMS, infertility, difficult menopause transition, polycystic ovary syndrome (PCOS), and male menopause.
Symptoms of low progesterone include:
- Irritability and mood swings
- Depression and anxiety
- Irregular menstruation (including frequent periods)
- Inability to concentrate
- Low libido
Manage life stress to prevent pregnenolone steal
While you might think progesterone replacement therapy would be the fix for pregnenolone steal, it’s not the best solution. Instead, reduce stress factors and support the body’s response to stress.
Each person has unique stressors in their life, and not all can be eliminated. However, it’s very helpful to take an honest look at what stress factors exist in yours, and to decide which you can eliminate and which you can only reduce. Then, commit to making those changes.
While some of these changes might be relatively easy, such as reducing the number of activities in your life, others might be difficult to make, such as leaving a bad job. So do the best you can, strategize coping mechanisms for the lifestyle stressors you can’t eliminate (make sure to include regular time in your life just for you), and work on reducing stressors in the body.
Support stress response with these tools
Because it is impossible to eliminate all stress, it’s important to do what you can to support the body’s ongoing stress response.
While there are many causes of stress that lead to pregnenolone steal, in my new patients I see these factors quite frequently:
- Food sensitivities
- Systemic inflammation
- Viral infections
- Leaky gut
- Poor sleep habits
- Inflaming the body with over exercise or over work
- Poor diet full of sugars and processed foods
Support blood sugar balance
Among the factors that cause pregnenolone steal, blood sugar imbalances are the most common.
High-carbohydrate diets and the ensuing insulin surges are extremely taxing to the body, keeping it in a constant state of stress — which as you now know, leads to pregnenolone steal.
Nutritional support for healthy insulin response:
- Supporting a healthy response to insulin resistance is the goal. Key ingredients include chromium, vanadium, alpha lipoic acid, mixed tocopherols, magnesium, biotin, zinc, inositol, and gymnema sylvestre.
- Essential fatty acids to support a healthy response to insulin resistance. Key ingredients include EPA and DHA from micro-emulsified fish oil, taurine, green tea extract, odorless garlic extract, and evening primrose oil.
Adrenal function is closely tied to blood sugar balance, and supporting one always helps to support the other.
Adrenal adaptogens and phosphatidylserine for healthy stress response:
- Nutritional compounds to help the adrenals adapt to the physiological stress responses. Key ingredients include panax ginseng, Siberian ginseng, ashwagandha, holy basil leaf extract, rhodiola rosea, punarnava, and pantethine.
- Liposomal cream that delivers nutritional compounds to modulate the stress response. Key ingredient includes 2,000 mg a day of phosphatidylserine.
Please work with a qualified healthcare practitioner to safely and correctly use these nutrients in the right amounts.
Healthy hormone levels aren’t only necessary for proper mood, energy and fertility; they also play a key role in brain health, inflammation, and more. If you have symptoms of pregnenolone steal, consult with your functional medicine practitioner to determine your next steps.