What sort of changes? Stress is the most important and frustrating one. When you undergo stress, whether it's due to illness, increased workload, or personal disasters and your emotional response, your body goes into an overdrive "fight or flight" mode. In order to call forth a number of metabolic shifts designed to shut down processes not vital to ultimate survival and reallocate resources for pure survival response, your body gears up to stress by producing a specialized stress hormone called cortisol. Cortisol is produced by the adrenal glands using progesterone or progesterone precursors as the raw materials. Since we only have a finite quantity of progesterone in our systems in surgical menopause, every molecule that is shifted to cortisol production is that much less we have available for ovarian hormone uses.
As we have seen in the sections on balancing progesterone in particular and hormones in general, any change in the circulating levels of our ovarian hormones can lead to near-universal uproar as every hormone-reliant function pushes and shoves for its share of the pot. Hot flashes are the particular hallmark of hormonal disruption, but you may also notice that your already fragile emotional state in stress is further compounded by the hormonal moodiness and emotional instability that reflect a lowered level of ovarian hormones. Your libido may disappear along with your patience. The whole realm of low-hormone signs may manifest themselves if stress goes on side-tracking your progesterone long enough.
Coping and compensating
Cut yourself a little slack, knowing that this is going to be an unbalanced time. Warn your family, friends, co-workers—whoever may need an alert—that you are not really the ravening witch you may suddenly turn up to be these days and that your true self will return as soon as your chemical balance is restored. Try not to panic and figure that all your work balancing is now down the tubes. If you were balanced before, you'll be balanced again when this is over and your adrenals go out of alarm mode. If your imbalance isn't too severe, just ride with it till the stressor's done with, and cut yourself some slack in the meantime. A few hot flashes aren't the end of the world, so long as you know they're not heralding the end of the world.
One thing about stress that's important to remember when we're trying to figure out where our balance went askew is that stress can happen as a result of positive as well as negative factors. Going on a much-looked-forward-to vacation, getting married, a holiday season, even a surprise birthday party: things we might enjoy can still provide stress.
There are many tactics for dealing with stress non-medically, including exercise, yoga, meditation. If you don't yet have a stress tactic, entering surgical menopause might be a good reason to develop one. Even though they won't make stressors go away, they have a proven capability to reduce the uproar of stress and its effects on our bodies.
(If you've been a long-term follower of this website, you may notice that we've removed some previous discussion from this article about manipulating progesterone doses as a coping measure. Given the current research findings to do with progestogens and cancer, it's hard for us to consider raising those risks, even in response to stress, a valid or responsible strategy. If this is something you've practiced in the past, you might want to read up on the topic to be sure you're still comfortable with it.)
If the stress is severe or especially prolonged, you may instead need to heed the signs of hormonal turmoil as a wake-up call for a small adjustment. It's the pits getting thrown back into the need to balance when you're already dealing with the stressors that did it to you, but TANSTAAFL. Life's like that. Stop, listen to your body, make those small slow tweaks and reach for a new balance.