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Running Head: Womens Health and Stress

Stress Management in Womens Health

By
Womens Health Family Practitioner Student
Primary Care for Women in the Family: NURS 650
Family Nurse Practitioner Students
Helen Fuld School of Nursing
Coppin State University
July 24, 2014.

Womens Health and Stress

Introduction
For as long as one can remember, there are many demands on women with the roles that
they partake in the care for their families. With the economic decline in todays society, women
are under much pressure to perform in the work place as well as being caregivers to their
children and wives to their husbands. Keeping a balance between what is necessary to be done
and what is a healthy limit for the individual is quite a struggle. It can be both mentally and
physically challenging, taking a toll on both body and mind.
Types of Stress
There are at least three different types of stress according to the NIH (2014). The first
mentioned is a routine stress that entails stress from day-to-day activities, which includes work,
school, family, errands and other tasks done on a daily basis. Another type of stress is
unexpected stress that occurs when there is an immediate change to a situation bearing a negative
impact such as job loss, divorce, or illness. Traumatic stress is brought about when there is a
danger of being seriously hurt or killed. Examples include a major accident, war, assault, or a
natural disaster. This type of stress can also cause post-traumatic stress disorder (NIH, 2014).
Signs and Symptoms of Stress
Some of the signs and symptoms of stress that manifested in women, according to
Rodriguez (2014), would include emotional symptoms, behavioral symptoms, digestive
symptoms, pain and miscellaneous symptoms, and cardiovascular changes. Emotional
symptoms may include but not limited to depression, mood swings, low self-esteem, and
hostility. Behavioral changes may include eating and gaining weight, not eating and losing
weight, smoking, drinking, illicit drug use, poor concentration, forgetfulness, and indecision.

Womens Health and Stress

Digestive symptoms and manifestations that can occur include constipation, diarrhea and
heartburn (Rodriguez, 2014).
In a study published in the June 2010 issue of "Industrial Health," researchers found that
workers who felt they were under a high level of stress had 8 times more risk of an "irritable"
stomach, than the non-stressed workers (Rodriguez, 2014). Rodriguez also mentioned that:
women with low to moderate amounts of stress may experience pain in the back or jaw pain,
headaches, stiffness in the neck, shoulders and back, while women under higher-level stress may
experience changes in their menstrual cycles and/or acne (Rodriguez, 2014). It has also been
studied that women experiencing high levels of stress for a prolonged period drastically increases
the risk for these cardiovascular abnormalities as opposed to women not undergoing these
stressors (Rodriguez, 2014).
Effects of stress on the various body systems
Dermatological
According to Fried (2014), stress makes the skin more sensitive and reactive therefore
causing exacerbation of psoriasis, rosacea, and seborrheic dermatitis; acne becomes more
inflamed and persistent. Stress can also cause thinning of hair, fragile nails, and worsen fever
blisters (Fried, 2014). In addition, stress has been known to impair the skin barrier function
therefore predisposing an individual to allergens and irritants that cause disease (Fried, 2014).
Furthermore, Fried (2014) notes that women who are stressed tend to neglect their skin and most
of the time they dont adhere to skin regimens which worsens existing skin conditions.
Cardiovascular
Stress incites an individual to engage in risky behaviors that predispose the individual to
heart disease (American Heart Association [AHA], 2014). Some of the risky behaviors the

Womens Health and Stress

individual is likely to engage in include indulging in alcohol, smoking, and overeating especially
high-fat foods, which result in arterial damage and heart disease in general (AHA, 2014).
According to World Heart Federation ([WHF], 2014), stress triggers decreased blood flow to the
heart, it also causes irregular heartbeat, and increases the incidence of blood clots which
ultimately leads to heart disease.
During a stressful event, the action of adrenaline and noradrenaline leads to release of
free fatty acids that contribute to a rise in cholesterol levels (McLeod, 2010). McLeod (2010)
note that a fast heart rate manifested in stressful occasions contribute to prompt cholesterol
buildup on arterial walls. Damage to arterial walls cause cholesterol buildup in form of plaque;
with time the blood vessel may become completely occluded causing a stroke (McLeod, 2010).
Gastrointestinal
Stress triggers the fight or flight response thereby decreasing gastrointestinal (GI)
secretions and decreases blood flow to the gut (McLeod, 2010). According to Simon and Zieve
(2013), stress can disrupt the digestive system by aggravating the large intestine with subsequent
diarrhea, bloating, constipation, and cramping. Irritable bowel syndrome can be strongly linked
to stress, in this condition the large intestine becomes irritated resulting in spastic movements
instead of the normal smooth and wave-like motions of the colon (McLeod, 2010). Simon and
Zieve (2014) also note that stress has also been identified as a key contributor in inflammatory
bowel disease (Crohns disease and ulcerative colitis) flare-ups.
Helicobacter pylori (H. pylori) and NSAID use are the instigating factors in peptic ulcer
disease (PUD); however stress predisposes people with H. pylori to PUD (Simon & Zieve,
2013). During stressful events, the stress hormone cortisol is released which causes craving for
comfort foods which lead to increased abdominal fat, weight gain, and obesity (Block et al.,

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2009). Adrenaline release in a stressful event may lead to gastric ulcer formation (McLeod,
2010). Furthermore, the fact that the GI system slows down during a stressful situation and
increases when the stress passes may cause ulcers (McLeod, 2010).
Neurological system
Simon and Zieve (2013) note that stress decreases the levels of serotonin, a brain
chemical responsible for positive mood and feelings of well-being consequently, anxiety,
depression, and addiction result. Chronic stress lowers an individuals concentration level both at
home and at work thereby lowering the individuals productivity (McLeod, 2010). McLeod
(2010) notes that tension-type headaches have been associated with stress and migraine
headaches are often triggered by stress.
An excess amount of the hormone cortisol has been linked to shrinking of the
hippocampus, which is the brains memory center (Simon & Zieve, 2013). Therefore, stress
predisposes an individual to memory impairment. Stress leads to insomnia; unresolved stress
causes an individual to awaken during the non-rapid eye movement (non-REM) sleep (Simon &
Zieve, 2013).
Reproduction
Simon and Zieve (2013) indicate that stress has been implicated in decreased libido
among women and erectile dysfunction in men. These may lead to lack of fulfillment and
satisfaction in a marriage leading to separation and the inevitable eventuality of divorce. Stress
affects the hypothalamus, which is responsible for production of reproductive hormones (Simon
& Zieve, 2013). These effects cause changes in the menstrual cycle and lower sperm count
among men thereby increasing the rate of infertility (Simon & Zieve, 2013).

Womens Health and Stress

In addition, maternal stress during pregnancy has been linked to low birth weight,
premature births, and a higher risk of miscarriage (Simon & Zieve, 2013). These can be
attributed to an increase in adrenal hormone levels and resistance in the arteries that cause a
decrease in placental blood flow (Simon & Zieve, 2013). A study on mothers who were stressed
during pregnancy revealed that their infants had low attention and cried more (Simon & Zieve,
2013).
Immune system
According to McLeod (2010), when an individual is stressed the immune system function
is compromised therefore reducing the ability to fight infections. The stress hormone cortisol
subdues the immune system function of fighting pathogens by decreasing the number of
lymphocytes (McLeod, 2010). In addition, McLeod (2010) suggest that individuals usually
engage in unhealthy behaviors like smoking and drinking when stressed which further
compromises their immune system.
Stress relief and/or management
Research has shown that, being able to engage in healthy habits such as diet and exercise,
leisure activities, rest, and giving up bad habits such as smoking, do not only help reduce stress
or help one better adapt to stress, it also help reduce the risk exacerbation of other diseases
secondary to stress (Fried, 2014). The following paragraphs will discuss various stress relief
techniques that will help improve health and well being among women across the life span.
Engaging in physical activity can significantly relieve the physical and mental tension
caused by stress (AHA, 2014). According to the AHA, physical activity is a great form of
pleasure that can lead to stress reduction (AHA, 2014). The United State National Library of
Medicine (USNLM) recommends that 150 minutes of aerobic exercise a week or 20 minutes of

Womens Health and Stress

brisk walk a day would greatly improve physical and mental well being (USNLM, 2014).
According to McNichol, exercise helps enhance well being because it boost the feel-good
chemicals such as endorphins while lessening negative ones like cortisol, which is released by
the body during stress (McNichol, 2014).
Having a strong peer network and social support system can greatly reduce stress.
According to the AHA, A daily dose of friendship is great medicine (AHA, 2014). Being able
to share your thoughts, feelings, joys, hopes, and laughter with one another is a great stress relief
measure (AHA, 2014). It has also been proven that people who have high levels of healthy social
support experience lesser negative chemical effects on the brain when stressed (AHA, 2014).
Some studies have shown that using humor and laughter as a coping mechanism can greatly
lower stress levels and improved increased self worth (Chang, Tsai, & Hsieh, 2013).
According to the Centers for Disease Control and Prevention (CDC), people should seek
support from their partners, family members, friends, counselor, clergy person, and even
healthcare providers who will provide a listening ear that will help lighten the burden (CDC,
2014). When social support system fails to help alleviate stress, the NIH recommends that the
client seek support from licensed professionals like psychopathologist, psychiatrist, or social
worker (USNLM, 2014).
Another way to reduce stress is by adopting healthy eating habits. Eating healthy food
items help improve health and wellbeing (USNLM, 2014). Foods such as vegetable, fruits, dairy,
and protein are the five major food groups that make up a healthy diet (USNLM, 2014).
Relaxation techniques such as listening to music, participating in yoga or meditation, rest,
and slowing down when necessary will help prevent or reduce stress level (USNLM, 2014). A
research study revealed a decrease in heart rate, respiratory rate, cortisol, and salivary alpha

Womens Health and Stress

amylase level in women who listened to relaxing music prior to being exposed to stressful
situation had different and also had a better response to stress when compared to the non-music
control group (Thoma et al., 2013). With regards to relaxation, people with hobbies and healthy
interests outside their daily routine are more capable of handling stressful situations than those
without hobbies or interests (USNLM, 2014).
Getting enough rest and massages relaxes the body making it a good stress relief
mechanism (USNLM, 2014). Taking naps during the day and being able to sleep for 7-8 hours
per night will help people cope or adapt better to stressful situations (USNLM, 2014). In a study,
researchers found that participants who received 40 minutes of foot massage each session for 6
weeks saw a decrease in perceived stress, an improvement in fatigue level, and an increase in
blood circulation (Jang and Kim, 2009).
Yoga and meditation has become popular in the American culture as a means of exercise
and also a means to bring the mind at peace. A study revealed that those who participated in a 10week yoga and meditation course noted an improvement in positive affects and a decrease in
physiological distress and stress when compared to the control group (Bilderbeck et al., 2013).
Thus, it would be helpful for people especially women to include yoga and meditation in their
daily routine so as to help decrease stress.
Conclusion
As human beings, we are bound to encounter stress in our day-to-day routine. Stress
affects everyone differently based on the type of stressful situation and personal habits. From the
above paragraphs, studies have shown that those who have a healthy social and professional
support, eat a healthy diet, listen to music, meditate, get enough rest, have hobbies and healthy
interests outside their daily routine, and exercise: be it yoga or aerobics, are more equipped to

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adapt to stressful situations than those who do not (USNLM, 2014).

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Womens Health and Stress

References
American Heart Association. (2014, June). Stress and heart health. Retrieved July 17, 2014,
from
http://www.heart.org/HEARTORG/GettingHealthy/StressManagement/HowDoesStressAffe
ctYou/Stress-and-Heart-Health_UCM_437370_Article.jsp
Bilderbeck, A. C., Farias, M., Brazil, I. A., Jakobowitz, S., & Wikholm, C. (2013). Participation
in a 10-week course of yoga improves behavioural control and decreases psychological
distress in a prison population. Journal Of Psychiatric Research, 47(10), 1438-1445.
doi:10.1016/j.jpsychires.2013.06.014
Block, J. P., He, Y., Zaslavsky, A. M., Ding, L., & Avanian, J. Z. (2009). Psychosocial stress and
change in weight among US adults. American Journal of Epidemiology, 170(2), 181-192.
doi: 10.1093/aje/kwp104
Chang, C., Tsai, G., & Hseieh C.J. (2013). Psychological, Immunological and Physiological
Effects of a Laughing Qigong Program (LQP) on Adolescents. Elsevier Ltd doi:
10.1016/j.ctim.2013.09.004
Fried, R. G. (2014). American Academy of Dermatology: Stress and the skin. Retrieved July 17,
2014, from http://www.aad.org/media-resources/stats-and-facts/prevention-and-care/stressand-skin
Jang, S.H. & Kim, K.H. (2009). Effects of self-foot reflexology on stress, fatigue and blood
circulation in premenopausal middle-aged women. doi: 10.4040/jkan.2009.39.5.662.
McLeod, S. (2010). Stress, Illness and the Immune System | Simply Psychology.
Retrieved July 20, 2014, from http://www.simplypsychology.org/stress-immune.html

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McNichol, J. (2014) Boost Your Resilience: When something stressful happens in your life, how
equipped are you to deal with it? The ASHA Leader.
doi:10.1044/leader.MIW.19052014.30
National Institute of Health. (2014). Stress. Medline Plus. Retrieved July 22, 2014, from
http://www.nlm.nih.gov/medlineplus/stress.html
Rodriguez, D. (2014). Signs and symptoms of stress in women. Livestrong Foundation.
Retrieved July 22, 2014, from http://www.livestrong.com/article/129849-signssymptoms-stress-women/
Simon, H., & Zieve, D. (2013, January 30). Stress: University of Maryland Medical Center.
Retrieved July 20, 2014, from http://umm.edu/health/medical/reports/articles/stress
The Center for Disease Control and Prevention (CDC). Managing Stress: Find out how to
manage stress by following CDCs recommended tips for self-care. Retrieved July 20,
2014, from http://www.cdc.gov/Features/HandlingStress/
Thoma, M. V., La Marca, R., Brnnimann, R., Finkel, L., Ehlert, U., & Nater, U. M. (2013). The
Effect of Music on the Human Stress Response. Plos ONE, 8(8), 1.
doi:10.1371/journal.pone.0070156
United State National Library of Medicine. Stress: Medline Plus. Retrieved July 20, 2014 from
http://www.nlm.nih.gov/medlineplus/ency/article/001942.htm