Lately I find myself feeling stuck in a chronic state of stress, constantly worrying about my work, my kids’ futures and yes, the health of my retirement portfolio. Sound familiar?
I didn’t always worry so much, but life has a funny way of piling on the pressures as we get older and take on more responsibilities. While my family is not in crisis now, it has gotten harder to manage this stress.
Because my specialty is urology, I also care about what acute and chronic stress are doing to your bladder and hormones as well as your overall health.
Difference between acute and chronic stress
It helps to distinguish between two types of stress: acute and chronic.
Acute stress is your body’s immediate reaction to a perceived threat. Think about how your heart pounds before a big presentation or how you jump when you hear a loud noise. It’s intense but usually short-lived. Our bodies are built to handle acute stress and typically return to normal afterward.
Chronic stress, however, is persistent. It’s the daily weight of ongoing issues, such as financial woes, relationship issues, work pressures or health concerns. Unlike acute stress, chronic stress keeps you in a constant state of high alert — chipping away at your health, often without you noticing.
The internal stress response
When you are stressed, your body launches a carefully coordinated response known as the fight-or-flight reaction. It all begins in the hypothalamus, the brain’s command center, which activates two parallel systems in your adrenal glands: the sympathetic nervous system and the hypothalamic-pituitary-adrenal, or HPA, axis.
The sympathetic nervous system triggers the release of adrenaline, which primes your body to act quickly. This fast-acting hormone increases your heart rate and blood pressure, opens up your airways, heightens your senses and sends more blood to your muscles.
Cortisol is released a little later through the HPA axis. Unlike adrenaline’s quick action, cortisol plays a longer-term role in helping the body cope with sustained stress. Cortisol increases blood sugar, enhances the brain’s focus and memory, and puts things such as digestion, fertility and immunity on the back burner — because in a crisis, your body is focused on survival.
Working together, adrenaline and cortisol seamlessly help the body cope with short-term threats. However, if stress becomes chronic, elevated cortisol levels can lead to fatigue, sleep problems, weight gain and other health issues.
For me, this response kicks in during intense moments in surgery — such as seeing an unexpected gush of bleeding. Instead of fleeing (which would be frowned upon in the operating room), my body shifts into fight mode: I zero in on the bleeding vessel, focus sharply and act swiftly to get things under control.
In such high-stakes moments, the stress response is not just helpful but essential. But when the triggers are constant — unpaid bills or work deadlines — your body can get stuck in that heightened state.
Over time, consistently high cortisol levels disrupt your immune system, impair metabolism, affect mood regulation and even contribute to chronic inflammation — all of which can increase the risk of long-term health issues.
Your bladder under stress
Have you ever noticed how anxiety makes you suddenly need the bathroom — especially right before a big speech or meeting? I experience this firsthand before every speech or live TV appearance: Without fail, my bladder goes into overdrive, and I find myself desperately looking for the nearest restroom.
Stress directly affects bladder control by overstimulating the nerves responsible for regulating bladder function, leading to increased urgency, more frequent trips to the bathroom and even occasional leaking.
My most memorable (and embarrassing) bladder moment was just before delivering a TEDx talk. There I was, backstage with two microphones strapped on, hair and makeup flawless, counting down the final two minutes before going live. Then suddenly — my bladder called.
With no time to spare, I sprinted to the bathroom. I was still there when they announced my name. I bolted back out, breathless, laughing awkwardly as I stepped onto the stage. I played it off as a joke then, but deep down I knew my bladder was reacting to stress.
Research has consistently linked higher stress and anxiety levels with overactive bladder symptoms. Your bladder doesn’t just respond to how much fluid you’ve had to drink; it also reacts dramatically to your mental state.
Stress in the bedroom
Chronic stress is no friend to your sex life. When your body is constantly flooded with stress hormones such as cortisol, it throws your natural hormonal balance out of sync — significantly reducing levels of testosterone in men and estrogen in women.
As stress hormones rise, sex hormones fall. The result? Lower libido, erectile dysfunction in men, difficulties with arousal in women, and trouble reaching orgasm for everyone. Studies have highlighted psychological stress as one of the leading causes of sexual dysfunction among otherwise healthy adults, emphasizing just how deep the mind and body are connected when it comes to sexual health.
But hormones aren’t the only factor. Chronic stress can also affect blood flow, which is vital for sexual response. And when stress disrupts your sleep, it further compounds the problem since sleep is essential for healthy hormone production and sexual functioning.
The emotional toll is equally significant. When you’re stressed, intimacy and connection often take a back seat as your mind becomes occupied with worries. Over time, this pattern can strain relationships, further dampening sexual desire.
If you’ve noticed stress affecting intimacy, remember it’s not “all in your head.” It’s a super complex hormonal, physical and emotional response — one you can address by taking steps to reduce stress and prioritize relaxation, intimacy and self-care.
Stress and sleep
Chronic stress can also hijack your sleep. High cortisol levels and persistent anxiety prevent deep, restorative sleep, leaving you feeling exhausted even after a full night in bed. Poor sleep then elevates stress levels further, creating a frustrating, self-perpetuating cycle that can profoundly affect your health.
I experienced this firsthand last year. I went through a period of terrible sleep — tossing, turning, waking frequently and never feeling truly rested. I started gaining weight rapidly, and despite dedicated workouts, I didn’t see progress in the gym. I felt sluggish, drained and defeated.
Eventually, I had to acknowledge that my poor sleep, driven by chronic stress, was the real culprit.
Chronic stress can cause serious health problems
Beyond affecting sleep, chronic stress is a powerful trigger for numerous serious health conditions. Sustained exposure to cortisol and other stress hormones promotes inflammation, suppresses immune function and creates conditions in the body that set the stage for disease.
Chronic stress has been directly linked to an increased risk of cardiovascular diseases such as high blood pressure, heart attacks and strokes. The American Heart Association emphasizes that stress not only directly raises blood pressure but also indirectly contributes to unhealthy habits, including smoking, poor diet and sedentary lifestyles.
At one point, chronic stress started causing me frequent heart palpitations. Initially, I blamed caffeine, lack of sleep due to being on call and general fatigue. When I finally saw a cardiologist and underwent extensive testing, my diagnosis was stress. I was stunned. I am a physician accustomed to diagnosing others, yet chronic stress had quietly compromised my own heart health.
The risks associated with stress don’t end at your heart. Research suggests chronic stress might even accelerate cancer progression by impairing your body’s immune defenses and creating conditions that encourage cancer cell growth. Chronic stress also increases the risk for metabolic disorders such as obesity and diabetes as well as mental health conditions such as anxiety and depression.
My own experiences served as a powerful wake-up call: Stress was not a minor inconvenience — it was a genuine threat to my overall health. Recognizing and addressing it through targeted stress-management strategies isn’t just good advice — it could literally save your life.