Social Anxiety Disorder Diagnosis How Hormones Play a Role in Social Anxiety By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on May 06, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print martin-dm / Getty Images Did you know that that hormones and anxiety are related in certain ways, such that your hormones may have a relation to how anxious you feel? When hormone levels are too high or too low, this can influence neurotransmitters, resulting in problems such as increased anxiety. People who live with social anxiety disorder (SAD) may find that levels of certain hormones related to feelings of increased or decreased social anxiety. Hormones That May Increase Social Anxiety There are three categories of hormones that may influence your social anxiety: stress hormones, sex hormones, and thyroid hormones. Learning more about how these hormones affect your body and mind is the first step to managing the impact of hormones on your anxiety levels. Sex Hormones (Testosterone, Estrogen) Sex hormones may also play a role in how much anxiety you experience. Changing levels of the sex hormones estrogen and testosterone can affect your social anxiety. Some studies link too little testosterone with increased anxiety, while low levels of the female sex hormones such as estrogen may also be linked to anxiety symptoms. This may be why anxiety often peaks during times of hormonal change such as during puberty, at certain times of the menstrual cycle in women, and during menopause in women. Stress and sex hormones can also have a combined effect on anxiety. For example, when you experience stress, cortisol increases, which slows your body's ability to make testosterone. The combined effect of increased cortisol and lowered testosterone may make you feel more anxious. If that isn't bad enough, testosterone has partial control of the release of cortisol, so when testosterone is lowered, cortisol is more likely to increase. You can see why anxiety is a cycle that feeds itself—and that breaking this cycle is key to overcoming your symptoms. Stress Hormones (Adrenaline, Cortisol) Stress hormones are released in situations where you feel threatened, out of control, overwhelmed, or are experiencing severe anxiety. When you experience a stressful social or performance situation, your body responds by releasing hormones like adrenaline and cortisol to help you cope with the threat and prepare you for action. However, in the face of no actual physical threat, excess levels of these hormones leave you feeling anxious and impact your body in various ways. This becomes a vicious cycle: your hormones increase anxiety, the anxiety causes more hormones to be released, and so on. Thyroid Hormones Finally, there is a third type of hormone that may influence your anxiety: thyroid hormones. An overactive thyroid can create anxiety in the form of physical symptoms such as increased heart rate, palpitations, shakiness, and increased sweating. If you live with a thyroid condition, this may make your social anxiety worse. Hormones That May Reduce Social Anxiety If you think hormones are all bad—think again! There are actually some ways in which certain levels of hormones can help to reduce your anxiety. Estrogen Estrogen is known to calm the fear response in women. Specifically, research has shown that women trained on a fear-extinction task do better when the level of estrogen in their blood is higher. As a female, you may have also noticed that your ability to feel calm and relaxed (versus anxious and afraid) is better at certain points during your menstrual cycle. Oxytocin You've probably heard of the "love" or "bonding" hormone, oxytocin. This is a peptide hormone, which acts as both a hormone and a brain neurotransmitter. It is known as the love hormone because it is released during contact with a loved one. Oxytocin is made in the hypothalamus and transported and secreted by the pituitary gland at the base of the brain. Its release also helps with childbirth and breastfeeding. In terms of its relation to mental health, oxytocin is known to have an anti-anxiety effect and may help to relieve social anxiety. Research shows that oxytocin promotes relaxation and trust, which makes it easier to manage social situations. In fact, studies are ongoing on the role of oxytocin and how it could be used in the treatment of social impairments (including the social challenges of autism). Testosterone Just as too little testosterone may increase social anxiety, increased testosterone may help to reduce it. Administration of testosterone, a steroid hormone, has been shown to reduce socially fearful, avoidant, and submissive behavior. Indeed, in general, men have half the reported rate of anxiety disorders as women; this may be partially due to the role of testosterone in levels of anxiety. Testosterone boosts the action of gamma-aminobutyric acid (GABA) and serotonin. These two brain chemicals are related to social anxiety disorder. Vasopressin Finally, vasopressin is a hormone that regulates the body's fluid balance. In addition, it is involved in the regulation of anxiety, stress, and social behavior. Vasopressin is produced within the hypothalamus and released from the pituitary gland. Some researchers think that a balance must be struck between oxytocin and vasopressin for optimal social functioning. Vasopressin is particularly related to social behavior, sexual motivation, pair bonding, and maternal responses to stress. Hormonal Ways to Relieve Social Anxiety Although hormonal changes may be related to social anxiety, treatment with hormonal therapy is not currently a common recommendation. Instead, your best option is some form of traditional treatment for SAD (e.g., medication or therapy) as well as understanding and adapting to the role of hormones in your anxiety. What is not helpful is self-medicating. Try to avoid temporary "fixes" like sugar, alcohol, smoking cigarettes, or other substances that give you a quick feel-good surge but don't solve the long-term anxiety problem. Below are six tips to get you started. Boost Testosterone and Oxytocin You can increase your levels of testosterone and oxytocin naturally! These are things that are easy to do, but that you have to make a commitment to following through with. Increase testosterone by doing the following: Eating a balanced diet Getting regular exercise Minimizing stress (and therefore testosterone-depleting cortisol) Sleeping enough each night Taking a multivitamin Increase oxytocin by doing the following: Being generous toward others (giving gifts) Cuddling with a loved one Going on social media Listening carefully when others speak Petting a dog or cat Trying "metta" meditation, which involves meditation designed to inspire love and kindness toward others Consider Supplements Take natural supplements that may help to lower stress levels (and cortisol) such as ashwagandha. Note, however, that these types of supplements are not regulated by the Food and Drug Administration (FDA) and have not been tested by this regulatory body for safety and efficacy. Get Thyroid Treatment If you have a thyroid condition that may be affecting your anxiety level, ask your doctor whether the two could be related, and how treating your thyroid condition may help. Strike a Pose Research shows that adopting a strong pose (such as the "Wonder Woman" pose, with feet hip-width apart and hands on your hips) for a few minutes may lead to increased testosterone and feelings of confidence, which in turn will help to lower social anxiety. Try Cognitive Behavioral Therapy Use cognitive-behavioral therapy (CBT) techniques to learn new patterns of responding to anxiety. Over time, neural pathways in your brain will change, which will help to reduce your anxious responses to stressful situations. Understand Hormonal Changes If you are female, learn how variations in hormones over your life and during the course of a month may influence anxious feelings. Just knowing how hormones may be affecting you may help you to stop and think: "This situation is not causing my anxiety; my body is reacting to change in hormones," which may allow you to take a step back and accept your feelings for what they are. Is Hormone Therapy for Social Anxiety Possible? While it may sound fanciful that one day we might treat anxiety disorders with hormone therapy, the truth is that research on this topic is already happening. In one study, it was shown that women exposed to trauma who were administered female sex hormones (in the form of the morning-after pill, after a sexual assault) were less likely to develop post-traumatic stress disorder (PTSD) after the event. This fascinating and ground-breaking research is likely to lead to advances in the area of hormone treatment of anxiety. It isn't that much of a stretch to imagine that this new understanding of the role of hormones in anxiety and fear could lead to treatments that relate to hormones. At present, however, beyond treating an underlying thyroid condition, or hormone replacement therapy (HRT) for problems related to menopause in women, your doctor is not likely to prescribe hormone treatment that will help to improve social anxiety. A Word From Verywell The best approach to managing social anxiety in light of the influence of your hormones is to understand natural fluctuations and learn ways to boost hormones that help to reduce anxiety. However, if severe social anxiety is a problem for you and you have not sought diagnosis or treatment, it's best to visit your family doctor for a referral to a mental health specialist. Effective treatments such as medication and CBT can be helpful in managing SAD that has gotten out of control. Remember—your anxiety does not define you and is not who you are. You can move past it with the right help. While hormones may be involved, you are not destined to live with social anxiety for the rest of your life. If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. The 7 Best Online Anxiety Support Groups 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. van Honk J, Bos PA, Terburg D, Heany S, Stein DJ. Neuroendocrine models of social anxiety disorder. Dialogues Clin Neurosci. 2015;17(3):287–293. Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab. 2011;15(1):18–22. doi:10.4103/2230-8210.77573 Harvard Gazette. Estrogen and female anxiety. 2012. Neumann ID, Slattery DA. Oxytocin in general anxiety and social fear: A translational approach. Biol Psychiatry. 2016;Feb 1;79(3):213–21. doi:10.1016/j.biopsych.2015.06.004 Ferree NK, Wheeler M, Cahill L. The influence of emergency contraception on post-traumatic stress symptoms following sexual assault. J Forensic Nurs. 2012;8(3):122-30. doi:10.1111/j.1939-3938.2012.01134.x By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Social Anxiety Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.