In plain words
The HPA axis is a loop of three parts: the hypothalamus in the brain, the pituitary gland below it, and the adrenal glands that sit on the kidneys. When the brain reads threat or strain, it sends signals down this chain. The adrenal glands then release cortisol, the body's main stress hormone. The loop normally switches off once the stress passes. Cortisol levels rise through pregnancy, and the system adjusts again after birth. Researchers study the HPA axis to understand anxiety and depression, including why stress can feel physical. The axis is not a diagnosis. It is the system many stress-related symptoms run through, such as a racing heart, poor sleep, and . A mother may hear about it from a therapist or a researcher.
The deeper version
The HPA axis comprises corticotropin-releasing hormone from the paraventricular nucleus, adrenocorticotropic hormone from the anterior pituitary, and cortisol from the adrenal cortex. Cortisol exerts negative feedback on the hypothalamus and pituitary through glucocorticoid receptors. In pregnancy, rises across gestation and total cortisol increases as binding globulin rises. Dysregulation, measured as the cortisol awakening response, diurnal slope, or dexamethasone suppression, has been linked to and anxiety (Yim and colleagues, Annual Review of Clinical Psychology, 2015). Findings are mixed, and most studies are small. The axis is better described as one contributor than as a single cause.
Where it comes up
- Anxiety in pregnancyPregnancy: Mind and Life
- Postpartum anxietyPostpartum: Mind
- Postpartum depressionPostpartum: Mind
What mothers here say about HPA axis
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Sources
- Yim IS et al. — Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annual Review of Clinical Psychology, 2015
- Glover V, O'Connor TG, O'Donnell K — Prenatal stress and the programming of the HPA axis. Neuroscience and Biobehavioral Reviews, 2010