Can stress affect Your period? Yes – and in some pretty weird ways
TL/DR: We all know stress can affect our mental health, especially if it never lets up. But it can also affect your menstrual cycle, wreaking havoc on hormones in charge of your cycle. In fact, stress can lead to irregular, more painful, or completely absent periods. Time to queue up the herbal supplements!
By now, most of us are pretty aware of the damaging effects stress can have on your mental health and its ability to impact physical well-being. But did you know that stress can impact your menstrual cycle, too? Yeah – turns out, working your ass off to pass that exam or get that promotion might make your period irregular, more painful, or even make it disappear altogether.
Here’s an in-depth look at the many ways in which stress affects the menstrual cycle. And – spoiler alert – even the tiniest fluctuations in hormone secretion can throw your entire system out of whack (did you know stress has pretty much everything to do with hormones?). Let’s jump in:
The real definition of stress (as it relates to your menstrual cycle)
You know what stress feels like, obviously. But do you know what happens in your body to create it? It’s a pretty complex process, involving a whole cast of endocrine and metabolic players that work together to keep your systems functioning and, ultimately, keep you alive.
At its most basic level, stress is just your body’s reaction to any perceived change in the environment, both physical and psychological.((Stress: Signs, Symptoms, Management & Prevention. (n.d.). Cleveland Clinic. Retrieved from my.clevelandclinic.org/health/articles/11874-stress)) On any given day, your body reacts to such changes – whether it’s stepping outside to a freezing gust of wind or running into your least favorite coworker at the grocery store – with physical, mental, and emotional responses.
Believe it or not, stress can actually be a good thing. It keeps us alert, motivated, and ready to avoid danger: If you smell smoke coming from your bedroom, you don’t just stay planted on the couch with your bowl of popcorn. You get up, assess the scene, and grab a fire extinguisher to put out the flaming sheets.
When stress becomes not-so-beneficial is when it happens to us over and over – especially without getting a moment to relax. And today, with our lives chronically overstimulated by phones, social media, and non-stop work, many of us have cortisol levels that remain elevated 24/7.
Hold up: What, exactly, is cortisol?
If you feel like you’re running on fumes, well, those ‘fumes’ are probably cortisol: It’s the HBIC of steroid hormones and your body’s built-in alarm system. Produced by your adrenal glands, cortisol has the ability to influence your mood, your metabolism, and lots of other physiological processes:((Chronic stress puts your health at risk. (2019, March 19). Mayo Clinic. Retrieved from mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037))
- Cortisol increases the availability of sugars (glucose) in the bloodstream and enhances your brain’s ability to use that glucose for energy and alertness, giving you a quick jolt of stamina
- Cortisol communicates with regions in the brain that control mood, fear, motivation, and even memory
- Cortisol slows down or temporarily halts processes that it considers nonessential in a fight-or-flight scenario, such as immune system responses, the normal functioning of the digestive system, the reproductive system, and others
Even in optimal health, your body needs a certain amount of cortisol in order to function. Problems only arise when those cortisol levels get way out of control, throwing off what’s called your HPA axis (the hypothalamic-pituitary-adrenal axis).
The HPA axis
The HPA axis has three major players: the hypothalamus, the pituitary, and the adrenals. All three communicate with each other via hormones that course through your bloodstream.
During a stressful event, the hypothalamus is alerted, and it responds by releasing hormones that travel through your body and eventually wind up in the adrenals. Like a long game of telephone, when the adrenals finally hear about this message, they push out cortisol, cortisol, and more cortisol.
Over time, if this process happens repeatedly, your body can’t catch a break. This state of prolonged stress may result in a phenomenon known as dysregulation of the HPA axis – and it can lead to major burnout, amenorrheaThe absence of menstruation, often defined as missing one or more menstrual periods. , and menstrual cycle irregularities.((Biller, B. M. (1990, February 1). Abnormal cortisol secretion and responses to corticotropin-releasing hormone in women with hypothalamic amenorrheaThe absence of menstruation, often defined as missing one or more menstrual periods. . PubMed. Retrieved from pubmed.ncbi.nlm.nih.gov/2153693/))
Stress and the menstrual cycle
So: How do elevated cortisol and a whacked out HPA axis create problems with the menstrual cycle?
Our bodies haven’t quite evolved to recognize the kind of stress we experience most often in modern life. Even though a looming deadline, a fight with your partner, or your friend suddenly requesting $527 from you on Venmo for Uber rides don’t necessarily qualify as life-threatening circumstances, our adrenal system still registers them as such.
When cortisol levels skyrocket, the body temporarily shuts down parts of “nonessential” systems (looking at you, ovaries) to conserve energy for outrunning that imaginary lion, tiger, or bear.
In the female reproductive system, high cortisol has an effect on two key hormones involved in the phases of your cycle leading up to ovulation: Follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH is responsible for stimulating the follicle growth; LH is responsible for prompting the release of the egg from the ovary. Stress impacts when and how these hormones (also known as gonadotropins) are produced.((Minkowicz, C. (2018). By What Mechanism Does Stress Affect Ovulation? The Science Journal of the Lander College of Arts and Sciences, 11(2). Retrieved from touroscholar.touro.edu/sjlcas/vol11/iss2/7))
When the HPA axis is activated, the delicate chain of hormonal processes may be disrupted. As a result, the follicle may not fully mature – or the maturation process is put on pause, delaying ovulation or preventing it altogether.((Minkowicz, C. (2018). By What Mechanism Does Stress Affect Ovulation? The Science Journal of the Lander College of Arts and Sciences, 11(2). Retrieved from touroscholar.touro.edu/sjlcas/vol11/iss2/7)) Kinda makes sense, if you think about it: Your body doesn’t want to set itself up for pregnancy if it assumes you’re under some sort of attack.
Your body’s failure to ovulate, known as anovulation, is the one of the most common reasons why your menstrual cycle (and menstruation itself) might become irregular during times of increased stress.((Rebar, R. (2018, January 15). Evaluation of AmenorrheaThe absence of menstruation, often defined as missing one or more menstrual periods. , Anovulation, and Abnormal Bleeding. NCBI Bookshelf. Retrieved from ncbi.nlm.nih.gov/books/NBK279144/))
Stress can also impact the length of your menstrual cycle (we’re talking whole-month-or-more, not just the duration of your period itself), the level of discomfort during your period, and whether your period shows up at all.((Laura Fenster, Kirsten Waller, John Chen, Alan E. Hubbard, Gayle C. Windham, Eric Elkin, Shanna Swan, Psychological Stress in the Workplace and Menstrual Function, American Journal of Epidemiology, Volume 149, Issue 2, 15 January 1999, Pages 127–134, https://doi.org/10.1093/oxfordjournals.aje.a009777))
Can stress cause heavy periods?
Stress can make PMS and period pain worse than usual.
One study found that high levels of stress caused premenstrual symptoms and dysmenorrhea – think awful cramps, bloating, nausea, vomiting, low back pain, and fatigue.((R. Kollipaka, B. Arounassalame & S. Lakshminarayanan (2013) Does psychosocial stress influence menstrual abnormalities in medical students?, Journal of Obstetrics and Gynaecology, 33:5, 489-493, DOI: 10.3109/01443615.2013.782272)) And if you already tend to experience severe PMS symptoms, stress may make them worse than usual.
However: Stress hasn’t technically been shown to directly cause menorrhagia (a fancy word for heavy bleeding)((Rafique, N. (2018, January 1). Prevalence of menstrual problems and their association with psychological stress in young female students studying health sciences. PubMed Central (PMC). Retrieved from ncbi.nlm.nih.gov/pmc/articles/PMC5885123/)). That said, it’s probably safe to assume that being under stress isn’t making things any better – especially for individuals who already often deal with a heavy flow, such as those diagnosed with endometriosis or PCOS.
Can stress make your period longer?
It has been proven to cause irregular periods and a longer (or shorter) overall menstrual cycle, usually due to the hormones that impact ovulation.
If you noticed that your cycle is lasting about 38 days (or 20 days, or even 50 days) instead of your usual 28, there’s a good chance it could be stress related. So maybe try:
- Deep breathing or meditation
- Taking care of yourself with a warm shower or bath
- A long walk or gentle stretching
- Herbal supplements to chill
P.S. If you experience very long or irregular cycles, missing periods, or have unusual levels of pain for more than a few months, make an appointment with your OB-GYN or primary care doctor: It’s a good idea to rule out anything potentially more serious.
