How Stress Could Be Affecting Your Period
On top of triggering insomnia, weird dreams, headaches, anxiety, and depression, stress from the COVID-19 pandemic can also impact people’s menstrual cycles — resulting in delayed or totally missed periods.
“It’s well known that under significant stress, you’re more likely to see some changes in the menstrual cycle,” Leah Millheiser, director of the Female Sexual Medicine Program at Stanford Health Care, tells Allure. “With the way things are currently, I’m getting emails from patients saying their period is totally out of whack.”
While experts say temporary, stress-induced menstrual changes are relatively common, it’s important to get checked out by a doctor, especially if the changes persist.
“Your menstrual cycle is an indicator of whole-body health,” says Shruthi Mahalingaiah, an OB-GYN at Boston Medical Center. “Having a healthy functioning cycle involves the brain, pituitary glands, ovaries, adrenal glands, and thyroid.”
But when do you have reason for concern, and what’s actually happening when stress changes your cycle? We spoke with three OB-GYN doctors to find out.
What’s a “regular” cycle?
According to Millheiser, normal menstrual cycle length can vary from person to person, but it’s typically between 21-35 days.
Mahalingaiah says irregularity, whether from stress or another factor, is defined as when “a cycle length is greater than 35 days, that’s unpredictable with variability in cycle length greater than 7 days.”
Some people, she says, experience a bit of variability month to month, and anything up to seven days can be normal. Other people have longer menstrual cycles, which aren’t problematic on their own as long as they’re predictable. “You can have up to seven days of flexibility and still have a regular period,” she says.
What’s typically concerning, Millheiser says, is when a person has a normal, predictable period but all of a sudden they begin to have a period every six weeks or three months: “When there’s a significant change outside of that normal range, then you need to speak with your doctor.”
How does stress change a menstrual cycle?
According to Leena Nathan, an OB-GYN at UCLA Health, people may notice their cycles or periods are delayed, or that they’re spotting between periods. While emotional stress like a pandemic can incite these changes, so can physical stressors, like recent weight loss or increased exercise.
The reason stress can alter the menstrual cycle likely has to do with hormones. Nathan says stress causes cortisol levels to go up, which can suppress the hormonal cycle responsible for a person’s ovulation and period. “When your body is in a time of stress, it’s really not the best time to get pregnant, so it’s shutting down,” she says.
In many cases, if you aren’t getting a period, you are also probably not ovulating. But don’t take an irregular period as a sign that you’re not producing eggs or can’t get pregnant. Ovulation usually happens two weeks before a person’s period, so Mahalingaiah says even if you haven’t had a period in a while, there’s always a chance you could be ovulating.
“If you are not having regular periods, your chance of being pregnant may be lowered, but I’d still recommend contraception to prevent pregnancy,” says Nathan.
A delayed or missed period can also be a sign of polycystic ovary syndrome (PCOS), which Nathan says usually comes with other symptoms, such as increased hair growth. Other health conditions, like thyroid or endocrine disorders, can also impact the menstrual cycle, according to Millheiser.
How can I get my cycle back on track?
For anyone concerned about their missed period, experts recommend ruling out pregnancy first, then talking to your primary care provider or OB-GYN to pin down other possible causes.
Many OB-GYNs, Nathan says, are available for tele-health, so contact your doctor to discuss your symptoms. You may be asked to go into the office for a blood test or ultrasound, which can help diagnose the problem.“Then, we’d arrange a second tele-visit to discuss results and treatment,” Nathan says.
Depending on what’s going on, your doctor may recommend hormonal therapy to regulate your cycle. Nathan says if someone anticipates prolonged stress (like during a pandemic), they can consider hormonal regulation with the birth control pill, especially if infrequent cycles become bothersome.
“Sometimes, when people haven’t had a period for a few months, they can have a really heavy and painful period, and we don’t want them to experience that,” she says.
Millheiser says a period that’s spaced out more than every three months can have health implications. “The reason we get concerned if it’s greater than every three months, even if it’s on a regular frequency, is because you are getting a build up of estrogen which leads to thicker lining of the uterus, which can potentially lead to cancer down the road,” she says.
If your doctor suspects your missed or delayed period is related to stress, focus on reducing cortisol levels. Nathan recommends getting at least six to eight hours of sleep a night, eating a healthy diet, exercising, and practicing meditation, yoga, or mindfulness. “These are all ways to reduce stress and get your body back into its normal cycle,” she says.
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Originally Appeared on Allure
