Stress is part and parcel of our lives. Stress is something that we all go along with in a series of life events. You may have stress due to your job or bad college grades. Your friend might have betrayed you, or you are under some financial difficulties. Stress always accompanies you everywhere.
In females, stress can disrupt the regular menstrual cycle. Menstrual health is indicative of a woman’s overall health. Any disturbances in the normal menstrual cycle can affect other physiological functions in the female body.
In this article, we will explain the relationship between stress and periods.
What actually stress is?
Stress is a physiological response to certain unwanted events of daily life. It is a state of mental discomfort brought on by unfavorable situations. Stress is a natural phenomenon. Whether it is emotional or physical, if stress is prolonged or continuous, it can alter the normal functions of the human body.
Some sort of acute stress acts as a good motivator but when stress becomes your permanent partner, then this chronic stress will have a negative impact on your mental as well as physical health. One of these harmful effects of chronic stress is on the menstrual cycle.
How stress affects the normal menstrual cycle?
Stress disturbs the hormonal pathways of the body, and the menstrual cycle is also controlled by one of these pathways. Stress, whether psychological or physical, can cause the release of stress hormones by stimulating areas of the brain that control many other functions too.
Stress causes the release of corticotrophin-releasing hormone that acts on the pituitary to cause the release of ACTH (adrenocorticotropic releasing hormone). ACTH stimulates the adrenal glands (glands located just above/on the kidneys) to release the major stress hormone, cortisol.
This is the hypothalamus-pituitary-adrenal axis that controls the body’s response to stress and puts the body into a fight or flight mode. In this condition, cortisol diverts all energy towards actions that help it manage the stressor. It increases heart rate, raises the temperature, mobilizes stored energy, and triggers specific other responses. It also decreases or stops the reproductive functions in females.
Role of cortisol hormone
- Cortisol acts upon the brain center (hypothalamus) and stops or decreases the release of reproductive hormones (GnRH, FSH, LH). It alters the hypothalamus-pituitary-ovarian axis.
- Chronic stress and elevated cortisol also suppress the release of estrogen from the ovaries. The effects depend upon the amount of cortisol; high stress leads to a high amount of cortisol and increased intensity of cortisol’s negative effects on the menstrual cycle.
- Cortisol greatly affects LH, so ovulation does not occur, and periods are delayed further. Hence, the follicular phase of the cycle is more likely to alter in length and can be prolonged excessively.
- High amounts of chronic cortisol release can totally suppress the release of reproductive hormones, which can cause amenorrhea (no periods) or anovulation (no ovulation).
Other factors
By affecting additional factors that lead to irregular periods, stress can also have a negative impact on the menstrual cycle. For instance, stress can interfere with sleep patterns, eating habits, and general lifestyle choices, which can affect the balance of hormones.
Additionally, stress can result in weight changes, such as weight loss or weight gain, that can affect menstrual cycle irregularity. When our body senses some sort of stress, whether it is due to upcoming exams or being caught in a war zone, cortisol works to deal with the stressor and provides all energy to find ways to escape.
What are the visible symptoms of stress-affected periods?
Stress can disrupt the delicate hormonal balance in the body, which in turn can affect the regularity of the menstrual cycle. Cortisol interacts with hormones that control ovarian functions. So, this disturbance of hormones causes many menstrual abnormalities.
Stress-induced menstrual abnormalities manifest as:
Delayed or early periods
The length of the menstrual cycle may be prolonged or shortened, depending on the time of the month when high stress hits. Cortisol can stop LH release, stopping ovulation and causing the menses to delay.
Cortisol can also alter the FSH levels, resulting in early periods. Chronic stress can also contribute to unhealthy lifestyle habits, such as poor sleep, inadequate nutrition, and lack of exercise. These factors can also disrupt hormonal balance and menstrual regularity, leading to early or delayed periods.
Periods that come before 21 days are considered early or shortened periods. If the length of the cycle increases from 35 days, then this is called a delayed period.
Amenorrhea
Amenorrhea means the stoppage of periods. When periods are continuously absent for 3 or more than 3 months, it is clinically regarded as amenorrhea.
High stress leads to an increased surge of cortisol levels. Such a high amount of cortisol for constant periods can completely stop the production and release of reproductive hormones until the stress subsides. When there are no hormones, ovaries do not function, and it results in amenorrhea. It is called functional hypothalamic amenorrhea.
Functional hypothalamic amenorrhea is also caused by other factors such as severe or intense physical exercise and nutritional disorders that lead to energy depletion.
Worsening of premenstrual symptoms
PMS refers to a range of physical and emotional symptoms that occur in the days leading up to menstruation. Premenstrual symptoms occur before the onset of menstrual bleeding. These are characterized by mood swings, abdominal pain/cramps, back pain, nausea, breast tenderness, and emotional sensitivity.
All of these occur due to sudden changes in hormones. But due to stress, these hormones are additionally affected, so symptoms worsen. Cortisol exacerbates these PMS symptoms.
Anovulation
Anovulation is the absence of ovulation (release of an egg from the ovaries). Intense stress can disturb the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential for ovulation.
This disruption can lead to anovulation where an egg is not released from the ovaries. Anovulation can result in irregular or missed periods.
Dysmenorrhea
Dysmenorrhea is painful period cramps. Hormonal imbalances can lead to intense uterine contractions and inflammation, resulting in pain and discomfort during menstruation. Also, stress decreases the threshold for pain and increases the sensitivity of the body to painful stimuli.
Further, cortisol increases muscle tension in the whole body, including the uterus wall muscles. All of these factors cause extremely painful periods.
Severe mood changes
Cortisol causes fluctuations in estrogen and progesterone levels. These disrupted hormones cause disturbances in neurotransmitter release from the brain, such as serotonin. Serotonin regulates mood.
Disrupted serotonin release impacts mood in a negative way and causes anxiety, irritability, and mood swings. The combination of stress and menstrual hormonal fluctuations can amplify these mood changes during the menstrual period.
Changes in menstrual flow
Stress can affect the blood flow to the uterus and also disrupt estrogen/progesterone levels, leading to changes in the intensity of menstrual bleeding. Periods might be light, or there might be heavy blood flow.
How to manage stress?
In a world with a busy and hectic routine, upcoming deadlines, health issues, and challenging tasks, it is absolutely impossible to eliminate stress entirely. We can not make our lives stress-free while living in the 20th century. However, what we can do is manage it.
Managing stress is crucial for maintaining overall well-being. Here are some strategies that can help you deal with stress effectively:
- Identify the root cause: Recognize the signs of stress and identify its root cause. This will help you become aware of stressors in your life that can harm your overall health.
- Relaxation techniques: Practice relaxing techniques that include meditation, yoga, and deep breathing exercises. These will aid in self-awareness and promote relaxation of the mind.
- Maintain healthy relationships: Have healthy and non-toxic relationships with your family and friends. Connect with them, talk to them, and spend quality time with your loved ones!
- Exercise daily: Even if you start with just a few steps, exercise has a positive impact on your soul, mind, and body. Exercise releases endorphins, the natural mood boosters.
- Eat a balanced diet: Consume a nutritious and healthy diet rich in vegetables, fruits, and nuts. Avoid junk, oily, and processed foods. This will lead to balanced hormonal levels and, ultimately, better overall health.
- Prioritize sleep: Maintain a consistent sleep pattern with adequate hours. Sleep restores normal functions and helps reduce stress.
- Engage in leisure activities: Take out some time for activities you enjoy. Whether it is painting, going for a walk, or planning a vacation trip to your favorite place, make sure to indulge occasionally.
- Self-improvement: Work on your weaknesses, motivate yourself, manage your time effectively, and boost your energy levels. This will help decrease the causes of stress.
While stress cannot be totally eliminated, by dealing with it and preventing it from becoming intense and chronic, you can maintain a healthy lifestyle and good menstrual health.
When to seek medical advice?
Stress can sometimes mess with our periods. If your periods keep being irregular for many months, it is a good idea to talk to a healthcare professional.
Major changes in your period could be a sign of other health problems. Very painful periods or heavy bleeding can be a sign of something more serious. If you see such changes in your menstrual cycle, it is important to consult your gynecologist.
Menstrual Portal also offers free online consultation, regarding all your menstrual health concerns.
Frequently asked questions
How much stress can cause menstrual irregularities?
The exact impact of stress on menstrual health can vary from female to female, as they may respond differently to stressors. One event might be so stressful for you, while your friend might take it as something normal.
So, the threshold for cortisol release varies among persons. But as soon as stress hits you, cortisol will be released, and if the stress is prolonged for an increased time, it will affect your menstrual health.
When will periods return to normal after stress?
Upon the removal of stress factors, periods will return to their usual pattern within one month. As soon as stress subsides, normal hormones will be produced and released, causing the ovaries to function in a normal way.
Does stress affect fertility?
Stress and fertility are interrelated. High and chronic stress can cause intense hormonal imbalances for constant periods. These imbalances will impede the ovaries’ function to produce and release an egg, ultimately affecting fertility.
But managing stress will reverse the ovaries’ function to normal, and there will be increased chances of conceiving.
How do stress and the menstrual cycle impact mood disorders like depression and anxiety?
Stress can intensify menstrual-related mood swings, while menstrual irregularities can, in turn, exacerbate symptoms of mood disorders. The interplay between stress, menstrual health, and mood underscores the importance of holistic approaches to mental and reproductive health.
