If you’re experiencing chronic stress, you might notice changes in your menstrual cycle. In particular, stress can affect how heavy your flow is and the length of your menstrual cycle — your periods can sometimes stop completely. Stress might also affect your fertility. Luckily, there are lots of lifestyle changes you can make to help you manage your stress levels.
Medically reviewed by Dr Rebecca Kingston MBChB, Medicine
- Stress and your period
- What’s a ‘normal’ menstrual cycle?
- How does stress affect your period?
- Does stress affect fertility?
- How to lower stress levels
- Where to get help
Stress and your period
Stress is a normal part of our every day lives. But if you’re finding it hard to cope with stress or you’re under a lot of strain, it can have a wide range of effects on your body — including your menstrual cycle and period.
Most commonly, chronic stress can delay your period or cause your flow to become much lighter. For some people, stress might cause a heavier flow. You might also experience:
- more painful periods
- worse PMS symptoms
- no periods at all
What’s a ‘normal’ menstrual cycle?
A typical cycle lasts between 21-35 days — your period usually makes up 3-5 days of this. To maintain this regular cycle, your body relies on a very fine-tuned balance of sex hormones. These hormones fluctuate throughout the month to:
- trigger ovulation
- build up the lining of your womb — in preparation of pregnancy
- maintain a pregnancy or lead to menstruation
If any of the hormones that control these processes are out of range, even by a very small amount, it can disrupt your cycle. Stress can often be lead to a hormonal imbalance like this.
How stress affects your period
If you’re in a stressful situation, your body responds by releasing a surge of stress hormones (adrenaline and cortisol) to help you cope with the situation. And a system called the hypothalamic-pituitary-adrenal (HPA) axis controls this response.
Your HPA axis also interacts with another system called the hypothalamic-pituitary-gonadal (HPG) axis. And it’s this HPG axis that’s responsible for producing sex hormones that play a key role in regulating your period and menstrual cycle — like luteinising hormone, follicle-stimulating hormone (FSH), oestrogen, progesterone, and testosterone.
If you’re stressed a lot, the repeated activation of your HPA axis can alter your HPG axis — which can lead to a condition called hypothalamic amenorrhoea (HA).
HA is when your hypothalamus (a region in your brain) doesn’t give the correct signals to produce the hormones you need to regulate your cycle — causing irregular periods or no periods at all. Other causes of HA include not getting enough calories or exercising too much. Again, this is because these also put your body under a lot of stress.
Does stress affect your fertility?
Stress and fertility are closely related. Your stress response system has been designed to protect you from danger. It helped your ancestors fight or run from physical dangers, like a hungry lion.
But while your environment has changed a lot since then, your body still reacts in the same way to something stressful. Everyday occurrences, like work stress, can trigger this response. So from an evolutionary perspective, it’s likely your body is protecting you from the demands of pregnancy — its priority is to help you deal with danger.
If stress affects your HPG axis and sex hormone production, a range of things can happen that might prevent pregnancy, like:
- not ovulating — no egg is released so fertilisation can’t happen
- having a short cycle — there mightn’t be enough time to properly implant a fertilised egg before your period starts
How to lower stress levels
There are lots of everyday things you can do to help you manage and reduce your dress levels.
- practice mindfulness — yoga and meditation can help reduce anxiety and lower cortisol levels
- get enough sleep — aim for at least 7 hours of sleep every night
- exercise — aim for at least 75 vigorous minutes of activity or 150 minutes moderate aerobic activity each week
- eat a diet rich in fruits, vegetables, and essential fatty acids (found in oily fish) — these are full of nutrients that keep your brain healthy and help balance your hormones
- do something you enjoy every day — like listening to music or dancing
- connect with family and friends — a good social support system is really important for mental wellbeing
Where to get help
If you’re worried about any changes to your cycle or you’re finding it hard to cope with stress, a good first step is to speak to your GP. You also have the option to consult with a private specialist or check your hormones levels with a private blood test.
Recommended listening for you
Barsom, S. H., Mansfield, P. K., Koch, P. B., Gierach, G., & West, S. G. (2004). Association between psychological stress and menstrual cycle characteristics in perimenopausal women. Women's Health Issues, 14(6), 235-241.
Damti, O. B., Sarid, O., Sheiner, E., Zilberstein, T., & Cwikel, J. (2008). Stress and distress in infertility among women. Harefuah, 147(3), 256-276.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169.
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of psychosomatic research, 57(1), 35-43.
Melón, L. C., & Maguire, J. (2016). GABAergic regulation of the HPA and HPG axes and the impact of stress on reproductive function. The Journal of steroid biochemistry and molecular biology, 160, 196-203.
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National Health Services (2018). Health A to Z: Stopped or missed periods. Retrieved 2 February 2020 from https://www.nhs.uk/conditions/stopped-or-missed-periods
Roca, C. A., Schmidt, P. J., Altemus, M., Deuster, P., Danaceau, M. A., Putnam, K., & Rubinow, D. R. (2003). Differential menstrual cycle regulation of hypothalamic-pituitary-adrenal axis in women with premenstrual syndrome and controls. The Journal of Clinical Endocrinology & Metabolism, 88(7), 3057-3063.
Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in clinical neuroscience, 20(1), 41.
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Toufexis, D., Rivarola, M. A., Lara, H., & Viau, V. (2014). Stress and the reproductive axis. Journal of neuroendocrinology, 26(9), 573-586.