Gynecologist Reveals 'Crucial' Factor That Could Make Your Periods Worse

As anyone who has ever menstruated will know, every period is different.

The menstrual cycle can be strongly affected by a variety of internal and external factors, including our lifestyle, weight fluctuations and infections. One of the most common and pervasive of these factors is stress.

According to the American Psychological Association, more than a quarter of American adults report feeling "too stressed to function most days," with a 2022 McKinsey and Co survey finding that 40 percent of female workers "always" or "often" feel burnout in their careers.

Chronically high levels of stress have been associated with a range of mental and physical health problems, including anxiety, depression, cardiovascular disease, asthma, diabetes, and chronic fatigue. It is perhaps, then, unsurprising that stress can also impact menstruation.

"Managing stress is crucial for maintaining menstrual health," Melanie Bone, a consultant OBGYN and U.S. medical director at gynecological health company Daye, told Newsweek.

"When we experience stress, our bodies release cortisol and other stress hormones like adrenaline. Elevated cortisol levels can suppress the production of reproductive hormones like estrogen and progesterone that regulate the menstrual cycle. This hormonal disruption can lead to delayed ovulation or lack of ovulation."

Bone said that, through evolution, this feedback loop may have played an important role in our survival. "From a biological perspective, the body stops ovulation during times of heightened stress so as to not add any further stress, which could be caused by a pregnancy," she said.

Even so, the resulting effects on our menstrual cycles can be disconcerting at best, and debilitating for many.

"Biologically, these changes may manifest as irregular or missed periods, changes in menstrual flow, and alterations in cycle length," Bone said. "Some women may experience longer cycles, while others have shorter cycles or more frequent periods. The unpredictability can be frustrating and concerning for many.

"Very infrequent periods can lead to a buildup of the uterine lining, potentially increasing the risk of endometrial hyperplasia or cancer if left untreated."

Beyond affecting cycle regularity, stress can also make your period feel much worse when it does finally come.

"Stress can exacerbate many common menstrual symptoms," Bone said.

"Women and assigned female at birth [AFAB] individuals under chronic stress often report more intense menstrual cramps, heavier bleeding, and increased mood swings or irritability during their periods. Additionally, the physical tension that often accompanies stress can contribute to increased back pain and headaches during menstruation.

"Stress may also worsen premenstrual syndrome [PMS] symptoms like breast tenderness, bloating, and food cravings. If you are struggling with PMS or have been diagnosed by a professional with premenstrual dysphoric disorder [PMDD], managing your stress levels and investing in relaxation activities like meditation, exercise, acupuncture, and long walks is essential, as elevated levels of cortisol can worsen the experience of PMS/PMDD."

Everyone responds differently to stress and it is important to find time to invest in yourself to understand which stress-management strategies work best for you.

"Stress management is deeply personal and you need to experiment and find the methods that work for you," Bone said.

"Some interventions to consider include meditation, deep breathing, yoga, engaging in regular physical activity, maintaining a balanced diet rich in nutrients and whole foods, prioritizing adequate sleep, setting boundaries and learning to say no to excessive commitments, as well as seeking support through therapy or counseling if needed."

Of course, stress isn't the only thing that can affect your menstrual cycles. Other factors include:

• Diet and nutrition: "Not fueling your system sufficiently can also lead to missed or irregular periods."
• Exercise habits: "Both too much and too little exercise can disrupt menstrual cycles."
• Sleep patterns: "Not getting enough sleep or changing the time you go to bed and wake up can also increase your levels of cortisol, making you miss a period or experience irregular menstruation. Keep in mind that the eight-hour-per-night rule is based on the male physiology rather than the female physiology, many women and AFAB folks need nine hours of sleep."
• Significant weight changes: "Losing weight or gaining a lot of weight quickly can have an impact on your overall hormonal balance resulting in menstrual irregularity. and impact how regular your menstruation is."
• Hormonal contraceptives: "These are designed to stop ovulation and produce a regular bleeding pattern to manage many conditions, including endometriosis, PCOS [polycyctic ovary syndrome] and perimenopausal hormonal fluctuations. They do not treat the underlying conditions and when stopped, the problem will come back."

Having said that, if you do experience irregular periods over several cycles, it is always worth checking in with your doctor or gynecologist. "It's important for patients to pay attention to their menstrual cycles and not dismiss irregularities as simply 'normal stress,'" Bone said. "While some variation is common, persistent irregularities warrant a discussion with a healthcare provider."

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