We get it: living in a pandemic can really feel like the sky is falling. The last thing you need is a late period, especially if you're not even sexually active. So what's the culprit: Hormones? Stress? Less-than-optimal eating habits? (I'm digging through a bag of kettle chips as I write this.) To find out, I talked to doctors about how stress, especially the kind we're going through during the coronavirus pandemic, can affect your period.
What stress does to your period
Think your uterus rules all when it comes to your period? It actually comes down to the brain-uterus connection. A region of the brain called the hypothalamus sends hormones to a gland at the base of the brain called the pituitary. These hormones signal the brain to release the hormones responsible for stimulating your ovaries, which in turn tell your uterus to menstruate. Cortisol, a stress hormone also made by your brain, can interfere with that—resulting in a delayed, missed, or even painful period.
"If we're physically stressed, we're showing that by not sleeping well, not eating well, or not exercising as much," Sherry Ross, MD, ob-gyn and author of She-ology: The Definitive Guide to Women's Intimate Health, tells Health. If your system is producing more cortisol than usual because of these responses to ongoing stress, that can "create abnormalities," says Dr. Ross, potentially resulting in irregular or MIA menstruation.
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"Cortisol affects our reproductive hormones by interfering with the feedback cycles that creates an imbalance of those necessary period hormones like estrogen and progesterone," Christine Greves, MD, a Florida-based ob-gyn, tells Health. While cortisol itself isn't all bad, too much cortisol can throw bodily functions, like menstruation, out of whack. The higher your cortisol levels, the greater the likelihood of menstrual weirdness.
A missing period is one result of this broken hormone feedback cycle, and irregular periods are another. Irregular periods affect between 2%-5% of those who menstruate, according to a 2015 study in the Journal of Clinical and Diagnostic Research. The study found a correlation between perceived stress level and menstrual irregularities; study subjects who rated their stress levels as higher were less likely to have regular (aka, once a month) periods.
Stress and pandemic periods
If your period has been late or irregular, could stress during the COVID-19 pandemic be a factor? Preliminary findings from a UK study suggest that lifestyle changes during lockdown affected female subjects' menstrual cycles and symptoms, and stress was the main contributing factor. The study authors say their analysis, which has yet to undergo peer review, is the first to detail the implications of the pandemic on menstrual cycles.
A total of 749 physically active women completed a 33-question survey about their menstrual cycle before and during the lockdown period. More than half—52.6%—experienced a change in their cycle during lockdown; more than third noted a change in bleeding patterns. Those who reported high levels of stress or worry about their own health or that of family members experienced a significantly greater increase in period-related symptoms than other women. Stress related to job security was associated with increases in bleeding time.
It makes sense that the health, financial, and family pressures so many people are experiencing right now count as psychological stress, the kind that can do a number on menstruation. So how can you control your stress response and keep cortisol levels down? Look to stress-reducing activities like meditation of light exercise. "We can't reset our cycles without managing ourselves in a way that's more balanced and similar to what it was like before the stress took over," says Dr. Ross.
RELATED: 10 Things That Mess With Your Period
What to do if your period is late
If your periods are not happening at their normally expected times or are missing completely, and you're pretty sure quarantine stress is to blame, consider checking with your doctor to be sure. Remember, periods go rogue for lots of reasons—it could be meds you're taking, a hyperactive thyroid, or, you guessed it, a possible pregnancy.
"There are other things besides stress that can go into weird periods; significant weight loss or gain can stop your ovulation patterns. A lot of exercise can also screw up the cyclical release pattern," Mary Jane Minkin, MD, clinical professor of ob-gyn at Yale School of Medicine, tells Health. "The most important thing I can say is 'don't panic.' Irregular periods are very common right now, given that we're all a little stressed out."
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