How Stress Can Impact Your Menstrual Cycle

You’ve been pretty stressed out lately — so stressed, in fact, that you’ve just realized it’s been a while since your period made an appearance.

If you’re sexually active, the first thing to do when your period is late is rule out the most common cause: pregnancy. But if a pregnancy test comes back negative, then what? And is it safe to go months without a period?

Ob/Gyn Swapna Kollikonda, MD, shares the low-down on how stress can delay your period.

What happens to your period when you’re stressed?

When you’re stressed, your body produces a hormone called cortisol, which can lead to irregular periods.

Here’s how it works.

The part of your brain that controls your period is called the hypothalamus. It releases chemicals that cause your pituitary gland to stimulate your ovaries. This causes your ovaries to release the hormones estrogen and progesterone, which bring on your period.

But your hypothalamus is sensitive to factors like stress, which can upset the process — and mess with your periods.

“The cortisol that your body makes when you’re under stress can wreak havoc on the connection between your hypothalamus, pituitary gland and ovaries,” Dr. Kollikonda explains. “Depending on how your body tolerates stress, the cortisol may lead to delayed or light periods — or no period at all, which is called amenorrhea.”

How stress affects your menstrual cycle is based on your unique brain and body. But the higher your cortisol levels, the more likely you are to have missed or irregular periods.

Should you be concerned?

A missed or delayed period here and there is probably nothing to be too worried about. But if you’re constantly stressed out, you may be more likely to have problematic periods, which can lead to other health issues.

“There’s a continuum. Brief, lighter stress may have fewer impacts, and heavy, lasting stress may have more dramatic impacts that last longer,” Dr. Kollikonda says. “If you continue to skip periods, your body will eventually develop a hormonal imbalance.”

She explains that estrogen and progesterone have important roles beyond menstruation. They also help to:

• Stabilize mood
• Promote bone health
• Support heart health

How long can stress delay your period?

“If stress continues, you can go without a period for a long time,” Dr. Kollikonda warns.

If you’ve ruled out pregnancy and have experienced three missed or dramatically different periods, it’s time to see a healthcare provider.

“They may prescribe contraceptive hormones that include estrogen and progesterone to correct the hormonal imbalance and regulate your cycle,” she says.

How to prevent stress from delaying your period

Managing your stress helps regulate your cortisol levels, which can get your periods back on track. Try these stress relief tips, to start:

• Move your body. Exercise is a proven way to reduce cortisol and lower stress.
• Prioritize sleep. Sleep deprivation can increase cortisol production, so work on getting enough good, high-quality sleep.
• Eat a balanced diet. Eating a variety of healthy, nutritious foods helps regulate your hormones. Certain foods are even associated with stress relief.
• Embrace relaxation techniques. Practicing breathwork and meditation can help you cope with the stress of everyday life.
• Focus on feel-good hormones. Taking proactive steps to boost your “happy hormones” can lower stress and combat cortisol creep.
• Take time for self-care. Establishing a self-care routine helps alleviate stress and anxiety and promotes overall well-being.

Beyond just affecting your periods, chronic stress can also wreak havoc on your overall health. It’s associated with depression, anxiety, immune dysregulation and a higher risk of chronic illness. So, it’s all the more important to work on your stress management skills.

“Tune in to your body to figure out what your stress triggers are, then work diligently to tamp them down,” Dr. Kollikonda advises.

Are you sure it’s stress?

Stress isn’t the only thing that can mess with your menstrual cycle. Other common causes include:

• Perimenopause: During this transitional period before menopause, your estrogen levels start to decrease. Your periods may change, too, becoming either longer or shorter than before.
• Thyroid disorders: “Sometimes, thyroid issues interfere with hypothalamus-pituitary-ovary interactions, which can cause a disturbance of the menstrual cycle,” Dr. Kollikonda notes.
• Polycystic ovary syndrome (PCOS): This condition causes a hormonal imbalance that can impact your menstrual cycle.

These are just a few conditions that can cause irregular periods, but only a healthcare provider can help you figure it out for sure. So, Dr. Kollikonda urges you to make an appointment to get to the bottom of things.

“If you’re period is changing, the first step is to rule out conditions that could be causing it.”