In the first of its kind in the United States, a new study examined the impact of stress on people’s periods. The findings reveal that, for many people who menstruate, feelings of stress coincided with irregular periods. Researchers set out to determine whether the two are linked.

The Research

For the study, researchers evaluated the online survey responses of 210 women and people who menstruate over a two-month span in the summer of 2020. Survey questions covered menstrual cycle changes and perceived stress levels during that period of time, but it did not account for vaccination status. The results, published in the Journal of Women’s Health, showed that 54% of participants reported experiencing changes in their menstrual cycle after the start of the Covid-19 pandemic in March 2020. These changes referred to menstrual cycle length and duration of menses, or bleeding, as well as changes in premenstrual symptoms. Compared to those with moderate perceived stress scale scores during the pandemic, individuals with high scores were more likely to experience a longer duration of menses, as well as heavier bleeding. “Therefore, the detrimental impacts of the pandemic on women’s mental health may have additional unintended health consequences,” the study says. The motivation to investigate this link came from one of the study’s researchers, who experienced an irregular menstrual cycle, herself, in April 2020. “Having worked in the field of women’s health for over a decade, I was well aware that stress could influence my menstrual cycle but I was shocked, like many others, to experience it in the context of the pandemic,” says the study’s lead researcher Nicole Woitowich, PhD, research assistant professor at Northwestern University Feinberg School of Medicine. When Woitowich began asking others if they’d experienced the same or similar, the response was overwhelming. This inspired the formal study, the first of its kind in the U.S. Woitowich notes that this likely hasn’t been studied in the past for two reasons. One, menstrual cycle irregularities caused by stress are not typically a major health concern. Two, biomedical research has been historically male-biased. “Even today, the majority of biomedical research studies fail to analyze data by sex and this has led to huge gaps in our understanding of women’s health,” Woitowich says. “I think that it falls on women and people who menstruate to advocate for and conduct research related to menstrual health. And until we are equitably represented in the biomedical workforce, these issues may remain understudied.”

Stress and Your Period

Amenorrhea, or the absence of menstruation, can be caused by both emotional stress and physical stress, such as too much exercise or consuming too few calories. Stress affects the body’s hormone production, and hormone irregularities can lead to disruptions in a person’s cycle. The hormone progesterone plays an important role in the menstrual cycle, says Anna Cabeca, DO, a triple-board certified OB-GYN and author of two best-selling books: The Hormone Fix and Keto-Green 16. It affects menstrual regularity, ovulation and premenstrual syndrome symptoms, and irregular levels can have such side effects as anxiety, depression, mood swings, brain fog and sleep disorders. One thing that can disrupt progesterone levels is cortisol, otherwise known as the stress hormone. High levels of cortisol produced by chronic stress can deplete the ovaries’ production of progesterone and majorly disrupt the menstrual cycle. “A menstrual cycle is a neuroendocrine event, it’s never looked at this way and it really should be,” Cabeca says.

Managing Stress, Regulating Your Cycle

Managing stress and regulating the menstrual cycle can often go hand-in-hand. Tracking your period can help you keep tabs on what’s normal for you, and make irregularities more clear right away. If you are seeing changes to your period, Cabeca recommends adopting a ketogenic diet rich in alkaline plant-based foods, which not only regulates hormones but boosts immune system function. She also suggests incorporating “alkalizing” practices into daily life. “By that I mean practice daily activities that make us feel good, and that support looking at life from the lens of beauty and gratitude,” Cabeca says. “Doing so through meditation, getting out in nature, laughing and talking with your friends, all of which are incredibly therapeutic.” Exercise and quality sleep are also important physical regulators with de-stressing benefits. Just like an intense workout can relieve stress, a lack of sleep can induce it. In the same way that everyone’s period is different, stress affects us all differently, so it’s important to know your cycle and understand what could be triggering disruptions. Develop an understanding of what helps you de-stress to bolster both mental and physical health. The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.