Stress can cause your menstrual cycle to be late or stop completely. Stress does this by decreasing the hormones in your brain that direct your ovaries to grow your eggs, make estrogen and ovulate. This in turn affects when your uterus bleeds. The effect of stress on your menstrual cycles depends on the level of stress, how prolonged it is and how you cope with it.
Stress and Menstruation
Sudden or prolonged stress can affect your reproductive hormones. It interferes with how your ovaries function to make estrogen and progesterone. In addition to making your period late, stress can also affect your menstrual cycle in other ways.
- Late periods: Your eggs grow and your ovaries make some estrogen, but it takes longer for you to ovulate. The first half of your cycle will be longer and your menstrual cycle will be late (oligomenorrhea). You will bleed about 12 to 14 days after you do ovulate. This is a moderate result of the effect of stress on your reproductive hormones.
- No periods: Your ovaries make low levels of estrogen so the lining of the uterus doesn't grow at all. You will not have a period that cycle (hypothalamic amenorrhea) because you have no uterine lining to shed. This is the extreme result of the effect of stress.
- Irregular periods: Your eggs grow and you make estrogen but you don't ovulate. In this case, the lining of your uterus will break down and shed when it feels like it. Your bleeding may come early or late and you may bleed on and off. The amount off bleeding depends on by how much and for how long your uterine lining was stimulated by estrogen.
The Hypothalamus and the Effect on Hormones
Stress exerts its effect on the menstrual cycle through the hypothalamus, a small gland that sits at the base of your brain just above your pituitary gland. Together your hypothalamus and pituitary glands direct all hormonal and other functions in your body, including how your ovaries function and how you get your period.
Stress is thought to interfere with the normal, regular, timed release of a hypothalamic hormone, gonadotropin releasing hormone (GnRH). In general, the effect on the hypothalamus and therefore the menstrual cycle depends on the level of stress. However, people cope with stress differently and this will influence how severely stress affects an individual's cycle.
Effect on Reproductive Hormones
In response to the change in the pattern of GnRH secretion, your pituitary gland in turn secretes less of its reproductive hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH). These two pituitary hormones are essential for your ovaries to function normally so you can have a normal, regular menstrual cycle.
When FSH and LH levels are low, your ovaries may not make enough estrogen to grow the lining of the uterus, or ovulate and make progesterone. This in turn causes the changes in your cycle.
How Stress Affects the Hypothalamus
Your body responds to stress by secreting stress hormones, including cortisol from your adrenal glands. Cortisol appears to be involved in the effect of stress on the hypothalamus. One of the ways the human body adapted to conserve itself under stress is to stop or delay reproductive function. In this way a woman is less likely to get pregnant in times of stress, be it famine, war, or modern day stresses.
Cortisol signals your hypothalamus to slow down your body's non-vital functions, such as reproduction, while another stress hormone, adrenaline, prepares you to survive the stress. One study reported in the journal Fertility and Sterility in 1997 found that women with stress-related amenorrhea had increased levels of cortisol, while women with normal menstrual cycles or other forms of missed cycles did not.
If stress is the cause of your late or irregular menstrual cycles, managing and reducing your stress can get your cycles back to normal. First examine your sources of stress and take steps to control or eliminate them. If you can't change your source(s) of stress any time soon, learn to cope with them to reduce the effect on your hypothalamus.
Any technique to reduce stress can make a difference, as long as you learn and practice it effectively and on a regular basis until your periods become regular. Tap into techniques such as meditation, passive muscle relaxation, or imagery.
Relaxation techniques are scientifically proven to change the body's physiologic response to stress. If relaxation techniques don't make your menstrual cycles regular, you should consult with your doctor.
Consequences of Abnormal Menstrual Cycles
- No periods (hypothalamic amenorrhea): If your menstrual cycle is late because of low estrogen levels or for more than six months, your bones can begin to thin. This puts you at risk for osteoporosis.
- Late or irregular menstrual cycles: The lining of your uterus could grow abnormally and put you at risk for cancer of the uterus if your periods are consistently late for more than three cycles or you bleed on and off for three or more cycles.
If any bleeding is heavy or last more than 10 days, this could be a sign of an abnormal uterine lining.
When to Consult Your Doctor
Any source of stress can cause your menstrual cycle to be late or irregular. The effect and how long it lasts depends on the level of stress and how you cope with it. Be sure to speak with your doctor or do a home pregnancy test if there is any chance you might be pregnant.
If you are not pregnant, keep a good record of your cycles and any other symptoms for the next three months. If your cycle continues to be abnormal, see your doctor for a preliminary evaluation which could be a simple examination and hormone testing, if needed.