Stress & Your Period

The menstrual cycle is such an interesting thing - some humans have the capability to carry and bear new life! Just like sleeping, waking and other rhythms of the body, having a period (usually) occurs on a regular schedule with routine changes in hormone levels.

And while it’s commonly known that food and exercise can impact a period, did you know stress levels can affect it too?

Stress, of any and all kinds, activates the hypothalamic-pituitary-adrenal axis, or the HPA axis, which is the central stress response system of the human body. This axis stimulates the brain to produce 2 hormones: corticotropin releasing hormone (CRH for short) and cortisol (the stress hormone you hear about all the time). We require these two hormones to stay safe – we need a little bit of stress to survive!

When these 2 hormones are produced in excess, this can suppress the normal levels of estrogen and progesterone needed for a healthy cycle. The result is abnormal or delayed ovulation, or in some cases a completed lack of ovulation. It can sometimes be missed as it’s possible to have a period without ovulating (called an anovulatory cycle), and for individuals not trying to get pregnant ovulation isn’t the first thing they’re thinking about. It might not be until a person has struggled with irregular periods, significant pain or infertility that hormonal issues are identified… and depending on the provider not even then.

Let’s consider the two hormones involved in the menstrual cycle.

1. Estrogen stimulates the release of gonadotropin-releasing hormone (GnRH) in the first half of the menstrual cycle or follicular phase. This causes the pituitary gland to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are both involved in the growth, maturation and release of ovum for potential fertilization. Estrogen then inhibits release of these in the second half or luteal phase, and works to stimulate thickening of the uterine wall.

2. Progesterone stimulates uterine lining build-up and prepares the uterus for pregnancy. It decreases in the luteal phase right before a period, causing the blood vessels and muscles of the uterus to constrict and allow releasing of the outer layer - this is menstruation.

Stress appears to interfere with progesterone production, sometimes causing spotting before a period. This change in stress may also result in heavier and more painful periods, called dysmenorrhea. If estrogen levels are also high, usually caused by other health conditions or difficulty detoxifying it in the liver, this compounds the effect of heaviness even more. Ick.

In small studies done to compare the effects of supplementation on dysmenorrhea, usually done with magnesium, B vitamins or other complementary products, both the group of women who were given a supplement AND the group given a placebo noticed a difference in symptoms before and during their period. It was a statistically insignificant finding but is interesting and potentially helpful. This might point to the role of counselling and stress management on period pain, versus focusing on medications and supplements alone.

Similar research shows that high stress in the follicular phase may increase dysmenorrhea more than when it occurs in the luteal phase. This may be because hormonal processes are already in place after ovulation and there is less impact on estrogen and progesterone levels.

So what helps to keep stress levels low for the long game of a cycle?

1. Prioritize good sleep. Stress is harder to manage when we’re running on low energy, so getting to bed at a reasonable time and making it high quality sleep is incredibly important.

2. Eat regularly and enough during the day. Poor nutrient intake exacerbates hormonal imbalances that can delay or prevent ovulation.

3. Include time to decompress and connect with yourself. Take social media breaks, turn off your phone, get fresh air and free time… we live in a busy world and we need time to relax.

And of course, working with a pro on your period problems provides the individual recommendations you need and deserve!