Can stress impact your menstrual cycle?

A regular menstrual cycle indicates that your hormones are functioning as they should be.³ Stress, however, triggers a number of physical and hormonal changes in the body⁴ that can have a knock-on effect on premenstrual (PMS) symptoms, the regularity of your period and the severity of your symptoms.⁵ 

Here are just a few ways that stress can affect your menstrual cycle.

When you’re seriously stressed, your body triggers your fight-or-flight response, releasing stress hormones – like adrenaline and cortisol – to help you cope with the perceived threat.⁴ When this happens, it sets off a chain reaction that causes one part of your body, called the HPA axis, to become activated. This then stops another part of your body, called the HPG axis, from working properly – and this is where things can go wrong for your period.^5,7

The HPG axis is important because it controls the hormones responsible for your reproductive health, like luteinising hormone (LH), follicle-stimulating hormone (FSH), oestrogen, progesterone and testosterone.⁸ However, when it isn't working correctly, it can mess up the regulation of your menstrual cycle and cause a variety of stress-related issues.⁹

Over time, this can lead to a condition called hypothalamic amenorrhoea (HA).10 HA is when a region in your brain called the hypothalamus stops working effectively.¹⁰ 

It can stop giving the correct signals to the rest of your body to produce the sex hormones needed for ovulation and also menstruation. This can then lead to a lack of menstruation, which is what’s known as HA.¹⁰

If you think about it, this response makes a lot of sense.

As mentioned, your body doesn’t know that you’re stressed because you have a deadline coming up, so it may respond to chronic stress as if you’re in a potentially life-threatening situation.⁶ And the last thing you need when you’re in a life-threatening situation is the ability to conceive. So, your body tries to prevent pregnancy by stopping ovulation, meaning you also don’t get your period.

Of course, if you’re trying for a baby, it’s a source of anxiety if your periods suddenly go missing or become less regular. Even if you’re not on a fertility journey, missing, late or early periods can also become a source of stress.

It’s important to note, however, that even if you don’t mind too much that your periods have disappeared, HA is a sign that the hormones in your body have become dysregulated. As a result, HA can have serious long-term consequences, including premature osteoporosis (thinning of the bones),¹¹ so it’s important to consult your doctor if you think you have HA.

In particular, research has found a link between stress and painful periods (dysmenorrhoea), the length and duration of the menstrual cycle and the amount of menstrual bleeding.⁵

Additionally, as we come to the end of our luteal phase, fluctuating hormone levels can impact our production of serotonin¹³ – one of the feel-good hormones. Chronic stress is known to affect serotonin transmission in the brain.¹⁴ 

So, you may find that your PMS symptoms, such as sadness or low mood, are worse when you feel stressed.¹⁵

Yet, all of these habits can contribute to more severe symptoms throughout menstruation. 

Exercise, for instance, is a well-established remedy for PMS and period pain,¹⁶ whereas poor sleep quality has been linked to various PMS issues, including more severe menstrual pain and more frequent menstrual symptoms.¹⁷

And don’t struggle on your own. If you’re struggling with stress that’s affecting your menstrual cycle, it’s important to speak to your doctor or a healthcare professional for help too.