How Does Stress Affect Your Period?

A little bit of stress is no bad thing. A HIIT workout, a cold shower, or a period of intermittent fasting can make the body more resilient through a biological process called ‘hormesis’ – the idea that ‘what doesn’t kill you makes you stronger’.

However, chronic stress is a different story. When stress permeates every aspect of your life, making even basic tasks challenging, it can affect your health in serious and pervasive ways. And yes, it can even mess with your menstrual cycle.

Here, we delve deeper into stress, exploring how it can affect your period and the best ways to manage it.

The stress response, commonly known as the 'fight-or-flight' response, is regulated by the sympathetic nervous system, a subdivision of the autonomic nervous system, which governs involuntary actions like breathing and digestion. 

When faced with a perceived threat, the sympathetic nervous system triggers the adrenal glands to release hormones such as noradrenaline, adrenaline, and cortisol. These hormones prepare the body to deal with stress by initiating several physiological changes: our hearts beat faster to provide increased fuel and oxygen, pupils dilate to enhance awareness, and muscles tense for immediate action.

The stress response first evolved to keep us safe. As hunter-gatherers, this highly sophisticated survival mechanism helped us fend off prehistoric predators and ensure the continuity of the human species.

Today we face different stressors. Instead of wolves and dinosaurs, we encounter long commutes, demanding jobs, and financial pressures, which activate our stress response as if we were still cavewomen. 

While some stress is manageable, navigating incessant daily stressors can put us in a perpetual state of 'fight-or-flight'. And if stress outpaces the resources available to manage it, unfortunately, it will just keep accumulating. 

The real kicker is that low-grade, chronic stress diverts the brain's attention away from other critical bodily processes, like the important job of balancing the reproductive system. 

To determine if your stress levels are affecting your period, it's important to understand the basics of the menstrual cycle. Contrary to popular belief, most women don't have a textbook 28-day menstrual cycle. A 'normal' cycle is highly individual and can range between 21 and 35 days. Tracking your cycle with an app or diary can help you identify what your unique cycle typically looks like.

If you experience a one-off longer or shorter cycle, there's no need to worry—this is still considered normal. However, if your cycle is consistently unpredictable and irregular, stress might be a contributing factor. Hormonal contraceptives, pregnancy, perimenopause, or underlying health conditions, such as PCOS, may also cause delayed or abnormal cycles, so keep that in mind.

Missed periods, heavy periods, late periods, early periods, and irregular periods can all be due to stress. When the body encounters stress, it triggers the hormonal pathway known as the hypothalamic-pituitary-adrenal (HPA) axis (1). This activation increases cortisol and corticotropin-releasing hormone (CRH), which kickstart the stress response.

High levels of circulating cortisol and CRH can have a knock-on effect on reproductive hormones, potentially leading to abnormal ovulation, anovulation (lack of ovulation), or amenorrhea (absence of menstruation) (2).

This makes sense from an evolutionary standpoint. If you were running away from a dangerous predator, your body's priority would be escaping unharmed, not making a baby.

Of course, since stress can prevent ovulation, it can delay your period, generally by around five days or more. Studies suggest that high stress is associated with both longer and shorter menstrual cycles (3).

In some cases, chronic stress can indefinitely disrupt ovulation, leading to a complete cessation of periods. It's worth noting that this outcome isn't solely attributed to psychological stress; factors such as eating disorders and intense exercise can also place unnecessary stress on the body and stop periods.

The absence of periods due to stress is known as functional hypothalamic amenorrhea (4).

Aside from delayed periods, stress has also been linked to heightened menstrual pain (dysmenorrhea).

One paper reported those who experienced stress two weeks before menstruation were two to four times more likely to have moderate to severe menstrual cramps (5).

Another study, meanwhile, found stress in the first part of the menstrual cycle (follicular phase) may increase period pain in the second half (luteal phase) (6).

While more research in this area of women's health is needed, it's certainly possible that stress could lead to heavy menstrual bleeding (7).

Unfortunately, we can't control the state of the world. There will always be global atrocities, the 24/7 news cycle, and climate concerns. However, we can control our response to stress, ensuring it doesn't interfere with our health and happiness.

Stress triggers a series of physiological reactions in the body called the stress response cycle. This mechanism consists of three stages: alarm, resistance, and exhaustion.

Technically, the stress response cycle should only last for a short amount of time before you recover and go about your day. But when stress is low-grade and chronic, you can find yourself stuck in a unrelenting and all-consuming loop.

Practising a few quick stress releases daily signals to your body that you're safe. This helps complete the stress cycle, preventing any unresolved tension from accumulating, which could otherwise impact your menstrual cycle.

Exercise intensely for five minutes

Do some deep, belly-breathing

Seek out positive social interaction

Have a big cry

Hug someone you trust

Laugh

Self-care is about reclaiming your power - it's anything but selfish. Try to diarise downtime weekly to help buffer against stress. We recommend blocking it out in your calendar so you’re more likely to honour this all-important need to rest.

You might want to nap without setting an alarm, fix yourself a fancy lunch, call your best friend, take a stroll in nature, or give yourself a relaxing head massage. 

Sleep isn't a luxury; it's a fundamental pillar of good health and wellbeing. During REM sleep, the principal stage where dreaming occurs, the brain processes emotions and memories, softening any sharp edges and making them less distressing (8). Renowned sleep expert Matthew Walker describes rest as 'overnight therapy,' highlighting its vital role in mental health (9).

The relationship between sleep and stress is complex. Stress can disrupt sleep, and lack of sleep can worsen stress, creating a negative feedback loop. However, with good sleep hygiene practices in place, you can help break this cycle.

Try to wake up and go to bed at the same time each day

Ensure your bedroom is dark, temperate, and quiet

Avoid alcohol before bed. If you want a drink, enjoy it earlier in the evening.

Refrain from drinking caffeine after midday

Try to get lots of natural morning light to regulate your circadian rhythm

Implement a strict curfew on all technology 90 minutes before bed

Remove all clock faces from your bedroom

Exercise stands as one of the best tools to support mental health and reduce stress. Movement triggers the release of feel-good endorphins, naturally lifting mood. Engaging in exercise can also serve as a distraction, diverting you from negative thoughts and endless rumination.

For menstruating women, the key lies in finding that exercise sweet spot. Some experts believe intense exercise, defined as any exhausting activity upwards of 60 minutes daily, may overly stress the body and increase the risk of ovulatory problems (10).

The occasional vigorous workout should be fine, especially when you're ovulating and your energy is sky-high. On the whole, however, try to move moderately.

Don't be afraid to take it slow the week before your period, either. As oestrogen and progesterone taper down, you may feel tired, sluggish, and unmotivated, so there's no need to push yourself. Consider doing restorative yoga or walks in nature instead.

The evolving field of nutritional psychiatry continues to highlight how the foods we eat can affect our mental health (11). In simpler terms, your dietary choices have the power to influence your mood and serve as a buffer against stress.

In recent years, scientists have discovered a stunningly complex neural network that connects the brain and the gut: the gut-brain axis (12). Researchers believe our gut microbiome, comprising trillions of bacteria in the digestive tract, can affect mood and emotion via this intricate communication system (13).

All this is to say, a happy gut often means a happy mind.

Aim for 30 plant foods every week. Plant foods include fruit, vegetables, nuts, seeds, whole grains, legumes (chickpeas and lentils), and beans.

Add live cultures, which consist of good bacteria to support the gut.

Try fructo-oligosaccharides (FOS), a soluble fibre that aids bowel regularity.

Include more fermented foods, such as kimchi, kefir, and kombucha, as they may increase microbial diversity.

It's worth mentioning that you need to eat enough, too. When the body doesn't receive adequate nutrients and energy, it may interpret this as a signal that conditions aren't suitable for reproduction.

Insufficient calorie intake, especially in combination with intense physical activity, can result in a condition known as hypothalamic amenorrhea, which can stop periods altogether (14).

On average, women generally need around 2000 calories per day, so try to stick within this window.

The likes of caffeine, refined sugar, ultra-processed foods, and alcohol can often worsen symptoms of stress. For now, at least, you may want to reduce your intake of these foods.

Aside from making simple tweaks to what you eat, adding certain nutrients to your diet may also support your emotional health and help reduce stress.

An essential mineral involved in over 300 biochemical processes, magnesium contributes to normal psychological and nervous system function, making it a useful addition for mental health. Find it: Cacao powder.

The B vitamins are essential for your emotional wellbeing. However, stress and certain medications can often lead to poor B vitamin absorption, so it’s worth paying extra attention to your intake. 

Vitamin B5 supports normal mental performance. Find it: Mushrooms.

Vitamin B6 contributes to normal psychological function. Find it: Bananas.

Biotin contributes to normal psychological function. Find it: Seeds.

Vitamin B12 contributes to normal psychological function. Find it: Nutritional yeast.

The long-chain omega-3 fatty acid, DHA (docosahexaenoic acid), is essential to good overall health. DHA contributes to the maintenance of normal brain function based on a daily intake of 250mg. Find it: Salmon or plant-based microalgae in supplement form.

Adaptogens like Ashwagandha and Rhodiola Rosea may help the body deal with stress.

An amino acid found in green and black tea, L-theanine, is known for its calming and soothing properties. It’s often recommended to people with busy, frenetic lifestyles. 

5 hydroxytryptophan, or 5-HTP, is the natural compound manufactured from the amino acid tryptophan. The brain converts 5-HTP into serotonin, the ‘happy’ hormone, which plays an important role in mood.

PEA (Palmitoylethanolamide) is a well-researched alternative to CBD. It’s often recommended to support mood and overall wellbeing. 

Our bodies are relatively well insulated against the short-term impact of stressors. However, chronic and unremitting stress poses significant risks to physical and mental health. including menstruation.

If stress starts to become too challenging, seeking support is always a good idea. Consider talking to your GP or consulting a therapist for guidance.

For more information on supporting your menstrual or emotional health, please feel free to reach out to our team of expert Nutrition Advisors.

Smith SM, Vale WW. (2006) The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues Clin Neurosci. 8(4):383-95. 

Chu B, Marwaha K, Sanvictores T, et al. (2022) Physiology, Stress Reaction. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

Hatch, M. C., Figa-Talamanca, I., & Salerno, S. (1999). Work stress and menstrual patterns among American and Italian nurses. Scandinavian Journal of Work, Environment & Health, 144–150; Fenster, L., Waller, K., Chen, J., Hubbard, A. E., Windham, G. C., Elkin, E., & Swan, S. (1999). Psychological stress in the workplace and menstrual function. American Journal of Epidemiology, 149(2), 127–134.

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Gollenberg, A.L., Hediger, M.L., Mumford, S.L., Whitcomb, B.W., Hovey, K.M., Wactawski-Wende, J. and Schisterman, E.F. (2010). Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study. Journal of Women’s Health, 19(5), 959–967.

Wang, L. (2004). Stress and dysmenorrhoea: a population based prospective study. Occupational and Environmental Medicine, 61(12),1021–1026.

Nagma S, Kapoor G, Bharti R, Batra A, Batra A, Aggarwal A, Sablok A. (2015) To evaluate the effect of perceived stress on menstrual function. J Clin Diagn Res. 9(3):QC01-3. 

Vandekerckhove M, Wang YL. (2017) Emotion, emotion regulation and sleep: An intimate relationship. AIMS Neurosci. 5(1):1-17.

Walker MP, van der Helm E. (2009) Overnight therapy? The role of sleep in emotional brain processing. Psychol Bull. 135(5):731-48. 

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. (2007) Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 110(5):1050-8.

Zhao, Y & Yang, L et al. (2023) The brain structure, immunometabolic and genetic mechanisms underlying the association between lifestyle and depression. Nature Mental Health.

Carabotti M, Scirocco A, Maselli MA, Severi C. (2015) The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 28(2):203-209.

Andrew M. Taylor & Hannah D. Holscher (2020) A review of dietary and microbial connections to depression, anxiety, and stress, Nutritional Neuroscience, 23:3, 237-250. 

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