Stress and the menstrual cycle: Can stress delay my period?

You might think of your menstrual cycle as a physical part of your health, but it can be influenced by mental and emotional conditions like stress as well. Stress is unfortunately very prevalent in our society, and women have been found to have higher instances of mental health conditions like anxiety and depression, particularly during stressful times like the COVID-19 pandemic [1].

Can stress affect your period?

If you’re noticing a change in your menstruation or your period is later than usual and you’ve been experiencing a lot of stress lately, the two may be related. Stress can affect your period by delaying the start date, stopping it from coming entirely, or by preventing ovulation. This happens because stress has a direct effect on the hormones that regulate the menstrual cycle.

Although the menstrual cycle has a series of phases, it's often changes to our period that let us know when something unusual is happening. Late or missed ovulation often goes unnoticed, as it's not as obvious as changes to your period. However, ovulating earlier or later than usual can have a knock-on effect on when your period arrives. Knowing if and when you ovulate can help you understand what's going on in your body and prepare you for any upcoming changes to your period.

How does stress affect the hormones that drive the menstrual cycle?

Mental and emotional stress is known to impact the menstrual cycle by affecting something called the hypothalamic-pituitary-gonadal axis (HPG). This hormonal mechanism allows your body to produce and regulate hormones. Any sort of interruption or dysfunction to this axis (including stress) can cause menstrual irregularities [1].

Bodily stress can also cause a delay in your period, or cause you to skip a period entirely. This type of stress usually comes from your body not having enough energy to produce and regulate the hormones related to your menstrual cycle, particularly gonadotropin-releasing hormone (GnRH), luteinizing hormone, follicle stimulating hormone (FSH), and estrogen. If you’re not getting enough food or doing excessive amounts of exercising, this can deplete your body’s energy resources and increase the level of cortisol (the stress hormone). Increased cortisol and low energy can cause a delay or stop to your period. This condition is called “functional hypothalamic amenorrhea (FHA)” and accounts for up to 35% of all instances of one or more missed periods after the age of 15. It’s more common in female athletes like runners, dancers, gymnasts, and figure skaters who have high energy expenditure, or in marginalized communities [2, 3].

There are other factors that can delay your period aside from stress, though. Irregular periods have a variety of causes, and as many as one in four women can experience menstrual irregularity at some point during their reproductive years [4]. Keeping track of your cycle over time can help you identify any irregularities.

What sort of menstrual changes can be caused by stress?

Ovulation changes

When stress affects the hormones that control the menstrual cycle, it can also cause early or late ovulation, or it may prevent ovulation entirely. A menstrual cycle without ovulation is called an anovulatory cycle [1]. You might not even be aware that you’re experiencing an anovulatory cycle unless you track your ovulation with the support of Natural Cycles — it can help pinpoint the timing of ovulation based on your body temperature and help you identify other signs of ovulation so that you can tell whether or not you’ve ovulated that month.

Just like a late period, anovulation can be a reaction to emotional or physical changes, like shifts in diet, exercise, and stress levels. As we mentioned earlier, chronic stress can lead to FHA by causing anovulation (if you don’t ovulate, you may not get a period later in that cycle) [1].

PMS amplifies

Another way that stress can affect the menstrual cycle is by amplifying premenstrual syndrome (PMS) symptoms. The same study that found that women tend to have higher instances of mental health conditions, particularly during stressful times like the COVID-19 pandemic, also found that 53% of women described worsening premenstrual symptoms, particularly painful cramps, during the pandemic. In times of high stress, women reported more and even brand new instances of PMS [1].

How do you know if stress is affecting your period?

The best way to know if your menstrual cycle is being affected by stress is to see your healthcare professional. FHA in particular, is known as a “diagnosis of exclusion,” meaning that other underlying conditions need to be ruled out first before settling on stress as the cause of a missed or delayed period [2]. Together with your doctor, you can figure out what’s happening in your body and how to treat it.

What should I do if my period is late from stress?

It’s best to consult with a healthcare professional if your period is late so that they can help figure out and address the root cause. While stress may be the reason, it’s best to consider all possibilities like early pregnancy, PCOS, or endometriosis that may be causing the late period. Your healthcare provider can do a full assessment and provide next steps for any of these conditions (including stress). 

It may be worth doing an at-home pregnancy test if your period is late and you’ve had unprotected sex. You may experience a late period and get a negative result on a pregnancy test, which may give you another clue that stress is the underlying issue. Again, it’s best to consult with a healthcare provider for a comprehensive health evaluation. 

What kinds of stress can affect my period?

“Stress” is an umbrella term for your body's physical and emotional response to new or challenging situations [5]. We’ve mentioned the common mental/emotional stress, along with bodily energy stress in this article so far. However, there are a few specific excess stress categories that healthcare professionals may use to get a better understanding of your situation. These include:

• Acute stress: Short-term stress that results from immediate stressors or stressful situations. This is where your “fight-or-flight” response usually comes in, leading to temporary physical changes like increased heart rate and adrenaline.
• Chronic stress: This occurs when stressors persist over a long period of time. Prolonged stress can lead to an increased risk of health complications such as cardiovascular disease, anxiety, and depression.
• Episodic acute stress: This type of stress happens when someone experiences frequent episodes of acute stress, like constantly facing deadlines or sporadic interpersonal conflicts. It can lead to impaired daily functioning.
• Environmental stress: Living in challenging conditions like noisy neighborhoods, pollution, overcrowding, or unsafe conditions can contribute to an overall sense of discomfort or unease, and have negative effects on both physical and mental health.
• Psychological stress: Cognitive or emotional challenges, such as perceived threats, worries, or negative thoughts, can increase stress and lead to mental health conditions like anxiety or rumination.
• Physiological stress: Physiological stress is the body's reaction to internal or external stressors like illness, injury, sleep deprivation, or nutritional deficiencies.
• Traumatic stress: When someone experiences a traumatic event(s) such as a natural disaster, an accident, or violence, the trauma may become overwhelming. This can lead to symptoms of posttraumatic stress disorder (PTSD) [3].

How does stress affect my body otherwise?

Chronic stress, particularly, can increase the chances of certain health risks other than irregular cycles, including:

• Body aches pains
• Changes in appetite and energy
• Headaches
• Increased use of alcohol, drugs, and other substances
• Skin rashes
• Sleep troubles
• Stomach problems
• Trouble concentrating and making decisions
• Worsening of chronic physical and mental health conditions [5]

However, in small doses, stress can be a good thing, too! It helps us learn and adapt to new situations, solve problems effectively, and even increase our energy in certain circumstances. This positive stress is called “eustress,” and it can replenish energy stores, boost heart health, sharpen mental function, and increase motivation [3].

Ways to manage stress effectively

A bit of stress here and there is a normal part of life, and we can only control so much in our environments. But we can control how we react to and cope with everyday negative stressors when they arise. Here are a few tips for effectively combating stress and staying healthy in mind and body:

Mental mindfulness

There are quite a few ways to take care of your mental health on a regular basis so that you’re prepared when stressors come around (plus, you’ll probably feel better in your day-to-day, even without stressors). A few of our favorites include:

• Less screen time: Taking breaks from the news and social media can significantly improve your mental health. It’s great to be informed and connected, but the constant stream of information available at our fingertips can become overwhelming [5].
• Regular relaxation: Making time in your schedule to unwind — however that looks for you — can give your brain some much-deserved downtime. If you’re looking for ideas, try meditation, breathing exercises, spending time outdoors, or other activities you find enjoyable [5].
• Write it out: Keeping a journal can help with self-expression, reflection, emotional processing, and keeping a log of memories [5].
• Gratitude: Reminding yourself of specific things in your life that you’re grateful for each day can help rewire your brain to look for the good throughout life [5].
• Cognitive behavioral therapy (CBT): This form of therapy can specifically target stressful events and help create a healthy response to them [2].

Take care of your body

Caring for your physical health can also help you prepare for (and combat) stress. Speak with your healthcare provider about what’s needed for your body, but a few general recommendations include:

• Getting enough sleep: Going to bed and waking up at around the same time each day, sleeping for at least seven hours, and keeping a dark, cool room can vastly improve sleep quality, ensuring that you’re rested and ready to take on anything the day throws at you [5].
• More movement: Exercise, or even just regular movement throughout your day, can greatly improve mental and emotional health. About 20-30 minutes of movement per day is recommended for positive health outcomes [5].
• Healthy eating habits: Again, speak with your doctor about your specific dietary recommendations, but eating lots of fruits and vegetables, lean protein, and whole foods can help you feel your best [5].
• Limit alcohol, smoking, and drugs: These substances can make it much more difficult to deal with stress. We know that they can be a big part of both socializing and relaxing for some people, which can lead to some scenarios where they’re hard to avoid. If you do partake, remember that moderation is key, and there’s nothing wrong with abstaining for a while if you’re going through something difficult [5]. (For support with addiction and recovery, check out https://drughelpline.org/ or call the U.S. National Drug Helpline at (844) 289-0879. For the UK, find NHS resources here.

Connect with others

Human beings are social creatures, so try to carve out time to connect with your loved ones and community. Whether it’s friends, family, neighbors, faith-based communities, or any other person or people you trust, talking with them about how you’re feeling can provide lots of stress relief [5].

Keep your routine

Humans are also creatures of habit. Whether it’s visiting your favorite coffee shop at lunch regularly, going for a walk after work, cooking your favorite meal once a week, or watching your favorite show each night or binging on the weekends, there are a few habitual comforts we can adopt and work into our lives so that we have something to look forward to, even if we’re stressed otherwise.

Set realistic goals

If you’re currently experiencing stressful times, it may seem impossible to integrate all of these stress management techniques into your life at once (especially if you’re dealing with the added stress of a late or missed period). Know that you don’t need to do all of these things in order to cope with stress in a healthy way. Just one may be enough to help you feel (and deal) better. Stay in tune with how you’re feeling, set realistic goals, go easy on yourself, and focus on what works best for you. Stress affects all of us differently, and simply showing up for yourself to try to address it is half the battle. Recognizing your efforts and achievements, no matter how small, can set you on a course for healthy stress management long-term.

When to seek care about period changes

To echo our earlier notes, it’s a good idea to see your healthcare provider any time you notice menstrual cycle irregularities so that they can help identify and address the root cause, whether that’s stress or another condition. They can also provide recommendations for dealing with stress effectively based on your unique health history and circumstances. 

Get to know your body better with Natural Cycles

Thanks for reading up on whether stress can delay your period. If you think stress might be affecting your cycle and you’d like to track the changes happening in your body over time, Natural Cycles can help you detect irregularities, and provides a downloadable Cycle Report, making it easy to discuss with your doctor when things don’t seem quite right. See how Natural Cycles can support you today.