What’s the lowdown?
- Our menstrual cycles are kept healthy and regular through a delicate balance of hormones (LH, FSH, oestrogen and progesterone)
- These hormones can be disturbed by stress and anxiety, leading to a whole variety of symptoms – be it irregular bleeding, a difference in your cycle length, heavy periods, or lighter periods
- Learning to manage stress levels could be the key to more predictable and less disruptive periods
- Tranexamic acid is one of the most effective options for reducing a heavy flow
Life can be really stressful. From the spiralling cost of living to the global climate emergency – we’re working harder than ever and under increasingly challenging circumstances. So it’s little wonder that in the past year, 74% of people in the UK have felt so stressed they have felt overwhelmed or unable to cope.
Stress can affect our bodies in many different ways. One impact of stress is that your body triggers a huge increase in cortisol and corticotropin-releasing hormone to help you to tackle the situation. Both of these chemicals can impact the levels of our reproductive hormones. In this article we are going to look at how stress can wreak havoc on our menstrual cycles. And, more specifically, whether stress could lead to a heavier period.
What is stress?
Everybody experiences stress at some point in their lives. In fact, at a low level, stress can be motivational and help us to accomplish more. In a nutshell, our body reacts to feeling threatened or under pressure – and stress is the result. However, there’s a fine balance. Excessive stress can be harmful to our mood and our bodies. Eventually, this can lead to burnout (physical, emotional and mental exhaustion), if you experience stress over a prolonged period.
What is anxiety?
Anxiety shares similar physical and emotional responses as stress but there is a key difference. Stress is in response to external causes such as an untenable workload or relationship difficulties. Anxiety is the internal response to stress, usually described as a ‘persistent feeling of apprehension or dread’ to scenarios in life that are not actually threatening. Also, you can still experience anxiety long after the stressful event has passed.
The menstrual cycle and stress
Studies show that stress has a negative effect on various aspects of the menstrual cycle. This is because the hormones that control the menstrual cycle are affected by cortisol, which is released when you’re experiencing stress.
As a result of the delicate balance of hormones being affected, your period can be affected in a few different ways. The most common responses are absent, very light or irregular periods. However, it can be quite difficult to clearly assess the effect of stress on the menstrual cycle in studies, because most research papers measure stress levels by self-reporting questionnaires. This is probably why there is such a range of results.
Is there a link between stress and heavy periods?
Research is mixed here, with some sources stating that stress can cause heavy periods. One particular study concluded that high-stress levels can lead to longer cycles with heavier bleeding. However, most research tends to suggest that menstrual irregularities or painful periods are the most common impact of stress on periods.
So, to be frank, from the research it looks like we can’t yet identify the exact link between stress, menstrual irregularities and heavy periods. But, it certainly appears possible that changes such as heavier bleeding could certainly occur as a result of stress.
In any case, if you notice that your periods are heavier or more unpredictable, please don’t assume that this may be due to any stressful circumstances occurring in your life without proper investigation or medical advice.
Can stress change the length of a menstrual cycle?
Again, the results are variable but some studies conclude that stress can have an effect on menstrual cycle length. Most commonly, this appears to be a shorter menstrual cycle length and cycle length irregularities in general. But, not to make it too confusing, there is also evidence suggesting that stress can cause longer cycle lengths too.
Can stress contribute to menstrual pain?
The studies are a bit clearer here, phew! Pain is one aspect of the menstrual cycle which seems to have a strong link to mental wellbeing. Lots of studies show that stress can cause painful periods. In fact, one research paper showed that people who experienced stress 2 weeks before their periods were due were 2 to 4 times more likely to experience moderate to severe period pains. Pretty mind-blowing stuff. More specifically, one study showed that stress experienced in the first part of the menstrual cycle (follicular phase) was more likely to lead to painful periods than stress felt in the second part of the cycle (luteal phase).
How to manage stress around the time of your period?
There are loads of lifestyle tips which you can test out, to try to minimise stress around the time of your period. Not only should this help your general wellbeing, but can hopefully reduce the likelihood of stress related menstrual disturbances.
Ways to manage your stress include:
- Regular exercise
- Healthy diet
- Plenty of sleep (aim for 7-8 hours of shut eye a night)
- A support network of close friends and family to confide in
- Reduce alcohol intake
But, one last point – please don’t be too hard on yourself! If you don’t feel up to exercising, or you have an insatiable chocolate craving, that’s totally fine..
How to treat heavy periods
In some cases, medication is not needed and the lifestyle changes may be able to make your flow more manageable. However, the types of treatments that you could be prescribed are:
- Some contraceptives can help with heavy bleeding, such as the combined contraceptive pill
- Anti-inflammatory painkillers e.g. mefenamic acid
- Tranexamic acid can help to reduce the amount of bleeding by between 26-60% and is more effective than many of the other alternatives including non-steroidal anti-inflammatory painkillers. Plus, the side effects tend to be pretty mild.
When to see a doctor
If you’ve been experiencing heavy periods for some time, and they mean that you have to make changes to your daily life – definitely talk to a healthcare professional, like your GP. Similarly, if you are in a lot of pain or you notice irregular bleeding, speaking to a healthcare professional would be the best bet.
If you have any burning questions about contraception or heavy periods, book an appointment with one of The Lowdown’s women’s health GPs – they can talk you through a range of management options!
One final tip: make sure you jot down any patterns around your bleeding. Building up a few cycles worth of information will be a really useful tool to take to your GP!
Emma is a Pharmacology & Physiology graduate with a huge passion for women’s health. Outside of work you’ll find her with a nose in a book, open water swimming or charging around with her standard poodle Zeki!