Your Period Is Late. Could It Be Stress?

Photographed by Beth Sacca.
Stress. Isn’t it an interesting little monster? When you first hear the word, it sounds benign and ordinary But it’s more than just the anxious feeling you get when a big deadline is approaching. It can actually wreak havoc on your skin, your health, and, yes, even your menstrual cycle
Dr. Mary Jacobson, an OB/GYN and Alpha Medical’s chief medical officer, says that stressors, both physical and mental, can affect your flow, often causing a delay. (We know — a late period is the last thing you need on top of your other problems.)
How does stress delay your period?
Jacobson explains that when stress causes an unpunctual period, it has to do with hormones. Specifically the communications between your brain, adrenal glands (which produces the “stress hormone” cortisol), and your ovaries.
Scientists have had a hard time studying the exact mechanisms because stress is such a complex thing, explains James Greene, MD,  medical director for women’s health at Kaiser Permanente in Washington. But here's the gist of what’s happening in the body: “We presume there is some suppression in the functioning of the hypothalamus and pituitary gland in the brain [when you’re stressed],” Greene says. “These glands work in tandem to control our endocrine system that includes the ovaries and adrenal glands.” This then influences your ovarian hormone function and ovulation, or the releasing of the egg, he explains. Because it hasn’t been studied as much, doctors still do know how the degree of stress or length of exposure to it causes the period to slow down. 
How will I know if it’s stress or something else? 
Any woman with cycle changes should be seen by their primary care provider or her OB/GYN, Greene says. 
“By taking a careful history, physical exam, and specified lab work, we can rule out several causes,” he says. “If no abnormalities are found, and the history fits, we could determine that stress is the issue. Because many possible causes are treatable, it’s best to not assume it's a stress reaction on your own.” 
Still, you might be hesitant to book an appointment at the first sign of change in your cycle. But Jacobson says if you’re late for three months or more, you should definitely look to the experts. At that point, the lack of menstruation is classified as amenorrhea, which can be caused by stress — or hormonal changes, low body weight, medication, or other even more serious factors. Of course, that’s if you’ve already ruled out pregnancy, breast-feeding, and menopause as the cause for delay. 
For the record, a period should occur every 21 to 35 days, according to Jacobson, so be mindful of that timeframe when you think you're "late."
How else can stress affect menstruation? 
“Stress can cause all types of abnormal bleeding, from more frequent episodes to longer intervals between periods,” Greene says. “Anytime the normal ovulatory cycle is disrupted, bleeding patterns can be abnormal.” 
How can you lessen stress levels? 
Jacobson says cognitive behavioral therapy has been shown to be helpful for coping with stress, and can, in turn, help your cycle return to normal. 
Greene adds that it can help to identify the source of your tension first. “Certainly making sure you are getting adequate rest, regular exercise, and eating a well-balanced diet is key. Specific types of exercise may be better than others, such as yoga or swimming, but usually any type of low impact movement is good.” All that is a great start, but it’s also important to recognize when it’s time to get help through counseling. 

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