Why Stress Causes Irregular Periods: Delayed, Heavy, or Multiple Cycles Explained

Primarily, stress can affect your periods by disrupting your hormones and, ultimately, your menstrual cycle, which can cause:

• Hormonal imbalance

• Heavy periods

• Spotting

• Delayed periods

Stress can disrupt your period mainly because it affects your hypothalamic-pituitary-gonadal (HPG) axis and your hypothalamic-pituitary-adrenal (HPA) axis. ⁽¹⁾

The HPA axis is responsible for regulating hormone balance in response to stress. During a stress response, a part of your brain known as the hypothalamus releases corticotropin-releasing hormone (CRH).

The production of CRH then triggers the HPA axis stress response, leading to the release of the stress hormone cortisol.

According to Randa J. Jalloul, MD, an OB-GYN specialist with UT Physicians: Stress, whether emotional, nutritional, or physical, can cause an increase in endorphins and cortisol secretion, which interrupts hormone production. This can lead to an abnormal menstrual cycle. It’s the body’s way of expressing unreadiness for ovulation and pregnancy. ⁽²⁾

Stress can also cause longer periods by disrupting estrogen and progesterone levels in the body.

Progesterone helps thicken the uterine lining, and if implantation does not occur, progesterone levels drop, leading to the shedding of the uterine lining and, ultimately, menstruation. When you are under stress, your progesterone levels fluctuate, which may affect the luteal phase of your menstrual cycle, leading to delayed periods. Similarly, if the lining sheds frequently, you may experience spotting or frequent periods.

MedBound Times reached out to Dr. Nikki Jairath, a resident in MD Gynecology. Let's see what she has to say about this.

According to her, stress triggers the release of cortisol, a hormone that can interfere with the production of reproductive hormones such as estrogen and progesterone. Prolonged stress keeps your body in "fight or flight" mode, deprioritizing non-essential functions like reproduction. High cortisol levels can sometimes cause spotting or breakthrough bleeding. Stress can also disrupt the hypothalamic-pituitary-ovary (HPO) axis, which regulates the menstrual cycle, leading to delayed or skipped periods.

How to manage stress to help regulate periods:

• Regular exercise

• A balanced diet

• Meditation, yoga, and breathing exercises

• Avoiding negativity and overthinking

• Limiting exposure to online content that disrupts mental well-being

Consult your gynecologist for appropriate treatment options.

References:

1. Sonnier, Simone. "How Stress Can Affect Your Menstrual Cycle." UT Physicians, August 2, 2022. Accessed January 28, 2025. https://www.utphysicians.com/how-stress-can-affect-your-menstrual-cycle/.

2. "Can Stress Mess Up Your Period?" Healthline. Accessed January 28, 2025. https://www.healthline.com/health/stress/can-stress-mess-up-your-period.

By Dr. Anam Khan