Can Stress Delay Your Period & Impact Your Cycle?

Medically reviewed on November 22, 2022 by Karen Janson, MS, MD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• How does stress affect your period?
• Are my problems from stress?
• Check in on your cycle with Everlywell
• Related content

Feelings of stress, anticipation, or unease can impact the whole body. When a traffic jam or traumatic event triggers your body’s stress response, your brain will produce a stress hormone called cortisol. Long-term activation can lead to mood dysregulation, digestive problems, muscle tension, and memory impairment [1].

If you have female reproductive organs, chronic stress may also delay your menstrual period.

That said, missing your regular cycle doesn’t always mean something is wrong. However, regular disruption of your menstrual cycle can be linked to chronic stress that may suppress normal levels of reproductive hormones in your body [2].

How does stress affect your period?

Your regular menstrual cycle is highly impacted by the level of reproductive hormones in the body. Hormonal imbalance and changes affect a variety of menstrual functions, which trigger [3]:

• Maturation and release of eggs in the ovaries
• Building and shedding of the uterus lining
• Preparation for egg implantation

That said, cortisol—the stress hormone—can impact various reproductive hormones, including estrogen, progesterone, LH, and FSH, which are connected to the brain through the hypothalamic-pituitary-ovarian (HPO) axis [3]. When cortisol is released by the brain, it can disrupt this feedback loop.

To understand how can stress delay your period, let’s first explore how your normal menstrual cycle functions without the interference of cortisol:

• Step one – Your regular menstrual cycle starts when your body’s hormones cause you to ovulate, stimulating the release of a mature egg from your ovary.
• Step two – The egg travels down your fallopian tube toward your uterus, which is preparing for the possible fertilization of the egg [2].
• Step three – If the egg isn’t fertilized, your hormone levels decrease, and your uterus sheds the tissue it built up. This shedding is often referred to as your period, or menstruation [2].

When you’re experiencing high levels of stress, the hormones that trigger these steps may become disrupted. As such, you may experience a delayed period. More specifically, cortisol has a strong effect on your body’s ability to make estrogen, which plays a role in the thickening of the uterus lining [2].

In addition to having an irregular period, low estrogen levels may also lead to [4]:

• Hot flashes and night sweats
• Weight gain
• Headaches
• Fatigue, irritability, and moodiness
• Dry skin

One study also found that emotional, nutritional, or physical stress can affect the hypothalamic-pituitary-adrenal (HPA) axis, which releases epinephrine and norepinephrine during times of stress. In effect, disruptions in the HPA axis are thought to be a primary cause of amenorrhea—the abnormal absence of menstruation for three months or more [5].

Those who experience amenorrhea are often treated with hormone therapy by a healthcare provider [6].

Are my problems from stress?

While stress may cause a delay in your menstrual period, other common reasons include weight fluctuations, excessive exercise, pregnancy, and menopause [7].

To determine whether or not your regular period’s absence is stress-related, reflect on your mental health. Oftentimes, feelings of stress are coupled with feelings of irritability, overwhelm, anxiety, and disinterest.

You should also consult with your healthcare provider to receive a personalized assessment of your health. Your healthcare provider may:

• Perform a physical exam
• Check your hormone levels
• Ask about your stress levels
• Run any additional lab work they need

Check in on your cycle with Everlywell

The balance of reproductive hormones in your body is delicate, and stress hormones like cortisol can often disrupt this balance and, subsequently, your menstrual cycle. That said, many factors may affect your regular period, including changes in weight and exercise.

To stay in tune and in the know, look to Everlywell.

At Everlywell, we’re building a world where everyone can access insightful at-home lab tests to monitor their body’s health. Our at-home Women’s Health lab tests are affordable and easy to use. Simply follow the instructions, mail in your at-home collection kit, and receive your physician-reviewed results in days.

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References

1. Stress management stress relief. Mayo Clinic. Published April 8, 2022. Accessed November 4, 2022. URL
2. What is ovulation? American Pregnancy Association. Published June 13, 2022. Accessed November 4, 2022. URL
3. William Shaw, PhD; Susan Labott-Smith, PhD, ABPP; Matthew M. Burg, PhD; Camelia Hostinar, PhD; Nicholas Alen, BA; Miranda A. L. van Tilburg, PhD; Gary G. Berntson, PhD; Steven M. Tovian, PhD, ABPP, FAClinP, FAClinHP; and Malina Spirito, PsyD, MEd.Stress effects on the body. American Psychological Association. URL
4. Low estrogen: Causes, symptoms, diagnosis & treatment. Cleveland Clinic. Accessed November 4, 2022. URL
5. Fourman LT, Fazeli PK. Neuroendocrine causes of amenorrhea–an update. The Journal of clinical endocrinology and metabolism. Published March 2015. Accessed November 4, 2022. URL
6. Amenorrhea: Absence of periods. American College of Obstetricians and Gynecologists. Accessed November 4, 2022. URL
7. Stopped or missed periods. NHS. Accessed November 4, 2022. URL

Absent periods – amenorrhoea – Better Health Channel

Summary

Read the full fact sheet

• Amenorrhoea is the absence of menstrual periods.
• The most common cause is hormone disruption, which can be due to emotional stress, extreme weight loss, excessive exercise or certain reproductive disorders.

About absent periods

Periods are a natural part of the menstrual cycle. Periods usually happen every month.

Amenorrhoea is when you don’t get your period at all.

The menstrual cycle

The menstrual cycle prepares your body for pregnancy. If you are not pregnant, your hormones send a signal to your uterus to shed its lining. This is your period. Once your period starts, the cycle begins again.

A menstrual cycle is measured from the first day of your period to the first day of your next period. The average length of a menstrual cycle is 28 to 29 days, but every woman’s cycle is different.

Menstrual cycles can be longer at different times in your life. For example, when you get your first period, in the first 2 years after your periods start and in your teenage years (between the ages of 10 and 15 years).

Is it normal to miss one or more periods?

It’s normal to miss periods at different times in your life.

For example:

• when you first start getting your periods
• while pregnant
• while breastfeeding
• in the lead-up to menopause (your final menstrual period).

Primary amenorrhoea

Primary amenorrhoea is when menstrual periods haven’t started by the age of 16 years. This doesn’t happen often.

Causes include:

• abnormality or absence of reproductive organs
• lack of hormones needed to start getting periods
• genetic or chromosome abnormalities, such as Turner’s syndrome.

Secondary amenorrhoea

Secondary amenorrhoea is when periods stop for 3 months or more in a row. This is normal in pregnancy and in the lead-up to menopause.

Other causes include:

• excessive exercise or intense athletic training
• low body weight and poor nutrition – for example eating disorders such as anorexia nervosa
• severe anxiety and depression
• medications such as antipsychotics
• some oral contraceptives or intrauterine devices (IUDs)
• polycystic ovarian syndrome (PCOS)
• premature menopause
• problems with glands, including the thyroid and the pituitary gland.

Athletic amenorrhoea

Athletic amenorrhoea is when elite or excessive exercise suppresses the release of oestrogen, causing periods to stop.

Getting a diagnosis for amenorrhoea

Your doctor may ask about your medical history and do different tests to find the cause of the amenorrhoea.

For example:

• a pregnancy test
• a physical examination
• blood tests to check your hormone levels
• scans of your abdomen, pelvis, reproductive organs and skull (to check the pituitary gland).

Health risks of amenorrhoea

Low levels of oestrogen in the body can:

• reduce fertility
• reduce your chances of falling pregnant
• increase the risk of cardiovascular disease – such as high blood pressure
• increase the risk of early onset osteoporosis – a long-term disease that makes your bones less dense and more fragile
• cause premature menopause and ageing.

Treatment options for amenorrhoea

Treatment of amenorrhoea depends on the cause. If the amenorrhoea is caused by another condition, that condition will be treated first. This may help your periods start again.

Treatment may also involve:

• hormone therapy
• medication
• surgery
• nutritional advice
• counselling (in the case of an eating disorder).

When to see your doctor

See your doctor if:

• you have missed 3 or more periods in a row
• you have had fewer than 9 periods in a year
• you have noticed changes in the pattern of your periods.

You can also ask your doctor for advice if:

• a 13-year-old girl is not showing any signs of puberty (for example breast development)
• a 16-year-old girl has not started her period.

For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s HealthExternal Link.

Where to get help

• Your GP (doctor)
• Gynaecologist
• Sexual Health VictoriaExternal Link
• Butterfly FoundationExternal Link
• Jean Hailes for Women’s HealthExternal Link

• Shufelt CL, Torbati T, Dutra E 2017, ‘Hypothalamic amenorrhea and the long-term health consequences’External Link, Semin Reprod Med, vol. 35, no. 3, pp. 256-262.
• Klein D, Paradise, SL, Reeder, R 2019, ‘Amenorrhea: A systematic approach to diagnosis and management’External Link, Am Fam Physician, vol. 100, no.1, pp. 39-48.

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Irregular periods causes delayed periods

Irregular periods are not always a sign of a problem, but in some cases require a comprehensive medical examination. What causes irregular periods? And when should you see a doctor?

Menstrual disorders

There are three conditions in which we can talk about the anomalies of the female cycle.

1. Amenorrhea. Absence of menstruation for at least three menstrual cycles.

2. Oligomenorrhea. Periods more than 35 days apart.

3. Menorrhagia. Severe bleeding that lasts more than a week.

Normally, an egg is released from the ovaries during ovulation. If the egg is not fertilized by a sperm, then the change in hormone levels sends a signal to the body to release blood and tissues lining the uterus.

Bleeding usually lasts about five days. Then the monthly cycle repeats.

Some women experience what is called abnormal uterine bleeding, another term for irregular periods, which can occur for a variety of reasons, such as stress, lifestyle habits, and serious comorbidities.

What are irregular periods?

Irregular menstruation is a disorder in the body in which the duration of the menstrual cycle is unexpectedly outside the normal range.

irregular menstruation may include abnormal uterine bleeding, such as:

• Bleeding or bloody discharge between menstruation,
• Bleeding after sexual intercourse,
• Strong bleeding during menstruation,
• menstrual bleeding that lasts longer than usual,
• bleeding after menopause.

After puberty, many women have a regular menstrual cycle. However, it is normal for the cycle to change by a few days each time. Between 9 and 14 percent of women have irregular periods between their first period and menopause.

Causes of delayed, missed or irregular periods

There are a number of reasons why you may have irregular, missed or late periods.

1. Uncontrolled diabetes. The interaction between blood sugar levels and hormones can disrupt the menstrual cycle.

2. Eating disorders. Anorexia and bulimia can lead to irregular or missed periods because the body does not have time to produce enough of the hormones needed to control the menstrual cycle.

3. Hyperprolactinemia. Women who have too much of a protein hormone called prolactin in their blood may have irregular periods.

4. Taking medication. Some drugs, in particular antiepileptic and neuroleptic drugs, can lead to the failure of all rhythms in the body.

5. Polycystic ovary syndrome. It can be caused by an imbalance of sex hormones. It can disrupt regular menstruation.

6. Premature ovarian failure. The ovaries of women with this disease stop working before the age of 40. However, some women with this condition continue to experience periodic periods.

7. Stress. Stress hormones can affect menstruation, and prolonged stress can cause periods to be delayed or missed entirely.

When women first get their periods, it may take some time before they become regular. Periods can also become irregular up to eight years before menopause.

What should I do if my period is late?

If you are experiencing any of the following symptoms, it may be time to talk to your doctor.

• You haven’t had your period in 90 days.
• Your periods suddenly become irregular.
• Your period is more frequent than every 21 days.
• Your period is less than every 35 days.
• Your period lasts more than a week.
• Your period is very hard to bear.
• You bleed between periods.
• Your periods are extremely painful.

A gynecologist can determine the cause of irregular periods and help you develop the best treatment program.

These days: why companies introduce menstrual days off

Up to 20% of women worldwide experience severe pain during their periods. If they all start missing work, will this affect the financial results of employers? Understanding how attention to this topic affects companies, laws and perceptions of gender equality

In May 2022, it became known that the Spanish government plans to introduce monthly menstrual holidays lasting several days. According to the Spanish Gynecological and Obstetrical Society, a third of women in the country experience dysmenorrhea, a severe discomfort during menstruation. This condition may be accompanied by pain in the groin, headaches, nausea, and high fever. According to various sources, dysmenorrhea occurs in 5%-20% of women in the world.

Menstrual policy

For the first time, such days off were discussed at Soviet enterprises in the 1920s. In 1922, an article appeared in the Journal of Labor in which the author, one C. Pick, described (or described) the physical changes that occur to women at the beginning of menstruation, and argued in favor of rest at this time. By that time, such a measure had already been adopted in some industries – for example, a decree issued in January 1922 gave workers in the clothing industry a two-day day off at the beginning of menstruation (but not earlier than 21 days after the previous one) upon presentation of a certificate from a doctor. Later, the same practice was introduced for representatives of artistic professions – gymnasts, dancers, acrobats. January 19For 26 years, the labor protection department of the People’s Commissariat of Labor decided that any working women could receive time off during their periods if the pain was confirmed by a doctor – however, missed days were counted as ordinary sick days.

100 years later, more and more companies are adopting this practice. American app developer Chani has introduced menstrual days off without limits on days. “Having a womb is incredibly painful, and yet from an early age we are taught to overcome this pain and keep working,” CEO Sonia Passy commented on the decision. At the Indian company Zomato (which develops an international restaurant aggregator), a woman can take up to 10 additional days off per year. “Why 10? Most women have about 14 menstrual cycles a year. Adjusting for the fact that periods can fall on weekends, you can now take advantage of 10 additional days off compared to men, ”the message addressed to employees reads. Menstrual days off have also been introduced by the Polish game developer GOG, at the initiative of culture and communications manager Gabriella Semenkovic. “It promotes inclusiveness. This is how we recognize that there are biological differences in the workplace and that these symptoms are real,” she comments.

One of the first in 2016 to introduce menstrual days off was the British Coexist. “Over the years, I have supervised many employees and I see some women at work double over because of menstrual pain. Despite this, they feel that they cannot return home because they do not consider themselves sick, Director Bex Baxter explained. “… We wanted to introduce a policy that would allow women to take time for the natural cycle of their body without calling it a disease.” Later, in 2021, she recalled that the innovation made the atmosphere in the team more healthy and friendly.

But there were those who did not accept it immediately. “There was a huge backlash,” Baxter said. – One comment that stuck in my memory: “You are throwing feminism back 100 years.” Opponents of the initiative believed that menstrual time off made women look weak and created a stigma that would hinder their careers. A 2019 US survey on attitudes towards menstrual time off showed that people who do not support or doubt the initiative are mainly concerned about three things: injustice against men, the impact on the company’s economic performance, and the threat to gender equality.

Related material

Special Needs from a Feminist Perspective

Historically, menstruation has been seen as one of the proofs that women are less capable than men of education and careers. In 1875, the American sanitary doctor Aizel Ames published the book Sex and Industry, in which he described the impact of working conditions on women’s health, including reproductive health. Many of his assumptions were based on the belief that menstruation made women weaker workers. This tradition of research continued throughout most of the 20th century, and it was not until its last decades that works began to appear that challenged this prejudice.

The reaction of the women’s movement in the 19th and 20th centuries was the so-called “gender neutrality” – the assumption that women are in no way inferior to men and do not need concessions. Activists of the first and second waves adhered to equality feminism, from the point of view of which the characteristics of the female body, including menstruation, do not create a need for special working conditions.

Difference feminism began to take shape in the 1980s in opposition to equality feminism. Supporters of this trend have criticized gender neutrality because it ignores the specific needs of women and reproduces an androcentric model that takes into account only the needs of men (as “people by default”), including physiological ones. Feminists of this trend believe that differences between men and women should be noticed, but done in such a way that they do not become the basis for oppression. From the point of view of difference feminism, menstrual time off is just an account of specific women’s problems and needs.

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How menstruation affects women’s work

One of the most common stereotypes about menstruation is that during it women become especially emotional, weak and unstable. However, most of the studies that attempt to assess the impact of cyclical hormonal fluctuations on brain function are either not representative or raise questions about the interpretation of the results. Competently conducted studies show that there is no significant effect of menstruation on cognitive abilities.

However, many women feel worse. A Dutch survey of 32,000 respondents showed that 13.8% of women missed work at least once due to their period, 3.4% miss it almost every month. On average, women missed 8.9 days of work per year. However, only 20.1% of those who took sick leave or time off due to painful periods told their employer or school the real reason. 67.7% of respondents would like to have a more flexible schedule and the ability to reduce the load during menstruation.

A similar survey was conducted by the app developer Flo. Of the 1,867 respondents surveyed, 45. 2% reported being absent from work due to their periods. On average, women missed 5.8 days of work per year. 94.6% stated that they did not receive any benefits and indulgences in connection with menstruation.

In developing countries, absenteeism due to periods is more common due to menstrual poverty, when women have difficulty accessing toilets and hygiene items. Often in such countries there are cultural taboos that prevent women from discussing this issue even among themselves. A study in Kenya found that portraying menstruating women as “impure” and overly emotional excluded them from work communication.

But even in developed countries, women who come to the office during their period experience stress. They must ensure that they have time to change the hygiene product in time and that no one knows about it. It is especially difficult for those who do not have a separate women’s toilet at the place of study or work, or there are few of them. One participant in a study by scientists from the University of Edinburgh says: “Heavy bleeding means I have to leave meetings before they are over. I plan my days with access to the toilets… I have to leave classes to change hygiene items.” Part of the problem is solved by remote work, but not all companies and not all employees have such an opportunity.

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How menstrual time off affects companies

Since there are still few companies that have introduced menstrual time off, it is not yet possible to calculate how this affects economic performance – the sample is small. Cherie Hoger, CEO of British menstrual cup maker Saalt, says it’s important for young workers to match workplace values ​​with their own. Inclusive policies help retain talent and promote diversity, which is linked to increased performance. Dr Hyun-Yung Lee, Professor of Labor Relations and Organizational Behavior at the London School of Economics and Political Science, believes that being away from the office one day a month will not have an impact on the company’s financial results. It may seem like it’s costly for the business to have half of the employees take 10-12 extra days off per year, but when you consider the positive impact of such a policy on the well-being and productivity of each individual employee, it pays off in the long run.

After all, days off can be worked off. For example, in Girona, a Spanish city where local authorities introduced the practice back in 2021, the policy was that you could take eight hours of menstrual time off per month, but work them off over the next three months. However, for some women, eight hours may not be enough to survive the painful symptoms.

Why do you need a special day off, if there are regular ones

According to Article 125 of the Labor Code of the Russian Federation, days off can be used as part of a vacation or as compensation for overtime work. At the same time, at least one part of the vacation should not be less than 14 days, respectively, there are still 14 days left for time off. It turns out that if a woman has dysmenorrhea, then she can spend almost half of her vacation days on painful menstruation, while her colleagues can use them for relaxation. And to earn one day of extra time off, you need to work at least eight hours. You can take sick leave, which, unlike time off, is not limited in time. But for a sick leave, you need a doctor’s confirmation, and the amount of payments depends on the length of service.

The advantage of menstrual time off is that it does not require you to spend vacation days, work overtime or sacrifice earnings. In addition, the very presence of such a term in everyday life removes the taboo from the topic, which causes inconvenience to employees and demonstrates attention to their needs.

Like any initiative related to gender equality and inclusion, the introduction of menstrual time off requires consistency and sensitivity.