What Anxiety does to Your period

In the past few months since the world went on lockdown, many of us have spent more of our time in worry than ever before.  Fear of our financial future, the health of our family or the grim prospect of never being able to find a partner has been keeping many of us up at night.   The reality is that women are twice as likely as men to suffer from anxiety.  All this anxiety doesn’t just affect sleep and emotional wellbeing, but also the menstrual cycle.  It is not surprising that recently many of my patients have reported not getting a period since lockdown or that their periods are now heavier, more painful and coming more often than ever before. So how can all this increased stress, worry and anxiety cause major shifts in our monthly flow and what can we do about it?

What anxiety and stress are doing to our menstrual cycles

When we are stressed or anxious our Hypothalamic Pituitary Adrenal Axis becomes activated triggering the classic “fight or flight” response.  This activation also suppresses our Hypothalamic-Pituitary Gonadal axis (HPG-Axis) through the release of corticotrophin releasing hormone (CRH) of hypothalamus.  Besides telling our adrenal glands to pump out the stress hormone, cortisol, CRH inhibits the release of gonadotrophin-releasing hormone.  Without gonadotrophin-releasing hormone, the release of luteinizing hormone (LH) from the pituitary becomes disrupted.  LH signals our ovaries to start producing androgens, which serve as the precursors for estrogen.  As estrogen builds up it then triggers the LH surge causing ovulation.  If this doesn’t happen, we don’t ovulate.  As a result we either don’t get our period or we have breakthrough bleeding.   Breakthrough bleeding isn’t an actual period but a shedding of the uterine lining when ovulation doesn’t occur.  Normally progesterone is produced after ovulation, which serves as the scaffolding for the uterine lining if a pregnancy was to occur.  Breakthrough bleeding tends to be heavier than our normal period and cycle length is usually less than 20 days or erratic.

Not only can anxiety and stress lead to anovulatory cycles, it can also lead to estrogen dominance by way of cortisol progesterone steal.  What’s that?  When we are stress and anxious our adrenal glands produce large amounts of cortisol.  How does our adrenal glands produce cortisol?  From progesterone!  So when we are using progesterone to make cortisol the amount of progesterone to counteract estrogen decrease.  As a result we have estrogen dominance relative to low progesterone even if our estrogen levels are normal.  Estrogen dominance can cause fibroids, fertility issues, ovarian cysts and even endometriosis.

Can our periods make us anxious? 

Missing our period or having periods that are too heavy and painful can definitely be distressing but could our periods themselves have the power to change are moods?  The answer is yes.  If we remember again how changes to our menstrual cycle can lead to estrogen dominance.  Well our neurotransmitters actually respond differently to progesterone and estrogen.  Progesterone is the precursor for neurosteroid, which is an inhibitory neurotransmitter meaning that it has a calming effect on the body.   Neurosteroid enhances the effects of gamma amino butyric acid, GABA, which is a neurotransmitter that helps us relax and sleep well.  If progesterone levels are low either due to lack of ovulation or overuse for cortisol production, neurosteroid will decrease leaving us feeling more agitated and anxious.  Progesterone and estrogen also have effects on melatonin, which we often consider as our sleep hormone.  Estrogen decreases the secretion of melatonin while progesterone increases it.  This is why some of us experience sleep disturbances during certain parts of our cycles.

How can we get our periods under control when everything is out of control?

First don’t panic and start incorporating practices that naturally decrease stress and anxiety in the body.  A great place to start is with mindfulness practices like yoga, mediation and my personal favorite breath work.  By engaging in these practices daily we enhance our ability to react more calmly and collected when stress comes our way.  Exercise is another great way to handle stress and anxiety but with a little bit of caution.  Frequent high impact exercises can be problematic as they can actually increase cortisol levels and disrupt our sleep if we are exercising in the evening.  It is best to have a balance of low impact restorative exercises like pilates or walking with high intensity activities only a few mornings a week.  During times of anxiety it is important to eat well nourishing meals rich in protein, fruits and vegetables, healthy fats and complex carbohydrates.  Eating this way will not only make us feel less anxious but it will support our adrenal glands too.  Adaptogens which are adrenal support of herbs can also be beneficial especially Rhodiola and ashwaghanda. 

Want to get your period back naturally without the pill? Then schedule a naturopathic appointment with Dr Ivy.