Has pandemic stress changed women’s menstruation?

Has pandemic stress changed women’s menstruation?


During the pandemic, many women experienced high levels of stress while taking on a disproportionate share childcare and housework and dropped out from the workforce in large numbers.

Now, a new study suggests that all this extra stress may have changed women’s menstrual cycles in different ways. Some women who reported high levels of stress also reported early or delayed periods. Others had heavier menstrual flow or increased spotting between cycles. Some women said that during the stress of the pandemic, their periods lasted longer than usual, while others said their periods were shorter.

Martina Anto-Ocrah, an assistant professor at the University of Pittsburgh School of Medicine who led the study, called the results “alarming” because of the effects an irregular cycle can have on fertility and mental health.

“This really extends beyond menstruation, it’s about women’s well-being,” she said.

study, published in obstetrics and gynecology, relied on self-reported data from 354 women aged 18 to 45. The women were asked in early May 2021 to answer questions about their stress caused by the pandemic and to report any menstrual cycle changes that occurred between March 2020 and May 2021.

More than half of the women surveyed reported changes in menstrual cycle length, menstrual duration, menstrual flow, or spotting, and 12 percent of women reported a change in all four measures. Researchers have found a significant link between high levels of stress caused by the pandemic and changes in the menstrual cycle.

Younger women and women with previously diagnosed mental health problems were more susceptible to feeling high stress and changes in their menstrual cycle.

The authors of the study pointed out that the data were collected from a racially diverse and geographically representative sample. The women were not on birth control, menopausal or postmenopausal before the pandemic. The study did not include trans or non-binary people who also menstruate.

The research is part of a growing body of evidence suggesting that women’s periods have changed during the pandemic.

“Women are told all the time, ‘It’s all in your head,'” Anto-Ocrah said. “Until we get some data that shows that what’s in women’s heads is actually true, the medical community kind of rejects us and doesn’t believe it.”

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Stress can affect a woman’s menstrual cycle in a number of ways. The stress hormone cortisol can affect the body’s production of estrogen and progesterone, reproductive hormones that affect the menstrual cycle. Stress-related factors such as poor diet, weight gain, weight loss and poor sleep can also play a role.

Nicole C. Woitowich, an assistant professor of medical research at Northwestern University, found a similar connection between menstrual changes and stress since the 2020 pandemic after conducting an online survey of 210 women. Since it was not a representative sample, the findings are not conclusive. But Woitowich said both studies, conducted a year apart, suggest the pandemic has affected women’s stress levels and menstrual cycles over a long period of time.

“Women have really borne the brunt of the pandemic, in many ways,” Woitowich said. “From providing primary assistance, from doing distance learning, and often from working while managing it as well.”

Linda Fan, an assistant professor of obstetrics and gynecology at the Yale School of Medicine, said she has seen an increase in patients coming in to discuss irregular menstrual cycles. Generally, one or two abnormal cycles isn’t anything to worry about, but she encourages patients to talk to their doctors and continue to track their periods to make sure no worrisome patterns emerge.

In addition to stress, changes in the menstrual cycle can also signal thyroid disease, hormonal changes, cancer, pregnancy or infection, she said.

“It can be very alarming,” Fan said. “And I think doctors may be underestimating that.”

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Due to pandemic restrictions, Marcela Wakeham, 46, from Lancing, England, was unable to teach yoga and pilates and took a job as a carer. At the same time, her husband’s business was closed.

She believes all the stress she experienced during that time may have triggered early menopause symptoms, including shorter menstrual cycles, as well as “violent” hot flashes and insomnia. But her doctor told her she was “too young” to enter menopause and refused to prescribe the hormone treatment she wanted.

“I didn’t have any free minutes to myself,” Wakeham said. “My stress levels were through the roof.”

A prolonged irregular menstrual cycle can sometimes be a sign of worrisome changes in the body, said Amy Wagner, a professor at the University of Pittsburgh. If someone is in a chronically stressful situation, higher cortisol levels over time can not only affect menstruation, but can increase the risk of inflammation, autoimmune disease, heart disease, high blood pressure or other chronic diseases, she said.

Caroline Fan (41) from St. Louisa said that during the pandemic, she constantly felt “on edge” because she was worried that her husband, an infectious disease doctor, would get Covid. She also helped coordinate outreach programs to Asian-American communities and was concerned about anti-Asian violence.

During this stressful period, she noticed that her periods became heavier, her cycles became shorter and she had more painful cramps. She also missed one period entirely. Fan said she also lost weight and started having trouble sleeping. “I was so upset because I was running around trying to do all these things,” she said.

Her cycle length is now back to normal, but Fan said she still has more painful cramps that force her to miss work.

A recent report in International Journal of Epidemiology noted that questions about menstruation were not included in most large studies of covid-19. Gemma Sharp, an associate professor at the University of Exeter and lead author of the study, said more research is needed to inform women whether these stress-related changes in their cycle will have lasting effects.

“From what we know about how the menstrual cycle is regulated, we think these changes are likely to be short-term and unrelated to long-term health and fertility, but it is absolutely critical that scientists can produce evidence to give women the reassurance they deserve,” she said. is.

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