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Is the pandemic affecting your period? You’re not alone

Is the pandemic affecting your period? You’re not alone

Kindara | May 4, 2021 | Women's Health
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If you're lucky, the last year of COVID-19 lockdown has been boring and repetitive. Chances are, though, you've experienced some degree of anxiety and stress throughout the pandemic, and it's likely that you're feeling the impact of spending months inside, keeping a distance from loved ones and the world at large, and maintaining vigilance. The pandemic impacts every aspect of our lives, and for some, that may include your menstrual cycles. 

Let's talk about period disruption 

If your period has been wonky in the last year, you're not alone. In May 2020, Dr. Anita Mitra, a UK gynecologist, used her Instagram account to ask the question, "Have you noticed a change in your menstrual cycle or hormonal symptoms during lockdown?" 65% of respondents (3662) said yes. In another study that has not yet been peer-reviewed (that means that folks with similar qualifications have evaluated it), 749 physically active participants were surveyed as to their menstrual characteristics during COVID lockdown, as well as their nutrition, stress, and lifestyle, and 52.6% of those participants reported a change in their cycles (1). 

"I've skipped periods twice (not in a row) and been less regular in general despite years of being very regular," said Sally*, a Boston-area academic. "I called my [primary care physician] to discuss, and she said she's heard of several cases like this." 

Maggie, who works in reproductive healthcare in Washington, DC, also reported an unpredicted menstrual absence. "My period has strangely disappeared more than once during the pandemic, despite definitely not being pregnant and my birth control pill not changing." 

Some women reported not an absence of their period, but other changes. For the first time in the three years she's been taking hormonal birth control, which she describes as working "perfectly," Rhonda, a student in New York City, had breakthrough bleeding at the beginning of the pandemic. Laura has experienced increased PMS symptoms, followed by a "weird slow start and long finish." 

"I don't know if it's the stress of the pandemic, or the fact that I essentially don't leave the house, but it sucks," said Kerry, whose 28-day cycle has become one that's more like 24 days since the start of COVID. 

Anxiety and COVID

According to the World Health Organization, the main psychological impact of COVID has been increased levels of stress and anxiety, as people endure the current reality and envision the world after it (2). A study by the Centers for Disease Control (CDC) found that the number of adults reporting symptoms of anxiety or depression increased from 36.4–41.5% between August 2020 and February 2021 (3). Between January 20, 2021–February 1, 2021, more than 2 in 5 adults over the age of 18 noted symptoms of an anxiety or a depressive disorder during the past 7 days. 

The sense of isolation can be amplified by the social restrictions intended to mitigate the spread of COVID, like the closing of non-essential businesses, limiting the number of people able to gather in groups, unemployment, and virtual schooling. Combined with the desire to be glued to our devices for up-to-the-minute updates, and the fact that women in general are more prone to anxiety, it's no wonder many of us have been feeling anxious and stressed — and that our menstrual cycles might be looking and acting a little different these days (4). 

Periods and stress: What we know 

Your menstrual cycle is dictated by changes in hormones, but it's about more than just estrogen and luteinizing hormone (LH) surges. The hypothalamus, which resides in your brain and manages your pituitary gland, plays a big role in your cycle by regulating and secreting hormones. When you're stressed out, your hypothalamus teams up with your pituitary and adrenal glands to generate a hormone called cortisol. Acute stress manifests in symptoms such as sweating, rapid heartbeat, and quick breathing, and is also known as a "fight or flight" response, during which all body systems that aren't essential for survival shut down, and that includes your reproductive system (5). If you experience chronic stress, let's say, during a pandemic that lasts for more than a year, that constant stream of cortisol can result in a delay or, if the levels are very high for a long time, a total absence of your period (also called amenorrhea) (6). 

Not everyone reacts to stress in the same way, but if you know you tend to have anxiety and stress, your period's strange behavior during the pandemic might have something to do with it. Talking to your health care provider about what you can do to reduce your mental and physical stress response is an important step to feeling better. And if the idea of leaving your house to seek medical and mental health care makes you nervous, consider telemedicine/therapy, and check out this list of resources on mental health in COVID from the CDC. 

If it's not stress, what could it be? 

If you're not feeling particularly stressed out these days and your period is still off, there are other possibilities for culprits. Hormone levels are influenced by weight, so if  your diet and exercise routines have been altered during the pandemic and you've gained or lost some pounds,  that might be the source of changes to your period. Having a high body-fat percentage can increase the levels of estrogen in your body, causing irregular periods; a low body-fat percentage can result in slower hypothalamus function and the absence of menstruation (7, 8). Smoking (or quarantining with someone who's exposing you to secondhand smoke regularly) can also cause your menstrual cycle to become shorter and more painful (9). Quitting smoking may reverse the effects on your cycle, and within three months, the quality of your eggs will improve, but keep in mind that your overall egg supply is diminished by smoking, and once you lose eggs, you can't get them back (10, 11). 

Menstrual cycles are delicate, complex, and unique, and the ever-changing and yet seemingly unchanging atmosphere of the world right now can throw them into a tizzy. "It's hard to know what to do with all this," said Emily, who's been experiencing intense changes in her own cycle during COVID, like night sweats and insomnia, and dread. "We're all in this liminal space where we're trying to co-exist with the anxiety in our bodies and in the universe." Knowing we're not alone in encountering physical and mental changes can help us cope, and reaching out for support is vital to feeling better and going forward. 

* Some names have been changed to protect privacy.

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References +
5

Understanding the Stress Response. (2020, July 6). Retrieved March 28, 2021 from https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

6

Can Stress Cause You to Skip a Period? (2020, September 18). Retrieved March 30, 2021 from https://health.clevelandclinic.org/can-stress-cause-you-to-skip-a-period/

8

Patient education: Absent or irregular periods (Beyond the Basics). (2019, April 3). Retrieved March 30, 2021 from https://www.uptodate.com/contents/absent-or-irregular-periods-beyond-the-basics

10 How Stopping Smoking Boosts Your Fertility Naturally. (2019, April 16). Retrieved March 31,2021 from 

https://health.clevelandclinic.org/how-stopping-smoking-boosts-your-fertility-naturally/

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