The past two years have been nothing if not stressful. But a new analysis of menstrual cycle data from women in the United States suggests that pandemic-related stress may have knocked many menstrual cycles off-kilter – with potential consequences for their health.

The menstrual cycle is the monthly hormonal cycle a body goes through to prepare for pregnancy. Although the most obvious manifestation of this cycle is the monthly bleeding or “period” that most women of childbearing age experience, this hormonal cycle also affects many other aspects of women’s health – such as their memory and energy levels.

Such stress could impact women’s reproductive function, making it more difficult for them to conceive – at least until this stressful period has passed.

Previous research has found that menstrual cycle irregularities are often reported by people who are experiencing mood disorders such as anxiety and depression, or those living through extremely stressful events, such as natural disasters, famine or forced displacement from their homes. But what about the psychological distress triggered by the COVID-19 pandemic?

A new study published in The Journal of Women’s Health suggests that women who experienced high levels of stress during the early months of the pandemic were more likely to experience heavier menstrual bleeding and a longer duration of their period, compared to those with moderate stress levels.

What did the study do?

Noelle Ozimek and Karen Velez and their colleagues at Northwestern University in Chicago distributed an online survey with the title “Help us learn more about how the COVID-19 pandemic impacts women's reproductive health” to 210 women who menstruate, between July and August 2020.

The women were asked about their demographic backgrounds and menstrual cycle history, any changes in the timing between their periods or length of their menstrual cycle, how many days they bled for, and whether they experienced heavier or lighter bleeding or any intermittent spotting. They also completed an assessment to determine their levels of stress before and during the COVID-19 pandemic.

What did it find?

More than half (54%) of the women reported experiencing one or more changes in their menstrual cycle following the start of the COVID-19 pandemic. These included changes in the timing of their periods or menstrual cycles, how long they bled for, and their premenstrual symptoms.

Women who experienced higher levels of stress during the pandemic were around twice as likely to have experienced changes in the duration of their periods, compared to those with moderate stress levels (58% versus 29%). Those who were more stressed were also more likely to report heavier bleeding (42% versus 24%).

Have any other studies looked at this issue?

Although this was a relatively small study, and women who were concerned about their periods may have been more motivated to participate, the results are broadly consistent with a similar study which looked at the impact of the COVID-19 pandemic on the reproductive health of 1,031 women in Ireland. It found that 46% of participants reported a change in their menstrual cycle since the beginning of the pandemic, with 53% reporting worsening premenstrual symptoms, 18% reporting heavier or more prolonged bleeding and 30% reporting severe and frequent menstrual cramps and pain during their period, which they didn’t usually experience.

What are the implications of this research?

The two studies confirm anecdotal reports that periods and menstrual cycles have been disrupted as a result of stress caused by the pandemic. This is important, because such stress could impact women’s reproductive function, making it more difficult for them to conceive – at least until this stressful period has passed. Because female reproductive hormones have such wide-ranging effects on the body, pandemic-related stress could also trigger wide hormonal imbalances, with consequences for their mental and physical health. It is important that women pay attention to menstrual cycle changes and consult a doctor if they are worried about them, as well as trying to reduce stress as far as possible.

TOPICS: GenderCOVID-19Educational

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