Amenorrhea is becoming more and more common, but why is that? In short, stress!
Stress can be broken down into two types when discussing menstrual health: physical stress (i.e. exercise, calorie deficits, low body weight) and psychological stress (i.e. mental stress, anxiety). Below, we discuss the impacts that both types of stress have on a menstrual cycle.
Psychological and physical stress have similar mechanisms in how they disrupt our hormones and therefore, our cycles. When we are stressed, it signals the body to raise cortisol levels, which disrupts the hypothalamic gonadotropin-releasing hormone (GnRH) secretion. GnRH is a key regulator in our reproductive health as it plays a role in releasing two important hormones, being follicle stimulating hormone (FSH) and luteinizing hormone (LH). When our GnRH secretion is disrupted, it interferes with LH secretion. This ultimately results in ovarian dysfunction, causing anovulation (i.e. absence of ovulation) and thus, the absence of menstruation.
Low body weight/low body fat (whether this is a result of one’s diet or over-exercising) inhibits our body’s ability to produce enough hormones to support a regular, healthy cycle. Research has found that low carbohydrate diets or diets low in calories can interfere with the pulsatile secretion of LH, leading to anovulation.
When we are stressed, our sympathetic nervous system becomes activated, putting the body in “fight or flight”. This prolonged state of stress essentially tells our reproductive organs that the environment is not safe enough to create a baby and thus, causes our body to press pause on ovulation.
Note: If your period is missing for more than one cycle, make sure to speak to your doctor and perform all relevant tests to rule out any underlying condition (PCOS, Hyperprolactinemia etc.) and a pregnancy test.