Stress and anxiety can affect menstrual cycle and fertility – 07/19/2023 – Mental Health

Stress and anxiety can affect women’s menstrual cycles, changing characteristics such as the number of days and flow intensity.

Carlos Moraes, gynecologist and obstetrician at Santa Casa de Misericórdia de São Paulo and member of Febrasgo (Brazilian Federation of Gynecology and Obstetrics Associations), says that chronic stress, associated with a series of health problems, can also cause menstrual irregularity.

“Anxiety and stress overload generates changes in the number of days of the menstrual cycle, number of days of menstruation, menstrual flow, menstruation color and odor, in addition to changes in libido”, says Moraes.

A study published in the medical journal Fertility and Sterility, organized by the American Society for Reproductive Medicine, identified a relationship between high levels of stress and an increased risk of anovulation (lack of ovulation), which can lead to menstrual irregularities and infertility.

According to the gynecologist, emotions are related to the same region of the brain —the arcuate nucleus, located in the hypothalamus— responsible for the production and control of hormones that regulate the menstrual cycle.

When the body is placed under constant or excessive pressure, it secretes stress hormones such as cortisol, which alters the secretion patterns of a hormone called GnRH, which consequently affects the release of two other hormones essential for ovarian function and ovulation. : luteinizing (LH) and follicle stimulating (also known as FSH).

“When LH and FSH levels are low, the ovaries may not produce adequate estrogen for ovulation and, consequently, menstruation to occur. earlier than expected (shorter cycles) to menstrual delays that last for months”, says Moraes.

According to the doctor, the delay does not happen with those who use birth control pills. “That’s because they make women have an artificial menstruation, that is, menstruation does not happen by natural hormones, but by the ingestion of hormones contained in the pill, regardless of the functioning of the ovary.”

In this context, when there is a delay or absence of menstruation, the patient must undergo tests to be sure that she is not pregnant.

Pregnancy excluded, other factors need to be considered that can also delay or even stop menstruation, such as thyroid disorders, polycystic ovary syndrome and eating disorders – which can inhibit the production of certain hormones and interfere with the menstrual cycle.

Moraes recommends that women monitor their menstrual cycle, note the dates, duration and other flow characteristics for three months. If cycles are still abnormal, make an appointment with your doctor. But if there is a complete stop of menstruation, go to the specialist before this period.

Regarding the changes caused by the impacts on the emotional state, according to psychologist Monica Machado, founder of Clínica Ame.C and post-graduated in psychoanalysis and mental health at the Instituto de Ensino e Pesquisa of Hospital Albert Einstein, it is crucial to adopt strategies for managing stress.

“The ideal is to include activities such as regular physical exercise, meditation, yoga and therapy with a mental health professional. Often, the woman cannot deal with chronic stress alone, which can be prolonged and trigger more serious frames of mental disorders, compromising not only the reproductive cycle, but several organic functions”, says Machado.

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