Excuse Me, Have You Seen My Period?
Stress and the menstrual cycle.
Posted Jun 11, 2020
I missed my period last month. The previous month it came early, and the month before it came late. Two of my patients and three of my friends have had “pregnancy scares”—although, not all of them are sexually active.
So, where have all the periods gone? What can we do to return to homeostasis and how important is it to our health?
Let’s start at the beginning—and apologies for all the science-y stuff. I’ll try to make it less boring.
There are four major hormones involved in menstruation, and they were all birthed by the Greek Goddess in your brain, Hypothalamus.
Hypothalamus is one badass woman—she’s a woman in my imagination, because, you know, she is in charge of everything and never gets credit. And yes, men have Hypothalamus as well, and she is probably totally overlooked and underpaid there.
Hypothalamus gives birth to FSH, the goddess of pubic hair and making babies, and LH, the goddess of ovulation, a.k.a. the demanding boss who orders the ovaries to release eggs.
(When you’re pacing in your bedroom and anxiously tapping your nails on your kitchen table, waiting for one line or two to appear on that fortune-telling stick, you should probably pray to the goddess LH)
Hypothalamus also gives birth to Estrogen and Progesterone. Estrogen is younger, but bossier. She is the one who tells her older sisters, FSH and LH, to quit the game and shut it down when the egg isn’t getting enough action to make a baby. And progesterone is kinda the pinch hitter, regulating your menstrual cycle, but really called in to take action when the sperm manages a home run and hits that pregnancy out of the park.
The thing is, Hypothalamus, although a goddess, is a multi-tasker like most of us women. She has a lot of jobs, and A LOT of kids. Especially during the pandemic. And one of her kids, Cortisol, is kinda the red-headed step-child that she shares with Pituitary and Adrenal.
Cortisol is that car alarm that is extremely helpful when someone is trying to steal your car, but extremely annoying when it’s your neighbor’s car, which is not being stolen, and the alarm refuses to stop.
Cortisol is our stress hormone. We use it in research to quantitatively measure trauma and the ability to recover from trauma. Cortisol has no doubt paid you a visit during the last few months of COVID-19 and the movement to raise awareness of systemic racism. Cortisol is fantastic. It increases focus and awareness, which allows you to focus on the danger you are facing, and it increases fear memory, which is a not-so-subtle nudge to remind you that the things you are afraid of have been dangerous or hurtful in the past.
So, what could go wrong?
Too much cortisol over too long of a time messes up your sleep/wake cycle, your immune system, and increases your blood pressure. And if that isn’t enough, too much stress (cortisol) can cause weight gain, anxiety, depression, heart disease, headaches, and—lack of sex drive, irregular periods, missed periods, or the total elimination of periods until your stress level goes down.
If you think about it, this makes a hell of a lot of sense. It is your caveman body’s weigh of protecting you from giving birth to a child in a dangerous, messed-up world.
So, how come no one told us this?
How come women all over the world are confused and mystified that our precise and rhythmic birth control has lost its power? How come so many of us women are left confused, or scared, or tragically hopeful in a way that will soon end in tears of disappointment?
I started researching all of these dreadfully complicated hormones on a hunch. A guess. The belief that my friends, family, patients, and myself couldn’t all be caught up in a sort of Freudian-esque hysteria or Aristotle-like explanation that our wandering uterus was to blame for this common experience.
Science—actual science—supported my hunch, which I couldn’t wait to share with you, my readers. Because some of you out there are white-knuckling it out of fear of pregnancy. And others, I know, have been desperate for this one last attempt to work before you and your loved one have to start the very lengthy, emotionally and physically draining process of fertility treatments.
And we, as women, deserve this information. We, as women, deserve for our menstruation to be treated as something more than that which should be feared, laughed at, or longed for: Your menstrual cycle is a signal of your perceived safety.
So, what now?
1) First, and foremost, take a pregnancy test. And another a week later. Make sure this is a false alarm that is a result of your amazingly powerful feminine energy—rather than a baby.
3) Eat a “good diet.” Yeah, well, the world is going up in flames, so let’s be more specific with our “good diet” and more gentle with our coping mechanisms: dark chocolate, bananas and pears, black tea and green tea—add these into your day. (No judgment for wine time)
4) Get a good night’s sleep. (Psst… a good night’s sleep means you literally sleep at night. Not at 4 AM.) Our bodies do best when we function according to our circadian rhythm. Sleep when it’s dark, wake when it’s light.
5) Laugh with your people: your friends, your family, even hanging out with your grumpy, fat cat can help lower your cortisol levels.
6) Exercise. And if you exercise outdoors you get the bonus of dopamine and serotonin—also helpful, happy hormones.
7) Fish oil and an Asian supplement called Ashwagandha**[Author's note/correction: Ashwagandha was initially identified by the author as an Asian supplement, but a helpful reader pointed out that this is actually a supplement from a region in India, best known for its role in Aruveydic medicine, commonly practiced in Eastern faith/yoga practice]. Ashwagandha has both been shown to reduce cortisol levels.
Here’s the thing, ladies, the last thing we need right now is one more thing to stress about. And yet, here we sit, silently, privately, stressing about the loss and absence of our monthly frenemy, who has been providing reassurance or disappointment since we hit puberty. We don’t have to stay silent. We have to understand this. Together.