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Written by Dr. Jordan Robertson, ND 

Stress is a natural part of being human, and it can either be motivating or hindering. From family and work demands, to illness, and even social media – we’re constantly being exposed to stressful situations. Stress can take a toll on not just our emotional and physical health, but also hormones. 

HORMONES AND THE CYCLE

Many women and people who menstruate don’t realize that the menstrual cycle begins in the brain. The beginning of the cycle starts with the rise of FSH, a hormone appropriately named follicle stimulating hormone, that begins the growth of the egg each month. From the growth and maturation of the follicle to the release of the egg through ovulation, the entire cycle is orchestrated through brain-based hormones1.

Many of the symptoms that women feel through PMS, perimenopause and menopause are actually brain-based symptoms. From mood swings to sleep changes to insomnia, each of the areas of the brain that are sensitive to hormone fluctuations create the symptoms that people feel during PMS and perimenopause2,3.

STRESS AND THE MENSTRUAL CYCLE

The stress response responds to both acute and chronic stressors, by mobilizing hormones, blood sugar and other resources that can help the body and brain manage stress. The stress response also begins in the brain and can impact other brain processes by enhancing or suppressing various functions, depending on whether they support the body during stress or not 4,5.

Knowing that both the menstrual cycle and the stress response originate in the brain, it’s not hard to see how stress can impact the menstrual cycle. Studies in young women have shown that stress of exams or daily stress can impact menstrual cycle length 6,7. The effect of cortisol, the stress hormone, on the menstrual cycle is indirect, but when released, cortisol can have an inhibitory effect on the cycle, which may delay ovulation or prevent it from happening at all 8. Most studies that show an impact of stress on the cycle show a lengthening of the cycle 7.

Stress can indirectly affect the menstrual cycle by changing behaviours of people who are suffering from long-term chronic stress. Under-eating, or significant dietary deficiencies can cause ovulation to be delayed or the loss of a menstrual period 9. Studies on young university students have also linked stress to higher rates of cramps and heavy menstrual bleeding 7.

Stress also impacts the way that people experience PMS. PMS is triggered by hormone fluctuations and causes both physical and mental symptoms in response to rapidly changing estrogen levels2. Areas of the brain that are sensitive to hormone changes are affected by the rise and fall of estrogen throughout the cycle, and can create physical symptoms, such as increased pain and sensitivity, and mood symptoms such as depression and irritability. Women who have been exposed to trauma or chronic daily stressors become even more sensitive to these hormone changes, and may experience worse PMS as a result 10. Research has started to connect early ovarian decline or early menopause with stressful life events 11.

As women age, their stress response has the potential to interact with the hormone changes that occur during perimenopause and menopause. Stress worsens the overall menopause symptom experience, with people reporting higher rates and severity of hot flashes12, insomnia and depression in the final menstruating years when stress levels are high13. On the other hand, strategies that reduce stress such as cognitive behavioural therapy, meditation, mindfulness 14 and developing self compassion15 have been shown to reduce the physical and emotional symptoms associated with menopause.

SUPPORT FOR STRESS 

Supplementation for stress and symptoms of the menstrual cycle have been studied extensively in research, but we have yet to study whether supporting the stress response with supplements improves PMS or other menstrual symptoms. B vitamins have been shown to reduce perceived stress in patients16. Rhodiola is a herb that improves mental capacity under stress and can improve fatigue and concentration in people exposed to chronic stressors17. Patients with heavy menstrual bleeding would also benefit from testing for and treating iron deficiency18. Patients with low iron are at an increased risk of anxiety and depression19.

Stress is an everyday experience that can have an impact on the hormone and menstrual symptoms that people feel throughout their lifetime 6,7,20. Through their close relationship, the stress response and hormone systems can impact each other and heighten the way that women feel through menstrual years and into menopause. Stress reduction techniques have the potential to support female hormone symptoms and should be considered as part of an overall healthy plan for all menstruating people.

Luckily, Adrenasmart has four synergistic, non-glandular, adaptogenic herbs that work brilliantly to offer your body the support it desperately needs.  Each capsule of Adrenasmart contains Rhodiola, Suma, Schisandra Berries and Sensoril® Ashwagandha. Adrenasmart is formulated to help relieve symptoms of mental fatigue related to stress and supports cognitive function, physical stamina, mental focus and helps to temporarily relieve symptoms of stress.21 Take 2 capsules with breakfast and dinner to give your body the support it needs to help you cope with the world of daily stressors!   

References: 

  1. Physiology, Menstrual Cycle – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK500020/.
  2. Gudipally. Premenstrual Syndrome – StatPearls – NCBI Bookshelf. file:///Users/jordanrobertson/Zotero/storage/MFJ8GM5P/NBK560698.html.
  3. Peacock. Menopause – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK507826/. 
  4. Sheng, J. A. et al. The Hypothalamic-Pituitary-Adrenal Axis: Development, Programming Actions of Hormones, and Maternal-Fetal Interactions. Front Behav Neurosci 14, 601939 (2021). 
  5. Physiology, Anterior Pituitary – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499898/. 
  6. Mittiku, Y. M., Mekonen, H., Wogie, G., Tizazu, M. A. & Wake, G. E. Menstrual irregularity and its associated factors among college students in Ethiopia, 2021.Frontiers Global Women’s Heal 3, 917643 (2022).
  7. Alhammadi, M. H. et al. Menstrual cycle irregularity during examination among female medical students at King Abdulaziz University, Jeddah, Saudi Arabia.Bmc Women’s Heal 22, 367 (2022). 
  8. Ozgocer, T., Ucar, C. & Yildiz, S. Daily cortisol awakening response and menstrual symptoms in young females.Stress Health 38, 57–68 (2022). 
  9. Vigil, P. et al. Chronic Stress and Ovulatory Dysfunction: Implications in Times of COVID-19. Frontiers Global Women’s Heal 3, 866104 (2022). 
  10. Rieder, J. K., Kleshchova, O. & Weierich, M. R. Estradiol, Stress Reactivity, and Daily Affective Experiences in Trauma-Exposed Women.Psychological Trauma Theory Res Pract Policy 14, 738–746 (2022). 
  11. Sun, J. et al. Chronic and Cumulative Adverse Life Events in Women with Primary Ovarian Insufficiency: An Exploratory Qualitative Study.Front Endocrinol 13, 856044 (2022). 
  12. Arnot, M., Emmott, E. H. & Mace, R. The relationship between social support, stressful events, and menopause symptoms.Plos One 16, e0245444 (2021). 
  13. Sözer, G. A., Öz, H. G. & Yangın, H. Relationship between menopausal symptoms and perceived stress during the COVID-19 pandemic.J Women Aging 34, 675–686 (2022). 
  14. Sood, R. et al. Association of mindfulness and stress with menopausal symptoms in midlife women.Climacteric 22, 377–382 (2019). 
  15. Brown, L., Bryant, C., Brown, V., Bei, B. & Judd, F. Investigating how menopausal factors and self-compassion shape well-being: An exploratory path analysis.Maturitas 81, 293–299 (2015). 
  16. Young, L. M., Pipingas, A., White, D. J., Gauci, S. & Scholey, A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals.Nutrients 11, 2232 (2019). 
  17. Anghelescu, I.-G., Edwards, D., Seifritz, E. & Kasper, S. Stress management and the role of Rhodiola rosea: a review.Int J Psychiat Clin 22, 1–11 (2018). 
  18. Peuranpää, P., Heliövaara‐Peippo, S., Fraser, I., Paavonen, J. & Hurskainen, R. Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding.Acta Obstet Gyn Scan 93, 654–660 (2014). 
  19. Lee, H.-S., Chao, H.-H., Huang, W.-T., Chen, S. C.-C. & Yang, H.-Y. Psychiatric disorders risk in patients with iron deficiency anemia and association with iron supplementation medications: a nationwide database analysis.Bmc Psychiatry 20, 216 (2020). 
  20. Ojezele, M. O., Eduviere, A. T., Adedapo, E. A. & Wool, T. K. Mood Swing during Menstruation: Confounding Factors and Drug Use.Ethiop J Heal Sci 32, 681–688 (2022). 
  21. Government of Canada. Product information. Accessed on Oct 11th, 2022 at https://health-products.canada.ca/lnhpd-bdpsnh/info.do?licence=80033271