How the Coronavirus Pandemic Might Be Messing with Your Period

Is your cycle wonky or MIA right now? You're not alone.

With this being a time of such massive uncertainty, it may feel like your period is the only sure thing in life right now.

Ha.

The truth is that it really doesn't take a lot to disrupt your cycle—and if your period has been all over the place since this whole thing began, you're not alone. Many women are reporting that their cycle has been shorter, delayed, or even completely missed since this pandemic began, writes Sarah Toler, D.N.P., a doctor of nursing health in a post for the period-tracking app Clue.

Although it's often easy to draw concern from a missed period (hi, pregnancy), if you're going through a stressful time—and especially if you're on birth control—you shouldn't be overly concerned. That being said, it's always important to understand the reasons why your menstrual cycle may be getting disrupted. (

What Might Be Causing Your Cycle Irregularities

Few women have completely "regular" cycles, and it's very normal for cycles to fluctuate here and there. But when a cycle is completely "skipped" or the length is greatly different than your last, it's important to acknowledge the difference. This could signify pregnancy or miscarriage, or even an underlying condition like the thyroid disorder polycystic ovary syndrome (PCOS) or endometriosis.

In the context of this pandemic, though, the main factor is most likely stress.

It's no secret that there are plenty of reasons to be stressed right now. You may have lost your job, have a loved one who has contracted the virus, be overwhelmed by stay-at-home orders, or even have contracted the virus itself. The COVID-19 pandemic has shaken up finances, workout routines, diets, and the way society functions as a whole—it's entirely overwhelming.

In fact, Natural Cycles, a non-hormonal birth control app, found no immediately clear "COVID-19 effect" on their users' cycles, though many did report cycle changes. What they did see was an increase of anxiety tracking mid-March to early April when users logged anxiety 50 percent more than normal. The day with the most anxiety tracking was on Tuesday, March 17th with a 100-percent increase compared to normal levels. Sure enough, the World Health Organization reported that the main psychological impact of COVID-19 is elevated rates of stress and anxiety.

"And stress can be a huge factor in cycle regularity," says Mary Jane Minkin, M.D., a clinical professor of ob-gyn at Yale University. "Your uterus does not control your menstrual cycle, nor do the ovaries," says Dr. Minkin. "The control of menstrual cycles actually resides at the base of the brain, in the hypothalamus." The hypothalamus produces hormones such as gonadotropin-releasing hormone (GnRH), which then stimulates the pituitary gland to produce follicle-stimulating hormone (FSH), the hormone responsible for starting egg development and inducing an increase in estrogen, according to the Center for Reproductive Health at the University of California San Fransisco. During times of stress, the hypothalamus also signals to the body to produce cortisol, the stress hormone, according to the American Psychological Association. "So any stressors that besiege our brains can interfere with the process of ovulation and cycle regularity," she says.

If you normally struggle with cycle-related mood swings, they could be made worse because you're likely already under stress, says Dr. Minkin. "In turn, mood swings from stressful quarantine life could likely be causing erratic hormonal secretion, messing with your period, while also making you more irritable," she says.

This could be especially true if you're working on the frontlines of the pandemic or are an essential worker of any kind. "Presuming the essential workers are under perhaps even more stress, their cycles certainly could become quite erratic," says Dr. Minkin. (See: How to Cope with Stress As an Essential Worker During COVID-19)

What about other factors besides stress?

Sleep pattern changes.

Variations in sleep patterns or even jetlag can be a common reason for period changes. This is because your body's circadian rhythm (your "internal clock") controls a variety of biological functions, including your menstrual cycle. Melatonin, the hormone that helps regulates your sleep cycle, is a crucial factor in regulating your circadian rhythm, as well as modulating estrogen and progesterone receptors (the two important reproductive hormones that affect your cycle), as Shape previously reported.

It's no secret that the coronavirus pandemic is affecting people's sleep patterns and quality—so if your sleep has been off (especially if it's been a result of stress), it makes sense that those effects might carry over to your menstrual cycle as well.

Exercise or diet changes.

If you've been using this time to go hard on your workout routine—or, on the other hand, have stopped moving as much—you could be wondering if that might be messing with your period. But Dr. Minkin notes that, unless you've made some insanely significant alterations to your workout routine, it's unlikely to be the cause of a missed period. "Changes in exercise need to be pretty significant to alter the cycles," she says. However, professional athletes or those who exercise as such might be more prone to irregular or skipped periods. (See: What Is the Female Athlete Triad and Are You At Risk?)

The same applies if you've decided to switch up your diet. "A change in diet is possible to be the disrupter, but more than likely, stress itself is the common denominator," she clarifies. Like exercise, "dietary changes need to be pretty big to be the cause." And excess alcohol consumption can have an effect on your menstrual cycle, too; if you've been drinking more in quarantine, that could play a role.

Changes to your sex life.

Being in quarantine has had a varied effect on many women's sex lives across the board, so it's difficult to generalize the effects, says Dr.Minkin. With couples being in such close quarters, many are feeling no desire to be sexually active at all, while others may be feeling more intimate than ever. Or, you could be masturbating way more or way less than usual due to the current situation.

Sexual activity changes the levels of various hormones that can affect your cycle, according to the period tracking app Flo. Specifically, orgasm releases a large amount of oxytocin, a hormone that regulates hormone fluctuations, reduces stress, and manages the menstrual cycle, which can actually make your cycle more regular.

The virus itself.

And, of course, there's also the issue of contracting the virus itself. "Getting the virus certainly can be a disrupted," says Dr. Minkin. "Most of the time, infectious diseases associated with significant fevers tend to make periods lighter and sparser. One of my colleagues has also been hypothesizing that, with the inflammation that often comes with infectious diseases, women might experience it in their uterus, and in turn experience heavier bleeding," she says. (

Changes in medication.

Changing up your medications (especially contraceptives) is a very common reason for missed periods as well. Contrary to some widespread myths, most antibiotics do not affect hormonal birth control, and shouldn't mess with your cycle. However, certain prescription and OTC medications can affect your menstrual cycle, including non-steroidal anti-inflammatory drugs (NSAIDs, such as Advil), blood-thinning medications, and thyroid medicines, according to the University of Michigan Health System. If you've been taking any of these medications (or any new ones) during quarantine, they could play a role.

How does birth control factor in?

It's also essential to understand how different methods of contraception can affect your cycle. "If you're on birth control pills, in general, stress should not affect your system: birth control pills shut down the regular ovulation processes and provide you with external estrogen and progesterone which then controls your cycle," explains Dr. Minkin.

If you have a progestin-coated IUD (ex: the Mirena), you may not be having periods as a side effect from the IUD itself, which helps to prevent the thickening of the lining of the uterus—and so you will likely not bleed much, she says. "With the copper-coated IUD, you certainly can have the same irregularities that women without an IUD would," she says.

What to Do If Your Cycle Is Weird Right Now

When your cycle is all over the place, you shouldn't rule out pregnancy, nor should you assume you can't get pregnant. (FYI, changes in your menstrual cycle make the cycle-tracking method of birth control especially risky, in this case.)

"If you're having erratic periods and at risk for pregnancy, use birth control [e.g. condoms]," says Dr. Minkin. "With the erratic periods that women may be having, it would be a good idea to have some home pregnancy tests on hand as well. The most sensitive test available is the First Response home pregnancy test kit, which will detect a pregnancy as early as six days before the first day of the missed period," she says.

To ease your mind, Dr. Minkin has one take-home message: "Try not to worry too much, and if you're concerned about anything else which could be altering your cycles, do contact your health-care provider. They can discuss it all with you, and order any blood tests to check hormone levels, if needed. Doctors are well equipped to intervene if your irregular cycles are really bothersome." All via telemedicine, of course.

The information in this story is accurate as of press time. As updates about coronavirus COVID-19 continue to evolve, it’s possible that some information and recommendations in this story have changed since initial publication. We encourage you to check in regularly with resources such as the CDC, the WHO, and your local public health department for the most up-to-date data and recommendations.

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