Review on stress-induced menstrual disorders

Stress, encompassing emotional, nutritional, or physical dimensions, significantly influences the menstrual cycle by disrupting hormonal balance. Elevated stress levels lead to increased secretion of cortisol and endorphins, which can interfere with the production of hormones regulating menstruation. This disruption may result in menstrual irregularities, such as changes in cycle length, flow, or the occurrence of dysmenorrhea (painful periods). Research indicates a strong association between high stress levels and menstrual disturbances. For instance, a study found that women experiencing high stress were more likely to report changes in menstrual duration. Similarly, another study observed that elevated stress levels were linked to irregular menstruation and menorrhagia (heavy menstrual bleeding). The underlying mechanism connecting stress to menstrual irregularities involves the hypothalamic-pituitary-gonadal (HPG) axis. Chronic stress can lead to the deactivation of the HPG axis, resulting in conditions like oligomenorrhea (infrequent menstruation) and secondary amenorrhea (absence of menstruation). This deactivation disrupts the pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus, leading to altered secretion patterns of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. Consequently, ovarian follicles may fail to develop properly, leading to insufficient estrogen production and anovulation (lack of ovulation). Additionally, workplace stress has been identified as a contributing factor to menstrual dysfunction. Women in high-stress jobs have reported both shorter and longer menstrual cycles compared to those in less stressful occupations. This association underscores the impact of occupational stress on reproductive health.