How Long Does Stress Amenorrhea Last?
Stress amenorrhea consists of the absence of menstruation due to functional causes and is an increasingly frequent situation. It is estimated that almost 5% of women of childbearing age suffer from it. This percentage is increasing, in part, due to the lifestyle we assume today.
Stress plays a very important role in our body and has a great impact both physically and mentally. It alters the levels of certain hormones, such as cortisol and adrenaline, so it can influence many parts.
The menstrual cycle occurs thanks to a fairly sensitive hormonal balance. In this article we explain the mechanism by which stress amenorrhea occurs and how to deal with it.
Functional hypothalamic amenorrhea
Stress amenorrhea is actually a specific cause of functional hypothalamic amenorrhea. This name refers to an absence of menstruation caused by a non-structural alteration of the hypothalamus. The hypothalamus is a part of the brain that plays an important role in the hormonal system.
Stress amenorrhea can begin with one or more cycles without menstruation. It may even be that the cycles are increasingly irregular, even if there is slight bleeding. On some occasions, this situation subsides as soon as the stress disappears.
However, in many women it can be maintained for two or more years. This is because, in most of them, it is not a specific stressful situation, but is due to a general perception. In fact, many patients are not even aware that they are living in a stressful way.
Within functional hypothalamic amenorrhea we find two other main types, in addition to that caused by stress. They are those that are related to intense exercise and caused by weight loss. The problem is that these situations can and often are associated.
Why does stress amenorrhea happen?
Before explaining the mechanism of this pathology, it is important to note that it does not refer only to a stressful situation (such as an exam or a job). The concept of stress goes further.
It can be a permanent state of tension that, as we mentioned before, that person may not even perceive. Stress amenorrhea is also associated with conditions such as depression, anorexia nervosa, and bulimia.
What happens is that stress activates a hormonal pathway in the body. The result is increased levels of two hormones: cortisol and corticotropin-releasing hormone (HLC). These substances interfere with another hormonal pathway in charge of reproductive hormones.
In this way, cortisol and HLC inhibit the synthesis of gonadotropin-releasing hormone in the hypothalamus. The latter is part of that circuit by which normal menstrual cycles occur. When inhibited, both ovulation and menstruation are altered.
That is, for menstruation to occur, minimum levels of gonadotropin-releasing hormone are needed. When a woman undergoes stress, blood cortisol values increase, which inhibits the synthesis of the latter. Therefore, the cycle does not occur.
How can stress amenorrhea be fixed?
Stress amenorrhea, as we mentioned at the beginning, can last for years. It is more common in perfectionist women with high levels of self-demand. Also in those who have problems with eating.
It is a situation that, in the long run, affects a woman’s fertility. Not only that, it is also associated with an increased risk of osteoporosis and complications if they become pregnant.
Therefore, it is important to treat it and prevent the situation from continuing. It should be approached in a global way, since all aspects of that woman’s life can influence amenorrhea. For example, sports, diet, work, and your relationships with other people.
It is recommended to lead a healthy lifestyle, which includes moderate exercise and a balanced diet. In addition, you must take care of the quality of sleep and seek good emotional support.
A trial published in the journal Fertility and Sterility verified the effectiveness of cognitive behavioral therapy in reducing stress in women. It was successful, as amenorrhea was terminated in a considerable number of patients.
To keep in mind
What we must bear in mind is that stress amenorrhea is a common disorder that is due to a hormonal alteration. It can last for years and have an impact on fertility and overall female health.
Therefore, it is important to treat it and approach it with specialists correctly. Therapies that help manage stress can be tried. In addition, it is essential to make changes in lifestyle, with a full diet and moderate exercise.
