Can Depression Make Your Period Late?

How your emotional health can affect your menstrual cycle

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There are many reasons a woman's period may be late or her cycle may go off schedule. An obvious one is pregnancy. Others include poor nutrition, excessive exercise, and long-term illness. A not-so-obvious one is depression.

This makes sense when you think about it. Nature does everything it can to create favorable conditions for reproduction. If a woman is chronically stressed, anxious, sad, upset, she's really not in a physical or emotional position to go through a pregnancy and then take care of and nurture a child.

Under these less-than-ideal conditions, the female reproductive system can shut down.

How Depression Affects the Menstrual Cycle

A stress hormone called cortisol is primarily responsible for changes in a woman's cycle when she's depressed. As cortisol levels rise in response to stress, the hypothalamus, an organ in the brain that plays an important part in regulating the reproductive system, stops sending the go-ahead to the ovaries to do their job. Without this signal, ovulation (the monthly release of an egg from the ovary) is either delayed or stops altogether.

The result: a late period—or even sometimes no period at all. The medical term for absent periods when there's no pregnancy is amenorrhea, which also can be caused by health issues other than stress, including problems with the hypothalamus, the pituitary glands, the ovaries, the uterus, or the vagina.

Pinpointing the Cause When You Skip a Period

Of course, the first thing you should do if your period is late is to take a pregnancy test, which can be accurate as early as the first day of your missed period.

If it's negative and you don't get your period in a few days or you completely skip it that cycle, or if you're having chronic problems with menstruation, make an appointment to see your gynecologist. She'll likely do a repeat pregnancy test; if it's negative, she'll move on to some basic evaluations—ask you about your medical history; do a pelvic exam; and take blood samples to check your hormone levels.

Depending on what these preliminary tests reveal, plus other basic factors such as your age, she may move on to more specific diagnostic methods, which may include:

  • Genetic testing to see if you have fragile X syndrome
  • Chromosome evaluation to look for chromosomal variations such as Turner syndrome
  • An ultrasound computed tomography (CT) scan or magnetic resonance imaging (MRI) scan to make sure your reproductive organs are normal
  • An MRI to check for a pituitary tumor
  • A hysteroscopy to examine the inside of your uterus

Is Depression the Problem?

Amenorrhea caused by chronic stress and depression is called hypothalamic amenorrhea. If you tend to eat more or less than usual when you're depressed and have gained or lost weight, that also could play a part in your menstrual irregularities.

Once your doctor has determined that depression is behind your late or missed periods, getting back on track will be a matter of finding an effective way to reduce your stress and treat your depression. A antidepressant, such as Prozac (fluoxetine) or Zoloft (sertraline), is an effective way to relieve symptoms. Stress-lowering activities, such as yoga, meditation, and light exercise also can help you get back to feeling normal and your body back to functioning normally.

Source:

National Institutes of Health. "Amenorrhea." May 7, 2013. 

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