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Corona periods...menstruation lockdown...



Getting a regular menstrual cycle or period, is an important indicator of a healthy reproductive system for many women of reproductive age (Godari Akhila et al., 2020). For those of us with PCOS missing periods is nothing new. In fact, one of the defining signs of PCOS is having periods less regularly, more or less than monthly or having no periods at all. Most women without PCOS or other conditions, usually have a period every 28 days give or take a few days. Recently, however, some women have related how their periods have been disrupted since the beginning of lockdown despite testing negative on pregnancy tests. So, what has changed?


There are several reasons why someone may miss their period including pregnancy, stress, sudden weight loss, having overweight, excessive exercise, the pill, menopause and of course PCOS and some other medical conditions. Thus, it is important to speak to your GP or healthcare provider to rule these out. Given the lockdown and increased levels of anxiety it is possible that stress is one reason that we have seen this change. (Stopped or missed periods - NHS, n.d.)


Undoubtedly, the lockdown has caused tremendous upheaval to our lives. Many of us have experienced physical isolation, restricted food availability, an increase in sedentary behaviours, and increased psychological stress. The unpredictability of the spread of the coronavirus has increased concern for those we know working on the frontline or with other health conditions who are at high risk and all of this has contributed to heightened levels of anxiety and stress.


Stress can impact your cycles by making them longer, shorter, more painful or it may make them stop altogether. Stress is a common cause of hypothalamic amenorrhoea as the menstrual cycle relies on remarkable co-ordination between the hypothalamus, pituitary and ovaries, which make up the reproductive axis (Xiao & Ferin, 1997). The mechanism that links stress with menstrual function occurs along the dysregulation of the body’s stress responses, along the hypothalamic-pituitary-adrenal axis. Once disrupted maintenance of regular menstrual function stops for some time and is dependent upon the continuation of the initial stressful event (Godari Akhila et al., 2020).


Given the indeterminate impact of covid19 on our lives, it is vitally important that all of us, and especially those with PCOS, try to minimise stress. So, how can we do this? Firstly, Mindfulness and meditation have been shown to be an effective way to reduce cortisol (Pascoe et al., 2017). There are many apps that can help. Check out covid19.orcha.co.uk for a selection of health and wellbeing apps.


Secondly, keep moving and reduce your sitting time. Low levels of physical activity are strongly associated with irregular periods (Godari Akhila et al., 2020). Furthermore, positive associations have been found between self-reported physical activity levels and improved mental health in women with PCOS (Stepto et al., 2019). Try to incorporate activities into your daily routine. Experiment with different types of activities that you can do indoors, at home or in your local area in line with government restrictions.


Thirdly, well-rounded nutrition is also important for the menstrual cycle, so try to ensure (where possible), that you have adequate protein, wholegrain carbs, good fats (from fish, nuts and avocados), plenty of vegetables and limit added sugar and sweeteners or sugary drinks. (Huhmann, 2020). Also, make sure not to skip breakfast, the most important meal of the day, as this is not only beneficial to your menstrual cycle but also your mood (Ak, 2018).


Finally, we cannot stress how important it is to consult your GP if you are not pregnant – had a negative pregnancy test and have missed more than 3 periods in a row - especially if you have PCOS you must get this checked out due to the increased risk of endometrial cancer. If you are sexually active and haven’t taken a pregnancy test yet, your GP will probably advise you to take one to rule this out first. (Stopped or missed periods - NHS, n.d.). If you need to connect with others with PCOS at this unprecedented time, do feel free to get in touch with us via any of our socials or join our Facebook Peer Support Group which is a very friendly and supportive environment and much needed at this moment in time. Most of all, stay safe, from all of us at PCOS Vitality.

© PCOS Vitality, 2020

NOT MEDICAL ADVICE, PCOS VITALITY DOES NOT RECOMMEND ANY PARTICULAR COURSE OF ACTION. ALL INFORMATION PROVIDED IN GOOD FAITH.

References

Ak, M. (2018). Skipping Breakfast Everyday Keeps Well-being Away. J Food Sci Nutr Res, 1(1), 18–030. https://doi.org/10.26502/jfsnr.2642-1100003

Godari Akhila, Asra Shaik, & R. Dinesh Kumar. (2020). Current factors affecting the menstrual cycle. International Journal of Research in Hospital and Clinical Pharmacy, 2(1), 18–21. https://doi.org/10.33974/ijrhcp.v2i1.165

Huhmann, K. (2020). Menses Requires Energy: A Review of How Disordered Eating, Excessive Exercise, and High Stress Lead to Menstrual Irregularities. In Clinical Therapeutics (Vol. 42, Issue 3, pp. 401–407). Excerpta Medica Inc. https://doi.org/10.1016/j.clinthera.2020.01.016

Pascoe, M. C., Thompson, D. R., Jenkins, Z. M., & Ski, C. F. (2017). Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. Journal of Psychiatric Research, 95(September), 156–178. https://doi.org/10.1016/j.jpsychires.2017.08.004

Stepto, N. K., Patten, R. K., Tassone, E. C., Misso, M. L., Brennan, L., Boyle, J., Boyle, R. A., Harrison, C. L., Hirschberg, A. L., Marsh, K., Moreno-Asso, A., Redman, L., Thondan, M., Wijeyaratne, C., Teede, H. J., & Moran, L. J. (2019). Exercise Recommendations for Women with Polycystic Ovary Syndrome: Is the Evidence Enough? Sports Medicine, 49(8), 1143–1157. https://doi.org/10.1007/s40279-019-01133-6

Stopped or missed periods - NHS. (n.d.). Retrieved May 16, 2020, from https://www.nhs.uk/conditions/stopped-or-missed-periods/

Xiao, E., & Ferin, M. (1997). Stress-related disturbances of the menstrual cycle. In Annals of Medicine (Vol. 29, Issue 3, pp. 215–219). Informa Healthcare. https://doi.org/10.3109/07853899708999339

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