Personal Q: Has your period been weird lately? Maybe your cycle’s been longer? Your flow heavier—or lighter? The intensity of your PMS had an inverse negative correlation to the intensity of your positive reaction to Harry’s Style’s “Watermelon Sugar” video? If you’ve answered an “OMG, now that you mention it, yes!” you’re not alone. And, no, we’re not all suffering from some kind of collective Dalgona-coffee induced delusion: The pandemic really is funking up our menses.
“It’s totally legit,” confirms Dr. Fiona Mattatall, a Calgary-based obgyn who talks about periods all day, every day. “I’m seeing it with my patients, and I’m seeing it in my own house.” People who menstruate are coming into her clinic with a litany of changes to their cycles: The pattern of bleeding changing, either more frequently or further apart, which goes “hand-in-hand” with changes in volume (“the mother of all periods” if you go longer between bleeds, lighter flow if they’re happening more often); increased pain before or during periods; more intense fluctuations in mood.
“And when I thought about what was causing these three things, I realized there’s a lot of overlap,” she says. “When you think of all the ways a pandemic could be impacting periods, outside of all the usual things that could be happening in the background, they all lead back to an area of the brain called the hypothalamus.”
It’s all in your head
Yes, she said the brain, not the ovaries, the fallopian tubes or any other part of the anatomy your gym teacher glossed over back in sex ed. “I don’t think a lot of people know that our periods begin in our brains,” Dr. Mattatal explains. Basically: The hypothalamus, a very small region of the brain with outsized, if somewhat mysterious, influence, is constantly taking in information about our body—our blood pressure, our food intake, our stress levels, how much we’re sleeping—and also the environment we’re in. Using this info, the hypothalamus gives instructions to our nervous system. When it comes to our periods, the orders that really matter are the ones it gives to the pituitary, the pea-sized gland between our eyes that regulates our hormones. They’re the ovaries’ boss, telling them how/when to make hormones, and whether they’ll be releasing an egg that cycle. The hormones created by the ovaries then dictate the plan for the uterus, the building and subsequent shedding of the lining that is, at the end of all this, your period.
Why have we just made you complete this intro module in human reproduction? Because understanding the role of the hypothalamus is key to understanding why the pandemic is making your period weird.
Blame it on quarantine life
“The information that the hypothalamus takes in is all things that are likely changing in our lives now,” says Dr. Mattatal, pointing to changes in her own eating habits (“I’m going to comfort food”), physical activity (“I used to go to the gym but that’s closed now”) and stress, a known cause of skipped periods. “I’ve had patients come to my clinic who haven’t had a period in months, and then it turns out that a parent died, or they lost a job,” she says.
A jacked-up sleep situation often accompanies stress (hello, 3 a.m. fear, my old friend), and Mattatal says a lack of proper rest has also been associated with irregular cycles. Essentially: The information we’re feeding our hypothalamus is suddenly different, and, it’s reacting to that, well, poorly.
Disruption is a total pain
If your monthly period pains feel like they’ve ratcheted up from the normal “rusty razor blades in your abdomen” cramps to “the Devil himself sawing you in half with a blunt machete,” you might be able to blame it on your disrupted routine. Exercise, for instance, is a great treatment for painful periods, but if you haven’t been able to hit the spin bike or swim those laps, you might be noticing more discomfort this month. Same goes for that banana bread you’ve gotten so good at: Mattatall cites studies that suggest high-sugar, high-fat foods have been associated with more painful periods, while eating high-fibre, low simple-sugar foods have the opposite effect. “I’ve always found that ironic,” she says, “because that’s not what I crave when I’m on my period. I want Nutella!”
It’s also worth noting that the pandemic has led to increased food insecurity, which makes access to healthier choices much more difficult. It’s also meant that it can be harder to access pain relief drugs or prescriptions like birth control, which are often used to treat bad cramps.
All of this uncertainty could also be making your usual hormonal mood swings worse, even though, weirdly, remembering that your “sky is falling” feeling is just Day 26 being Day 26 can make you feel so much better about things. “Remember that it’s your physiology, it’s what’s going on hormonally in a pandemic,” says Dr. Mattatal. “Give yourself permission to have a bad day.”
Read this next: I Donated My Eggs Because I Was Sure I Wouldn’t Use Them
When you should talk to your doc
For most of us, our periods will eventually go back to “normal,” whatever that looked like for us. (A reminder! The “28 day cycle” thing is only an average, and if you’re younger than 20 or older than 50, irregularity isn’t unusual.) For now, consider keeping notes or tracking your period on a calendar. Dr. Mattatal says it’s cool to call your doctor if you’re even a tiny bit worried, and most consults about periods can be done virtually, although they may ask you to come in for an exam or blood tests after you’ve had an initial conversation.
She does say, however, that there are two particular triggers that definitely warrant further investigation, sooner rather than later: 1) If your period gets really heavy, which she measures by filling a super-absorbent tampon or overnight pad in two hours, or you have consistent heavy bleeding that makes you lightheaded or really fatigued; 2) if you’re someone who used to have regular periods but you’ve now gone six months without one. “If you get to the fall of this year and you haven’t had a period, it might be time to get that checked out,” she says. “If you’re 50, it might menopause. If you’re 24, there might be something else going on hormonally—or you could be pregnant!”
Speaking of procreating: If you’re someone who uses cycle tracking as your method of contraception, Dr. Mattatall suggests that this might not be the best time for that: “If you’re not having your usual pattern, ovulation might happen when you don’t expect it,” which could result in an unplanned pregnancy. “Stock up on condoms for the next few months.”