The pandemic (also) influences menstrual cycles

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This feeling that the back has suddenly aged ten years. Cramps. The sudden urge to cry, for no apparent reason. Fatigue, often. These symptoms, and more, are the monthly lot of many people with a uterus. Except that for the past year, the discomforts of premenstrual syndrome (PMS) – all the disorders preceding the onset of menstruation – such as those that persist during menstruation have intensified in some women. “I had strange symptoms like pain in the breasts, then cramps more intense than usual during the rules, and much longer flows,” says Paula *, 27, who says that “several friends are experiencing same thing”.

It does not take long to unearth other testimonies of this kind in his entourage, or on forums. In a recent article in the British daily The Guardian, we also discover that Dr. Anita Singh, gynecologist and creator of the podcast The Gynea Geek, launched an informal online survey to find out if women experienced any changes in their cycle or hormonal symptoms since the first lockdown. Of a total of 5677 respondents, 65% answered yes.

Stress and hormones

So what has happened in the past year for the period to be disrupted? First, stress, quite simply. Its level has only increased since the spring of 2020, as shown, among others, the Swiss Corona stress study conducted by the University of Basel. From 9% in April, the rate climbed to 18% in November.

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Regarding the disruption of the cycle due to stress, the explanation is biological. For menstruation to come “normally”, the “hormonal loop” must be complete. The hypothalamus, a brain gland, secretes a hormone (GnRH) that stimulates the pituitary gland, another gland. This in turn stimulates the ovaries which secrete estrogen and progestins. Depending on the level of hormones released, the endometrial wall thickens more or less, and if the ovary is not fertilized, the wall breaks off. “But for this to work smoothly, the secretion of GnRH has to be pulsatile. And this is where stress comes in, whether psychological or physical, by preventing this pulsatility. The cycle may then experience spacing, lengthening, or even the periods may not come, ”explains Dr. Martine Jacot-Guillarmod, assistant physician in child and adolescent gynecology at the Woman-mother-child Department of the CHUV. .

What about the development of cramps in recent months? “Period pain can be linked to lesions, diseases like endometriosis, but we cannot show that they are directly linked to stress. However, there is another category of so-called functional pains, the origins of which cannot be explained but which are sometimes due to muscle tension. And these tensions can result from stress, ”adds the specialist.

Cycle center

The women interviewed also speak of an intensification of their premenstrual syndrome (PMS). The latter is not the fact of all women, but can be very disabling when it manifests itself, in many forms: mood changes, depression, back pain, stomach ache, headache, etc. It can take a more severe form called premenstrual dysphoric disorder (PMDD) which involves psychiatric disorders. It is a hypersensitivity to the hormonal fluctuations of the cycle which would be responsible for this syndrome.

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“We do not yet fully understand what this hypersensitivity to hormonal changes consists of, in biological terms. It is a subject of research. There could be elements linked to genetics, but also questions of a more psychological nature (trauma, etc.), a series of elements that contribute to the development of these symptoms ”, explains Laura Symul, an engineer who has worked through the field. EPFL, now a researcher at Stanford University, where she examines period tracking applications to find out more about the menstrual cycle.

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“This cycle is central, continues Laura Symul, it is as if we were discovering it (to laugh). There are links between it, the immune system and mental health. It has also been proven that the risks of suicide attempts are higher during the premenstrual and menstrual periods. It is therefore not surprising that the current situation, stress etc., have an impact. ” But the young woman also says she is “ready to bet” that despite the tensions and uncertainties experienced this year, some women may have experienced positive effects on their cycle, due to the slowdown in rhythms linked to confinements, teleworking, etc.

Lifesaving teleworking

Exactly. Since everything is never completely white or black, the pandemic has paradoxically generated “benefits” in terms of menstruation. Thus, Tatiana * reports that “teleworking, to manage your period, is a dream. You can make yourself an herbal tea whenever you want, lie down if you are in pain… ”Kylie * happily mentions her hot water bottle that she could never take outside. As for Zainab *, she points to the comfort of being at home to “not have to go discreetly to the bathroom while hiding my towel”.

Does this mean that the “classic” world of work is not yet adapted to the monthly discomforts of women? “The institution of work is historically masculine, man is therefore thought of as neutral. The organization of time and space does not take into account the specificities of female bodily functions, ”says Aline Boeuf, who has devoted her thesis in sociology to this question at the University of Geneva.

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She spoke with several women in the spring of 2020. If those who have not resorted to teleworking do not report particular difficulties, the others have noted the difference. “But in general, it depends on the professions, the flexible working hours and the open-mindedness that reigns in companies. To get by, some postpone appointments, adapt their work according to their symptoms, details the researcher. It’s still complicated to talk about it other than in a medical way. I mentioned the menstrual holidays that take place in certain countries such as Zambia or Indonesia with my respondents; several told me they feared that this would be stigmatizing, instead of sick leave in the event of severe pain. However, teleworking can be thought of as a form of menstrual leave. ” Why not? At the time when these lines are being written, a survey of the French Opinion Institute (Ifop) for 20 minutes has just been published and shows that 68% of our neighbors in France say they are in favor of this type of leave.