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How do stress-related brain signals sometimes affect menstruation?

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Detailed cross-sectional illustration of a human ovary showing the stages of follicle development, ovulation, and corpus luteum formation, with labeled structures including primordial, primary, secondary, and mature follicles, a ruptured follicle releasing an ovum, and corpus luteum and albicans. An inset at the bottom shows the ovary's location in the female reproductive system. — ovary The steps of ovulation, beginning with a dormant primordial follicle that grows and matures and is eventually released from the ovary into the fallopian tube.

Menstruation relies on an intricate hormonal balance between the hypothalamus, the pituitary gland, and the ovaries. The hypothalamus initiates this cycle by secreting gonadotropin-releasing hormone, which triggers the pituitary to release hormones that stimulate the ovaries to produce estrogen and progesterone.1

When an individual experiences significant emotional shock, anxiety, or fear, these stress-related signals can disrupt the normal function of the hypothalamus. Because the hypothalamus acts as the control center for this reproductive chain of events, such disturbances can lead to amenorrhea—the abnormal cessation or failure of menstrual cycles. Essentially, when stress interferes with the hypothalamic signals that regulate the pituitary and ovaries, the hormonal sequence required to maintain the menstrual cycle is interrupted.1