Dr. Beth Schwartz says she’s recently received questions from her patients on spotting and bleeding, as well as early, late and skipped periods.

Dr. Beth Schwartz, a gynecologist at Jefferson, wants you to know that you’re not alone if you’re feeling overwhelmed with stress during these unprecedented times and that stress could be affecting your period. “We see this happen with people who are newly diagnosed with diabetes or cancer, or put into other abruptly stressful situations” she explains. “Changes in periods can also come on when there’s a change in your routine, exercise patterns and eating habits.”

We spoke with Dr. Schwartz on how the stress of the coronavirus could be affecting menstrual cycles, and what to do if you’re experiencing irregular symptoms.

Could women be experiencing stress periods right now? Even on birth control?

If someone is experiencing sudden stress in their lives and disruptions to their routines, yes, that can absolutely bring on changes in their periods. It can also sometimes happen even if you’re on birth control, although theoretically, something like the pill has taken over your ovaries and hormones. But I hear it all the time and I think it’s especially possible when the dosage of the pill or other methods is very low.

Are there other factors that could be at play? Besides stress?

I think it’s a combination of stress and the upheaval of everyone’s normal routines. People are suddenly taking their pills at different times because they not on a regular schedule anymore. People are also changing their eating and activity habits. All of those things are at play and can affect your hormones.

Taking the pill at odd times could also be the reason why someone is experiencing spotting then too?

It’s important to remember that the pill is more effective if you take it at the same time every day. Does it matter if you’re an hour off your normal time? No. But the problem is that when some people don’t take it at their normal time, they don’t remember to take it at all. Now’s a good time to set an alarm on your phone if you don’t already to remind you to take your pill at the same time.

If you’re holed up with your partner, having more sex, having unprotected sex, there is an increased risk for pregnancy if you do not stay consistent with your birth control. If you’re spotting or miss a period, taking a pregnancy test is a good idea. On the flip side, because of the increase of stress, if you’re trying to get pregnant right now, it could make that more difficult.

What about if you have an IUD?

A stress-induced period is certainly possible if you have an IUD. When you have an IUD, your ovaries are not being controlled in the way that the pill or shot controls and suppresses ovarian activity. It makes even more sense in that scenario that there could be fluctuations in hormones or ovarian function.

Can irregular or stress periods be dangerous? Or just a temporary nuisance?

First of all, you should always let your doctor know if you any questions or experience any changes with your health. I don’t get too worried about things that happen one time, but if someone’s periods continue to be irregular, then they need an evaluation. Doctors’ offices may not be open in the same way they were before, but you can still reach out by phone or patient portal. My office is answering portal questions rapidly and doing a ton of telehealth visits. [Read more about telehealth services during the coronavirus pandemic here.]

I always tell people that if I don’t hear from you, I can’t help you. If there’s something that isn’t going well, I want to know about it so I can either reassure you or intervene, but I can’t do that if I don’t know what’s going on.

If you’re experiencing irregular bleeding on the pill, you should stop bleeding on day one or two after your placebo pill week. If bleeding doesn’t stop, then let your doctor know. The same goes for if you’re experience really heavy bleeding for more than one to two days—like soaking through a super pad or tampon in less than an hour. Feeling lightheaded or dizzy, chest pain, feeling like your heart is beating very quickly, or getting out of breath much easier than normal could be signs of anemia. These are all things you need to tell your doctor right away so they can rule out anything more serious or dangerous.