Chronic psychological and physical stress is a major contributor to menstrual disturbances in women of reproductive age. This review aims to synthesize current evidence on the mechanisms, clinical implications, and management of stress-related menstrual dysfunction, with particular focus on hypothalamic suppression. Methods included comprehensive evaluation of observational studies, clinical trials, and experimental research addressing neuroendocrine, metabolic, and behavioral pathways affected by prolonged stress, energy deficiency, and intensive physical activity. Findings indicate that chronic stress disrupts hormonal regulation by inhibiting gonadotropin secretion and impairing ovarian function, leading to reduced estrogen production and anovulation. Energy deficiency and excessive physical exertion exacerbate these effects, resulting in prolonged hypoestrogenism, impaired fertility, and decreased bone mineral density. Women affected may present with normal body weight, complicating early detection and diagnosis. Multidisciplinary management strategies, including lifestyle modification, nutritional support, moderated physical activity, and psychological interventions, have been shown to restore menstrual function and mitigate long-term complications. In selected cases, pharmacological interventions may be necessary to preserve bone health and support reproductive outcomes. Overall, stress-induced menstrual disorders result from a complex interplay between psychological, metabolic, and physical factors, requiring individualized assessment and treatment. Early identification and intervention are essential to prevent chronic health consequences, optimize reproductive potential, and maintain overall well-being. The review highlights gaps in understanding of individual susceptibility, recovery timelines, and long-term metabolic and cognitive outcomes, emphasizing the need for further research to develop targeted preventive and therapeutic strategies for women at risk of stress-related menstrual dysfunction.
Wiśniewska et al. (2026) studied this question.