Every aspect of our lives is impacted by our changing climate and environment, including menstruation. And not all are affected equally.
Whilst everyone’s experience is unique, those with heightened sensitivity are likely to be among the hardest hit by environmental impacts on their periods. Premenstrual Dysphoric Disorder (PMDD), which is estimated to affect 1.6% of women, is characterised by extreme reactions to normal hormone fluctuations and could lead to greater negative impacts on their experience of menstruation than for women in general.
Given the chronic underfunding of women’s health research, it’s unsurprising that there’s limited evidence available on how periods are affected by climate change and wider environmental issues. However, a possible picture can be pieced together to indicate how PMDD, and to a lesser extent pre-menstrual syndrome (PMS), may be impacted by climate change.
Exacerbated symptoms
Climate change is increasing the frequency and severity of heatwaves in the UK. In fact, the UK is particularly vulnerable to increasing temperatures and predictions suggest summer temperatures and extreme hot days in the UK could rise up to 50% faster than the global average. Heat worsens PMDD and PMS symptoms by intensifying stress, sleep disturbances, and fatigue. Heat is especially challenging for women in perimenopause or menopause, which is often more difficult for women with PMDD anyway. Premenstrual disorders are associated with increased risk of early menopause and more severe experiences of hot flashes and night sweats. And while most people associate hot flashes with menopause, they can occur as part of the menstrual cycle at any age.
Common PMDD and PMS treatments are also impacted by heat. Early research shows that the contraceptive pill, which some women find can ease their symptoms, may become less effective when exposed to prolonged heat. And SSRIs – the anti-depressant and anti-anxiety medications frequently prescribed for PMDD – can increase sweating and the risk of dehydration during heatwaves.
Air pollution has been linked to worse period pains and to mood swings. Women living in areas with higher air pollution levels report higher PMS rates, and even short-term exposure to some pollutants is associated with an increased risk of outpatient-visits for menstrual disorders, particularly among 18–29 year olds. Across the general population, air pollution is also linked to a 39% increase of common metal health disorders, a 32% increase community-based treatment needs, and an 18% rise in hospital admissions with mental health issues.
Climate change makes extreme weather like floods, storms, and heatwaves more likely. While emergency responses often address the physical aspects of menstruation during natural disasters, the emotional toll on specific groups, including women with PMDD, is rarely discussed.
Less cycle predictability and regularity
Eco-anxiety, heat stress, and financial pressures from climate-related disasters can heighten stress levels. Stress is a known disruptor of menstrual health, particularly for women living with PMDD because the condition increases reactions to stress in the luteal phase (late cycle). More widely, studies show that increased stress in the early cycle can heighten pre-menstrual symptoms for up to two subsequent cycles.
Air pollution also impacts menstrual regularity. This is especially challenging for women living with PMDD, as predictable cycles are crucial for managing their lives around symptoms. Pollutants disrupt the follicular phase, ovulation and menstrual regularity. Even exposure to air pollution before puberty can cause irregularities when periods begin.
Independent of climate change, menstrual cycles can naturally be 0.9 days shorter during summer due to increased hormone secretion and greater frequency of ovulation in warmer weather. How climate change might amplify this trend remains unknown.
Pollution and menarche
Exposure to pollution can affect when girls’ periods start (menarche). Chemicals like lead, polychlorinated biphenyls (PBCs), and polychlorinated diphenyl ether flame retardants are linked to delayed menarche, while other endocrine disrupting chemicals (EDCs), pollutants like the herbicide atrazine and some air pollutants are associated with early menarche.
Unknown vulnerabilities of hormone sensitivity
As potential environmental impacts on menstruation and hormone health are under researched, there are significant gaps in our understanding of risks. For example, we know that endocrine disrupting chemicals are found in everyday items like toiletries, cleaning products, non-stick pans and even menstrual products; and research shows impacts including hormone related cancers. However we do not know whether women with heightened sensitivity to hormones – such as women living with PMDD - might be more vulnerable.
Similarly, hormones from the contraceptive pill are known to be prevalent in our waterways and drinking water. The impact on humans is unclear, however such pollution is linked to hormone disruption in fish. This leaves unanswered questions about whether people in general, or women, or specifically women with heightened sensitivity to hormones might be affected.
Nature can ease symptoms
Not all environmental impacts are negative. Access to nature offers a broad range of benefits for physical and mental health. Research shows that stress levels decrease as green space increases in a neighbourhood. Visits to green spaces and even views of greenery are strong predictors of general health; and biodiverse areas offer the greatest mental health benefits. Nature even has the power to reduce our stress hormones and lower anxiety, for example via invisible chemicals (called phytoncides) emitted by some trees. Women in greener neighbourhoods experience fewer symptoms of PMS. Access to nature may be particularly beneficial for women with PMDD - although this has not been researched. PMDD often co-occurs with ADHD, and green spaces have been shown to reduce both ADHD risk and symptoms.
What women can do to keep themselves safe and well
While it’s premature to be alarmed by the impact of climate change on menstruation, or on PMDD in particular, evidence supports reducing exposure to air pollution, endocrine disrupting chemicals, and extreme heat. Simple actions like walking on the side of the pavement furthest from road traffic air pollution and using sustainable period products can help. More broadly, women can continue to advocate for deeper research into women’s health issues, including environmental impacts on periods and on PMDD.
If you’d like to work with me to explore the links between the work of your charity or funding body and environmental issues, then please take a look at my services and get in touch.
