Stress can make periods painful, irregular or extremely heavy. Mary-Claire Mason offers practical tips and advice in her book Coping Successfully With Period Problems

The first thing to ask yourself is whether or not stress could be responsible for your period problems or making them worse. Recognising that you're stressed is the first step towards doing something about it.

Taking action
You may be vaguely aware that you're having more problems than normal coping with the world, but spotting the signs and symptoms of stress isn't easy - especially when you're all knotted up. Sometimes it's easier to spot if, for instance, you've suffered a bereavement. Making a connection between the bereavement and how you're feeling and behaving is usually pretty clear-cut. Stress can be harder to spot, though, especially when it's become long-term and you're so stressed that you can't recognise it any more because it is your normal state.

Keeping a diary of how you're behaving and your mental and physical symptoms for a couple of weeks should provide clues to your stress levels. Identifying what may be causing you problems is the next step. Are you exhausted by work and family pressures, do you feel stuck? Can you do anything about the problems you've identified? Can you get more help at home if you're struggling to cope with the demands of a family and a job? Unpicking what you can do about the problem isn't always obvious. When it comes to stress, there's a useful saying: you should change those things you can and accept those things you can't. Just recognising you're under stress can also help you to destress!

Your approach to life
Change is an important cause of stress and some of us are better at dealing with it and more resilient to it than others. Dealing with several changes at once only adds to the problem. Change is a part of life, but the pace of change is getting faster and dealing with the adjustments that change requires can be very stressful for some people. There's a long list of stress-inducing life events. Some of those are the death of a partner, divorce, separation, illness, marriage, pregnancy, being made redundant and gaining a new member in the family.

There aren't necessarily any quick-fix solutions to any of these sources of stress, but it's true that time is a great healer. Allowing yourself the space and time you need to adjust and being kind to yourself meanwhile will help.

• Time management is important as it will help to reduce and defuse stress. Prioritise jobs and cut things down to size, breaking up big tasks.
• Keep a narrow focus and don't let yourself be distracted by other thoughts. If you're stressed, you'll find this particularly hard to do, but it means you'll get the job done and that will make you feel better.
• Pace yourself. If something happens that upsets you, allow yourself time to reflect before jumping in straight away with an angry response as this will fire up the stress response.
• Take a break when you feel you're banging your head against a brick wall or that you're about to blow up. If you can, go for a brisk walk and make an effort to notice what's going on around you as this will widen your horizons. You'll burn off the stress hormones and get your circulation going - all of which should help put life back into perspective again.
• Changing how you behave will be a bit stressful, so don't expect it to be plain sailing. Start with realistic aims and expect to feel a bit uncomfortable as you alter familiar ways of doing things.
• Setbacks are normal and not a reason to abandon whatever you're trying to change. Start afresh the following day. Give yourself treats from time to time as a pat on the back!
• Get on with things instead of getting stuck and worrying endlessly about what could go wrong.
• Try something new, even if it seems a tiny thing - doing your normal walking route the other way round, for instance - will help you build your confidence.
• Positive thinking will help you to stay cheerful and reduce your anxiety (No More Anxiety: Be Your Own Anxiety Coach by Gladeana McMahon, Karnac, 2005, is a useful book on the subject). Stressed people usually think very negatively about themselves and the works and these thoughts are usually inaccurate, so challenge them. For instance, the next time you write yourself off, saying, 'I'm a total failure', ask what the evidence for that statement is. You'll find you fail at particular things but not everything!

Mary-Claire Mason's book Coping Successfully With Period Problems is published by Sheldon Press and costs £7.99.