Dear Alice,

I know that some women do get fevers as a part of their period, but is it normal to get high fevers? I have never had a problem with my period before, but the last two periods have had me chilled, feverish, and with a temperature of up to 102 degrees Fahrenheit, I couldn't even go to work or anything for like a week. I don't use tampons, and I'm not sexually active. I am in pretty good shape. Please tell me I won't have to take a week off of my life every month from now on because of these awful fevers. Is there anything I can do?

Dear Reader,

Feeling like a hot mess during your period is no fun. A fever is a symptom that can be caused by a variety of illnesses. It most commonly accompanies a viral infection, but can also be caused by numerous other things: bacteria, fungus, drugs, toxins, heat exposure, cancer, injuries to the brain, or diseases of the endocrine system. Sometimes it is difficult to find the source of a fever, which can leave anyone feeling hot and bothered.

Have you been more stressed than usual lately? It is widely believed that stress can suppress immune function and increase susceptibility to disease. Researchers have found that during the menstrual cycle, women are more liable to immune system related diseases during the luteal (21-23rd days) phase. Other studies carried out in women have demonstrated that hormonal alterations during different phases of the menstrual cycle affected stress response and immune system function.

Since you don’t use tampons, toxic shock syndrome (TSS) is probably not the cause of your fever. TSS is an extremely rare condition linked with tampon use. TSS symptoms include a rash that is similar to a sunburn that develops with a fever of 102 degrees Fahrenheit or higher, as well as headache, muscle aches, sore throat, vomiting, diarrhea, stomach cramps, profound weakness, confusion, and signs of shock.

If you have been sexually active in the past, pelvic inflammatory disease (PID) can be a possible culprit, which can be caused by a sexually transmitted infection (STI). However, STIs are only one cause of PID. It can also be caused by regular bacteria in the vagina. During your period, bacteria can travel up the vagina and into the uterus and fallopian tubes, causing infection. This can occur at any time during the menstrual cycle, but is more common during menstruation. Common PID symptoms besides lower abdominal pain include fever, unusual vaginal discharge that may have a foul odor, painful intercourse, painful urination, irregular menstrual bleeding, and pain in the right upper abdomen (rare). If you have any of these other symptoms, see a health care provider.

Another (unlikely) possibility is Familial Mediterranean fever (FMF), which is a very rare hereditary disorder that involves repeated fevers and inflammation. FMF is a disorder that affects groups of people who originate from around the Mediterranean Sea. FMF is most often caused by a gene mutation that creates proteins involved in inflammation. The disorder is characterized by episodic attacks of fever accompanied by abdominal inflammation, arthritis, lung/chest inflammation, and/or skin rash. Many patients are normal between attacks, which can be followed by weeks, months, or even years of remissions. Attacks can sometimes be precipitated by cold, trauma, or menstruation, and there are case reports of FMF attacks in association with menstruation bleeding.

While stress, TSS, PID, or FMF could be the cause of a fever associated with your period, you may want to speak with a health care provider to find out more about what’s going on with your body so you don’t have to take a week off work every month.

Good luck outrunning your fever!


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