Health
More than five years post the emergence of the SARS-CoV-2 virus, ongoing research continues to unveil the complexities surrounding its long-term effects. Recent studies indicate that long COVID may significantly impact menstrual cycles.
By Carissa Wong
Menstrual planning can become problematic when long COVID extends its duration.
SeventyFour Images / Alamy
Long COVID is reported to disturb the menstrual cycle, resulting in heavier and prolonged periods. This alteration is thought to arise from persistent COVID-19-related complications that can modify hormone levels and induce inflammation.
The precise origins of long COVID remain ambiguous; theories proposed include the possibility of the virus residing at low levels in the body, a misfiring immune response, or disruptions within the gut microbiome.
Commonly observed symptoms of long COVID encompass fatigue and cognitive difficulties, with earlier studies indicating a correlation with menstrual cycle inconsistencies. However, these inquiries have often overlooked the precise changes in menstruation and whether these may occur independently of COVID-19 infection, or if they stem from transient infections.
To bridge this knowledge gap, Dr. Jacqueline Maybin and her team at the University of Edinburgh, UK, enlisted over 12,000 women to fill out a survey concerning their reproductive health during the period spanning March to June 2021.
Of these participants, more than 9000 had never contracted COVID-19, identified by negative tests or lack of associated symptoms like loss of taste or a persistent cough. Approximately 1700 women reported experiencing acute COVID-19, resolving in under one month; the remaining 1000 had symptoms persisting beyond one month, indicative of long COVID.
Findings revealed that more than half of the women suffering from long COVID reported heavier menstrual flows than usual. In contrast, about 40% of those who experienced acute COVID-19 and 35% of those without a known infection noted similar issues.
Furthermore, long COVID was significantly associated with periods lasting over eight days. In contrast, acute COVID-19 didn’t appear to influence the length of menstruation, indicating that specific physiological changes tied to long COVID are likely responsible for these alterations, distinct from the initial infection.
To investigate the underlying mechanisms, researchers examined blood samples collected from 10 women experiencing long COVID and 40 women who donated blood prior to the pandemic, spanning the menstrual cycle.
The analysis discovered that women with long COVID exhibited elevated levels of a hormone known as 5α-dihydrotestosterone, which has been associated with irregular menstrual patterns in the latter half of their menstrual cycle. Additionally, there was a correlation between long COVID and increased levels of cytokines—signaling molecules of inflammation—within both bloodstreams and uterine biopsies.
These findings imply that long COVID could instigate hormonal and immune responses that disrupt normal menstrual functioning; however, additional research is warranted to fully elucidate these mechanisms, states Maybin.
Moreover, the study noted that women suffering from long COVID reported heightened symptoms—such as dizziness, fatigue, and muscle pain—during and just prior to their menstrual periods, while symptoms like nausea, headaches, and respiratory issues intensified during the post-menstruation phase leading up to ovulation. Dr. Maybin explains, “This suggests that ovarian hormones might actually be amplifying the severity of some symptoms.”
Nevertheless, the study primarily involved white women from the UK, a high-income nation, suggesting that further research is essential to determine the applicability of these findings across diverse demographics.
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