Women with long COVID may have longer, heavier periods, study finds

New research finds that long COVID may affect women’s menstrual cycles – and that their periods may in turn affect their long COVID symptoms.

Dr Jacqueline Maybin, one of the study’s authors, said that during the COVID-19 pandemic, she and other gynaecologists started hearing the same story from patients: after getting sick with COVID-19, women’s periods seemed to change.

The anecdotes “became so much that we couldn't ignore it,” Maybin, who is also a researcher at the University of Edinburgh’s Centre for Reproductive Health, told Euronews Health.

That prompted her team to survey about 12,000 women in the United Kingdom, including more than 1,000 with long COVID, about their menstrual cycles.

Women with long COVID reported longer, heavier periods and also experienced bleeding between periods, according to the study, which was published in the journal Nature Communications.

Meanwhile, those who had recovered from COVID-19 reported minimal disruptions to their periods.

The menstrual changes are significant because they can have knock-on effects on women’s health, Maybin said.

“Heavy menstrual bleeding is really common, and it is causing iron deficiency in reproductive-aged women,” Maybin said. “If long COVID is adding to that blood loss, then we really need prompt treatment for it”.

Iron deficiency causes fatigue, shortness of breath, and headache – shared symptoms with long COVID, creating a potential “compound effect,” Maybin said.

Notably, long COVID was not linked to impaired ovarian function, meaning it does not appear to affect women’s fertility.

How the menstrual cycle affects long COVID

To understand how periods may affect long COVID, the researchers asked a smaller group of women about their symptoms and analysed blood samples and endometrial tissue taken during menstruation.

They found that women’s long COVID symptoms ebbed and flowed throughout their menstrual cycles. Their symptoms worsened in the days just before their periods and in the proliferative phase, which begins when women stop bleeding and continues until ovulation.

That suggests “there may be a hormonal influence on long COVID symptoms,” Maybin said.

In a small, preliminary analysis, women with long COVID also had inflammation of the endometrium – the inner lining of the uterus that is shed during menstruation – and disrupted regulation of the hormone androgen, which plays a role in reproduction.

The researchers said the inflammation could contribute to abnormal uterine bleeding and the worsening of long COVID symptoms, and that their findings could be used to help develop new treatments for women with long COVID.

In the meantime, Maybin said women should be aware of any changes to their menstrual cycles and speak up if they begin to impact their daily lives.

“For people with long COVID – or anyone experiencing menstrual disturbance – if your periods are heavy or irregular and really impacting on your life … you should be seeking help from your primary care physician,” she said.