Women with long Covid are more likely to experience heavier, longer periods and more bleeding between cycles compared to women who had acute Covid-19, new research suggests.
A study led by researchers at the University of Edinburgh and published in Nature Communications suggests that abnormal uterine bleeding (AUB) was more common in women with long Covid. The severity of long Covid symptoms also fluctuates at different points in the menstrual cycle, becoming more severe around the time of each period.
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The findings indicate that menstrual disturbances are linked to hormonal imbalances and excess inflammation.
Retrospective study in women
Long Covid affects about 30 per cent more women than men and is prevalent in women of reproductive age. Although women reported menstrual disruption during the pandemic, analysis was hampered since menstrual health data was rarely collected at the time.
Scientists from the Universities of Edinburgh, Montpellier and Oxford created a survey advertised to a diverse population of women of menstruating age on Facebook during 2021. Researchers asked the women about the length, frequency, and volume of their menstrual cycles, as well as whether they experienced any intermenstrual bleeding. The survey was retrospective and self-reported and included data on behaviour, life circumstances and health before and during the pandemic, as well as Covid-19 disease and vaccination history.
The sample included more than 1,000 women with long Covid, 1,700 who had recovered from an acute Covid infection and 9,000 women who had never been infected. Ninety-five per cent of respondents were of White ethnicity, and all were between 18 and 45 years old.
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Heavier and longer periods with long Covid
Women living with long Covid were more likely to experience heavier and longer periods, as well as bleeding between cycles, compared with those who had Covid-19. In contrast, women who recovered from a short-term Covid illness reported less menstrual disruption.
By using an app to track daily symptoms, researchers found that women with long Covid experienced peaks in their symptoms, including brain fog, dizziness, and breathing issues during, just before, or just after their periods. Their symptoms ease after their expected date of ovulation, suggesting that hormonal changes may influence the severity of long Covid symptoms.
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The researchers analysed the impact of hormonal changes in a smaller subsection of participants by examining samples of blood and tissue from the lining of the uterus from women with and without long Covid. The findings could be used to help shape new treatment strategies for women with long Covid.