“Two weeks into my COVID-19 battle, I was supposed to get my period, and nothing came. Nothing followed the next month, either. Eight months later, and I’ve only had five periods,” a woman named Rose told a medical publication.
As India continues to battle the massive second wave of the COVID-19 virus, the learnings continue to grow on how it affects different parts of the body. While it has shown to mainly target the respiratory system, studies are gathering data about its impact on menstrual health.
‘Long COVID’ is a patient-created term used to describe the prolonged effect that patients have seen on their health even after recovering and testing negative. Some women are reporting that they have noticed changes in their menstrual cycle post-recovery as part of long COVID, according to a medical publication. They revealed that they were experiencing a range of issues including irregular cycles, increased clotting of period blood as well as worsened pre-menstrual syndrome symptoms.
Stress comes into play
Dr Tripti Sharan, a Delhi-based gynecologist and obstetrician shared that women’s menstrual cycles have not been pathologically affected but there could be other reasons as to why changes are being observed. “COVID-19 is a disease that has a lot of mental and physical repercussions and stress has its own effect on menstrual cycles,” she says, noting that it can lead to periods being prolonged or starting earlier. She stressed that irregular periods can be associated with COVID-19.
“When you have fever and cytokine storm or are very sick with COVID-19, patients have started bleeding,” she said but reiterated that at the moment, there is little research to show the effect that the virus has on hormones like estrogen and progesterone.
“When every organ is being affected, even the uterus can be affected,” she remarks. There have also been patients with heavy bleeding and intermenstrual bleeding. But fortunately, she says that menstrual complaints have been limited from those who are infected with COVID-19 and have shown good response to medical treatment.
Though every new strain has shown differences in how it affects bodies, Sharan maintains that thus far, issues caused by a COVID-19 infection has not shown any significant impact on gynecological health.
A Chinese study published earlier this year confirmed this and revealed that out of 177 patients who were studied, 25% of them presented with menstrual volume changes. 50 patients had menstrual cycle changes, mainly experiencing decreased volume and a prolonged cycle. The study concluded that this could be the consequence of hormone changes caused by suppression of ovarian function that quickly resumed after recovery.
Apart from the effect of the infection on menstrual health, there have been recent concerns about how COVID-19 vaccines could potentially affect menstruators and its potential interference with oral contraceptives. “When we give oral contraceptive pills and hormone replacement therapy, especially in the older group, they can be predisposed to thromboembolism (obstruction of blood vessels by a blood clot), but the risk of the vaccine causing thrombosis is not very high,” says Sharan.
In the US, a very small number of women have reported blood clots after taking the AstraZeneca and Johnson and Johnson vaccines. But, medical experts have said that more research is required to study the role that each vaccine may play in causing clots, and whether women face higher risks.
(Edited by Amrita Ghosh)