Long COVID: A Hidden Danger for Women's Health?

Recent research from the University of Edinburgh has unveiled alarming connections between long COVID and abnormal uterine bleeding among women in the UK. This study highlights increased menstrual volume, extended bleeding durations, and more frequent intermenstrual bleeding, all occurring without any signs of impaired ovarian function.

A Pre-existing Problem Magnified by the Pandemic

Prior to the pandemic, many women were already grappling with abnormal uterine bleeding—a condition affecting one in three women, which escalates to one in two as they approach menopause. In the UK alone, over 800,000 women annually seek treatment for heavy menstrual bleeding. U.S. costs related to menstrual disorders have soared to a staggering $12 billion each year.

Striking Changes in Menstrual Cycles Post-Infection

Throughout the pandemic, reports have emerged detailing shifts in menstrual cycles following COVID-19 infection, vaccination, and even stress. While minor alterations in menstrual frequency were noted post-vaccination, significant disruptions have been documented in those infected with SARS-CoV-2. Alarmingly, long COVID has impacted a greater number of women than men, yet the specific nature of menstrual disturbances remains largely unexplored.

Research Findings: The Link Between Long COVID and Menstrual Irregularities

In the pivotal study, "The potential bidirectional relationship between long COVID and menstruation," published in Nature Communications, researchers utilized a comprehensive approach, combining a UK-wide survey, symptom-tracking data, and timed biological sampling. The goal was to explore whether long COVID correlates with abnormal uterine bleeding and how menstrual symptoms fluctuate throughout different phases.

The survey included 12,187 participants, with notable groups including 1,048 women diagnosed with long COVID. Additionally, an app-based cohort provided daily insights from 54 women. Biological samples were taken from 10 women with long COVID for thorough analysis.

Startling Statistics from the Study

Survey results indicated that women with long COVID experienced heavier menstrual flow and reported longer periods, increased instances of intermenstrual bleeding, and more missed cycles compared to those who had never contracted the virus. However, menstrual regularity appeared consistent across all groups.

The Hormonal Breakdown: What’s Really Going On?

Interestingly, symptoms peaked during late and early menstrual phases, with elevated levels of a hormone called 5α-dihydrotestosterone noted in women with long COVID during the secretory phase. Contrarily, levels of estradiol, progesterone, and Anti-Müllerian hormone did not show significant disparities.

Moreover, tumor necrosis factor levels were higher in long COVID patients during menstruation, accompanied by immune cell aggregates within the endometrium.

The Takeaway: Urgent Need for Further Research