Long COVID & Periods: The Unspoken Impact on Female Well-Being
Many people with long COVID — who keep experiencing COVID-19 symptoms months after the disease should have subsided — have been pointing out that it has also affected their menstrual cycles. Medical News Today wanted to find out more.
Over the past few months, an increasing number of people worldwide say that after developing COVID-19, they are experiencing a prolonged state of ill health that people now refer to as long COVID.
People with long COVID often experience symptoms, such as fever, fatigue, or headaches, on and off for months after the initial disease should have subsided.
Existing evidence indicates that COVID-19 symptoms should disappear around 2 weeks after the onset of symptoms.
The reasons why so many people continue to experience disruptive symptoms remains unclear. However, researchers and medical doctors are now starting to look into possible mechanisms and the best ways to support individuals with long COVID.
Most recently, on social media and dedicated support groups, many people with long COVID have spoken about how this prolonged state of illness has affected their menstrual cycles, further impacting their quality of life.
Medical News Today spoke to six people with long COVID who have been experiencing disruptive changes to their menstrual cycles to find out more.*
MNT have also sought the opinions of two medical experts. One is Dr. Linda Fan, assistant professor of Obstetrics, Gynecology and Reproductive Sciences and the section chief of Gynecology and the Director of Gynecologic Quality and Safety at Yale School of Medicine in New Haven, CT.
The other is Dr. Valinda Nwadike, a board-certified obstetrician-gynecologist based in the United States.
Irregular Periods, Clots, Symptom Flare-Ups
Most of the people we spoke to told us that ever since they contracted COVID-19, they have been experiencing irregular periods, unusual clotting of their period blood, or worsened premenstrual syndrome (PMS).
However, while everyone we spoke to had experienced some changes to their menstrual cycle, the form of these disruptions varied.
One contributor, Rose, reported getting irregular periods since she developed COVID-19, months previously.
“I noticed that my menstrual cycles changed immediately when I became ill [with COVID-19],” Rose told MNT.
Julia, who is in her mid-40s, developed COVID-19 symptoms in March but had no access to a test. She believes she had long COVID, which has interfered with her menstrual cycle.
“In May, I skipped a whole month’s cycle of having a period. In June and then July, it returned, but [it was] very erratic, lasting a lot longer and stopping and starting,” she explained.
Several people told us that they were worried about an unusual amount of clots in their menstrual discharge or about unusually large clots in the blood.
Bianca, a woman in her late 40s, told us that she only started to experience these changes to her menstrual cycle some time after the initial illness.
“I didn’t notice anything different during the initial onslaught of COVID. It wasn’t until 3 months later […] when some symptoms came back that I noticed a change. I noticed an increase in clots — but quite a bit.”
Louise had a similar experience. “My cycles,” she told us, “have been more irregular — [going from] 24 to 28 days. The first 3 months, I had big clots that were very alarming for me, and I had to take a photo, and I sent it to the [family doctor] who said [that] this is normal.”
Yet, she added, “I know for sure it isn’t normal [for me].” Louise also noticed an increase in the severity of her long COVID symptoms around the time that she would get her period: “A week before my period I would relapse and [also become] more breathless.”
Edith also reported irregular periods and increases in the severity of long COVID symptoms around the time her period is due.
“[My periods] have changed in frequency, duration, flow, intensity, and pain level. I also experience COVID symptom flare-ups before my period starts, which is rather confusing because my periods are unpredictable,” she told MNT.
Edith also specified that her doctors diagnosed perimenopause in her case. However, she remains unconvinced by this assessment because of the peculiar timing of these changes to her menstrual cycle.
“[M]y perimenopause status has been attributed to the issues I’ve had with my periods post-COVID, which I don’t feel is at all accurate,” she explained.
Finally, Jean, who has been taking birth control pills for many years, worries because her periods are returning — even though she continues to take contraceptive medication.
She told us that she associates this change with the fact that she is experiencing long COVID. Like Bianca and Louise, she also started noticing unusual clots in her menstrual discharge.
How This Has Affected Quality of Life
Most of the contributors told MNT that, alongside other symptoms of long COVID, the changes to their menstrual cycles have affected how they can live their lives.
For instance, Jean explained that: “The reason I started birth control was due to incredibly painful periods and other debilitating PMS symptoms. Now, these are back, though not as bad as prior to taking the birth control. I am already housebound due to other symptoms.”
“One other thing is [that] my major issues, [and] emergency [hospital] visits, seem to all coincide with my cycle,” she added.
Louise reported that the changes to her period have “affected me mentally because I worried about clots and complications, but I have been OK.” However, “[t]he [long COVID] relapses have been mentally draining,” she said.
Edith told us about the significant emotional impact of these changes: “I feel like I have PMS all the time. COVID has [also] made me more sensitive emotionally, and I am aware of emotional ups and downs that I’m having now that I didn’t have before.”
Rose experienced a debilitating array of symptoms just before getting her period:
“[In] the days leading up to my period, my eczema would worsen, my breathing would start to get more difficult, my POTS [postural orthostatic tachycardia syndrome] would act up, I would get a migraine with aura, my fingertips would have sharp pains, my joints would start hurting, and my right leg would start tingling.”
Julia believes that the blood loss that she associates with her much heavier and unpredictable periods likely contributed to the development of anemia.
“[These changes were] an additional worry at the time, with all the other post-COVID symptoms, as it felt my body was shutting down,” she told MNT.
For Bianca, the changes she noticed in her menstrual cycle triggered worries about reported links between COVID-19 and cardiovascular complications.
“It made me pay attention to the advice related to the increased risk of heart attack and stroke for people suffering from post-COVID symptoms,” she said. “I started taking a daily low dose aspirin,” low doses of which can reportedly help prevent stroke in females."
Lack of Medical Support an Issue
All of the contributors who responded to MNT‘s queries said they had received little to no support from doctors when they sought help for long COVID symptoms, including disrupted periods.
Jean said that she received few explanations and even less support when she expressed her worries regarding her menstrual cycle.
Bianca said she was much less successful in receiving expert care. “I have seen my doctor, but not just [about] the period change, but for overall post-COVID help, and [they were] unable to help me. [Her doctor] immediately dismissed any COVID relationship [regarding the impact on menstruation],” she told us.
This dismissal led Bianca to worry about other possible reasons for the changes, such as breast cancer. She underwent a costly mammogram, which revealed she was cancer-free.
According to Bianca, her doctor rejected her worries about COVID-19 because she had been unable to take a test to confirm infection with SARS-CoV-2, the virus that causes this disease.
“I had COVID-19 in April, and [my doctor’s] own hospital said I did not qualify for COVID testing then because I had not been out of the country or near anyone who had been. And then they said I had symptoms consistent with COVID-19 and had [to isolate] for 2 weeks,” she recounted.
Because of the resistance she encountered from healthcare practitioners, Bianca told MNT that she is doing her own research into long COVID and self-medicating, which, she admits, can be dangerous.
“I understand that doctors and everyone are just learning about [COVID], but when you are dealing with it for months and months, and you experience what I did, you feel as if they are gaslighting you — as if they want to put you in a box that they are more comfortable dealing with because they don’t want to admit they don’t know,” she told MNT.
Her symptoms, as well as the process of seeking and not receiving appropriate health support, have taken their toll on Bianca: “There is trauma related to this, and I would rather get a referral to a doctor who is willing to admit what they don’t know [how to help].”
Like Louise, others confessed that they do not have enough confidence in the health system even to attempt to seek support for their disrupted periods or other symptoms of long COVID.
“I didn’t dare to discuss more [of] my issues with [my family doctor] as they always dismiss [them],” she told us.
A few have been luckier in their pursuit of specialist care. Rose told MNT that she was “able to receive some care after a fair amount of trial and error.”
Rose also explained that because she had not tested positive for COVID-19, she came across a lot of resistance from doctors, which, like Bianca, she described as gaslighting.
“I have finally found a team of doctors who believe me,” she told us, “but we’re still all learning about how long COVID affects the body. For my menstrual cycles, I recently found an endocrinologist I like who is monitoring my progress and contemplating testing my estrogen levels as a next step.”