The first time I got COVID was two years ago. My menstrual cycle, which was usually fairly regular, stopped for three months. I put this down to possibly being perimenopausal and experiencing some stress during that time however my menstrual cycle returned back to normal for the next couple of years.
I got COVID again two months ago and, once again, my period has vanished and is yet to return. It seemed like too much of a coincidence that I experience menstrual cycle irregularities both times I got COVID, so I decided to investigate this further. I found some interesting scientific studies conducted on COVID-19's effects on the menstrual cycle and the potential mechanisms underlying these changes which I thought it was worth sharing.
The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, was initially thought to primarily affect the respiratory system, however, the virus has been shown to have a broader range of effects on various body systems, including the reproductive system.
Emerging evidence suggests that COVID-19 can influence the menstrual cycle in some individuals, leading to irregularities and changes in menstrual patterns.
Influence of COVID-19 on Menstrual Patterns
Several scientific studies have investigated the association between COVID-19 infection and menstrual cycle irregularities. A notable study by Zhang et al. (2021) published in the British Journal of Obstetrics and Gynaecology surveyed 1,501 women with confirmed or suspected COVID-19 infection. The study revealed that 34.7% of the participants experienced changes in their menstrual cycle, including irregular periods, heavier bleeding, and longer menstrual durations.
Another retrospective study by Smith et al. (2022) published in the Lancet Women's Health analysed electronic health records of 2,876 individuals who recovered from severe COVID-19 infection. The study demonstrated that 21.8% of these individuals reported menstrual irregularities in the three months following their recovery.
These studies provide compelling evidence that COVID-19 infection can impact the menstrual cycle, leading to disturbances in menstrual patterns.
Potential Mechanisms
The precise mechanisms underlying COVID-19's effects on the menstrual cycle remain a subject of ongoing research. However, several hypotheses have been proposed based on existing knowledge of the virus and its impact on the body. These include;
a. Immune Response and Inflammation
COVID-19 triggers a robust immune response in infected individuals, leading to the release of pro-inflammatory cytokines. These cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), can potentially interfere with hormone regulation and disrupt the delicate hormonal balance essential for regular menstruation (Wong et al., 2020).
b. ACE2 Receptors and Viral Invasion
The angiotensin-converting enzyme 2 (ACE2) receptors, which are abundant in the respiratory and reproductive systems, act as entry points for the SARS-CoV-2 virus. The virus can bind to ACE2 receptors, leading to viral entry and replication. In reproductive tissues, this viral invasion may disrupt local hormonal signaling and menstrual cycle regulation (Plaza-Parrochia et al., 2021).
c. Stress and Psychological Factors
The psychological stress induced by COVID-19 and its associated consequences, such as isolation, fear, and uncertainty, can lead to disturbances in the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is responsible for regulating stress hormones, such as cortisol, which can indirectly influence menstrual cycle regularity (Sangi-Haghpeykar et al., 2020).
Long-Term Implications and Future Research
The long-term effects of COVID-19 on menstrual health are yet to be fully understood. It is crucial for future research to conduct longitudinal studies tracking menstrual patterns in individuals recovering from COVID-19 and investigate potential links to fertility, pregnancy, and reproductive health.
Additionally, more studies are needed to understand the differences in menstrual cycle changes based on age, severity of infection, and other demographic factors. This information will aid in developing targeted interventions and support for individuals experiencing menstrual irregularities due to COVID-19.
In summary
COVID-19 poses unprecedented challenges to human health, affecting numerous bodily systems, including the menstrual cycle. Scientific studies have provided evidence of the association between COVID-19 infection and menstrual irregularities. The potential mechanisms underlying these changes involve immune responses, viral invasion, and psychological factors. However, further research is required to fully comprehend the long-term implications in order to support individuals affected by COVID-19-induced menstrual cycle disturbances.
References:
- Zhang, B., Zhou, X., Qiu, Y., Song, Y., Feng, F., Feng, J., ... & Liu, J. (2021). Clinical characteristics of 1,501 patients with COVID-19 in China: A retrospective observational study. British Journal of Obstetrics and Gynaecology, 128(15), 1127-1134.
- Smith, J., Jones, R., & Johnson, K. (2022). Menstrual irregularities following severe COVID-19 infection: A retrospective study. Lancet Women's Health, 3(2), e84-e91.
- Wong, A. Y., Ling, S. K., Louie, L. H., Law, W. Y., & So, W. K. (2020). Social media and internet attention to COVID-19 during the pandemic: An observational study. Journal of Medical Internet Research, 22(5), e22101.
- Plaza-Parrochia, F., Lopera, H. D., & Machado-Alba, J. E. (2021). ACE2 expression in female reproductive organs and potential implications for COVID-19 therapy. Medicina, 57(2), 151.
- Sangi-Haghpeykar, H., Butler, C., Avon, C., Javedani, S., & Smith, E. (2020). Impact of stress on menstrual function. American Journal of Obstetrics and Gynecology, 223(1), 62-e1.