Long COVID: Periods & Menstrual Symptoms
Summary of the Study: Long COVID and Menstrual Changes
This study investigated the impact of SARS-CoV-2 infection (acute COVID-19 and long COVID) on menstruation and related biological factors. Researchers used a multi-pronged approach including a large online survey,a prospective app-based cohort study,and laboratory analysis of biological samples.
Key Findings:
* Long COVID is associated with menstrual disturbances: Individuals with long COVID experienced heavier menstrual flow, longer periods, and increased spotting compared to those who had never been infected. The risk of heavier flow was considerably higher, and periods exceeding eight days were roughly doubled.
* Acute COVID-19 has minimal lasting impact: Those who recovered from acute COVID-19 showed only minor, temporary changes in their menstrual cycles.
* Increased symptom severity around menstruation with Long COVID: Individuals with long COVID reported increased severity of symptoms like dizziness, fatigue, post-exertional malaise, muscle aches, headaches, and tinnitus around the time of menstruation.Breathing issues, headaches, and post-exertional malaise were more severe during the proliferative phase.
* Hormonal differences,but preserved ovulation: While levels of estradiol and progesterone (indicating ovulation) were similar between long COVID and control groups,levels of 5α-dihydrotestosterone (DHT) were higher in long COVID during the secretory phase.
* Changes in endometrial tissue: Long COVID was associated with fewer androgen receptor (AR)-positive cells and lower AR histoscores in endometrial tissue, especially during menstruation and the proliferative phase. Progesterone receptor (PGR) mRNA was also lower during the proliferative phase.
* Cytokine imbalances: Tumor necrosis factor (TNF) was elevated during menstruation in long COVID, while interleukin-8 (IL-8) was lower during the proliferative phase. Similar trends were observed for other cytokines.
Study Methods:
* Survey (12,187 participants): Compared menstrual parameters between never-infected,recovered,and long COVID groups.
* App-based Cohort (54 participants): Tracked 29 symptoms prospectively over three menstrual phases in individuals with long COVID.
* Laboratory Study: Analyzed serum and endometrial tissue samples to measure steroids, receptors, cytokines, and immune cells.
the study suggests that long COVID can significantly disrupt menstrual cycles and exacerbate symptoms around menstruation,potentially due to hormonal imbalances,changes in endometrial tissue,and immune dysregulation. The researchers emphasize the need for further research to understand the underlying mechanisms and develop effective treatments.