New research suggests that women suffering from long Covid experience longer, heavier periods compared to those who were never infected with the virus.
Scientists from the universities of Edinburgh, Oxford and Montpellier found that the severity of long Covid symptoms fluctuates at different points in the menstrual cycle, typically worsening as each period approaches.
Researchers said the findings demonstrate the complex relationship between menstrual health and long Covid, a condition known to affect about 30 per cent more women than men.
They expressed hope that the discovery may lead to the development of targeted treatments for women experiencing “menstrual disturbance” as a result of long Covid.
The research included the data from an online UK survey of more than 10,000 women between March and May 2021. The sample included more than 1,000 women with long Covid, 1,700 who had recovered from acute Covid infection and 9,000 never-infected individuals.
They found that women with long Covid reported heavier, longer periods and more bleeding between periods than those who had not been infected with the virus.
Those who had recovered from a short-term Covid illness experienced less disruption to their periods.
Dr Jackie Maybin, reader and consultant gynaecologist at the University of Edinburgh’s centre for reproductive health and NHS Lothian, said: “Heavier, longer periods can result in iron deficiency.
“Given the symptoms that those with long Covid are already enduring, it is essential that we rapidly identify menstrual disturbance and have effective treatments to prevent iron deficiency and its associated fatigue, weakness and shortness of breath.
“This study is the first step towards specific treatments for menstrual disturbance in women with long Covid and may also lead to new treatments for long Covid symptoms that are tailored for women.”
The research team examined the impact of different stages of the menstrual cycle on long Covid symptoms, using an app to track daily symptoms in 54 women for three months.
They found that long Covid symptoms – such as dizziness, breathing issues and brain fog – were most severe during or just before or after the women had their period.
Women reported that their symptoms eased after the expected time of ovulation.
Researchers also measured hormone and inflammation levels in a smaller number of women, with and without long Covid, using samples of blood and tissue from the lining of the uterus.
Higher levels of inflammation were found in the blood of those with long Covid around the time of their period.
Scientists suggest that this may also contribute to problematic bleeding and influence symptom severity during menstruation.
Levels of progesterone and oestradiol – hormones produced by the ovaries – were found to be similar in those with and without long Covid, indicating that long Covid does not significantly affect ovarian function.
Dr Alexandra Alvergne, senior researcher from the French National Centre for Scientific Research (CNRS), University of Montpellier, said: “It’s important to consider the potentially bi-directional relationship between disease and menstruation, where symptoms vary across the menstrual cycle and disease influences cycle parameters.
“Here we show this may be the case for long Covid, where long Covid associates with abnormal uterine bleeding and symptoms flare up around menstruation.”
The study, funded by Wellcome, the Royal Society of Edinburgh, Wellbeing of Women and UKRI, is published in the journal Nature Communications.
