“I THINK COVID MADE MY PERIODS WEIRD”: THE EFFECT OF COVID ON THE FEMALE REPRODUCTIVE SYSTEM AND MENSTRUATION
By: Tracy Brobyn, MD
I think from now on, anyone who is old enough to say they lived through the pandemic will look at the world as “before covid” and “after covid” or at the very least “during covid”. Those women who menstruated during the pandemic, often have an especially intimate relationship with the terms “before” or “after covid” because many of them experienced changes their cycles due to COVID infection and the issue has only been tentatively addressed by our healthcare system. Fortunately, the literature tells us that most women whose cycles were disrupted by infection experienced only a temporary abnormality. However many women who meet the definition of so called “long covid” also experience seemingly more persistent gynecological changes.[1] In my practice, many patients have complained of disruptions in their menses related to covid and/or the vaccine. Turns out it’s not just “in their head”.
What happens when COVID messes with your period? It runs the gambit from irregular cycles and heavy bleeding to worsening menstrual pain (like we need more of that). However, perimenopausal symptoms and PMS reared their ugly heads as well.[2-4] In fact when gynecological symptoms accompanied long covid; fatigue and poor quality of life runs rampant.[2] Many things in life can mess with a period including stress. Menstrual disruption due to COVID however, isn’t that simple. Turns out that there is a receptor in body for an enzyme called ACE2 and these receptors occupy many areas of the body including the lungs, hypothalamus in the brain, ovaries and the uterus. The COVID virus needs to bind to the ACE2 enzyme and its subsequent receptor in order to invade cells which could explain why COVID has a predilection for our lady parts as well as our lungs. Furthermore, the hypothalamus is the area of the brain that controls our lady parts which adds insult to injury. [4, 5] When COVID hogs all the ACE2 and its receptors, the body’s system that controls these chemicals goes haywire and releases inflammation. This is how many people died of COVID but it also explains why COVID leaves residual inflammation even in those who have won their fight with the nasty virus. So how do we bring put out the COVID fire?
At our practice, we are all about “de-inflaming” whether that’s through a discussion of mindfulness meditation, improving your sleep or just not letting the little things get to you (and yes, the coronavirus is little believe it or not…lol). Nevertheless, when you need a little more help, we can use the body’s internal energy system through acupuncture to further things along. Acupuncture is a beautiful thing because it is especially helpful for overall de-inflaming (is that a word? If it isn’t it should be). [6] But nirvana, it can also be tapered to a given organ system such as the kidneys, lung or, you guessed it, our lady parts.[7] And here’s a little secret, the highway of energy that gives us a nice menses is coupled to the highway that serves the lung so you can kill 2 birds with one stone so to speak. We also look at both the microbiome and homeopathy to help us further attenuate inflammation.[8, 9] Long COVID can be treated but it requires an out of the box approach that traditional medicine often lacks, i.e. the whole person approach. You aren’t just a uterus after all and COVID knows that. So why not use all your systems to take him out? Just a thought.
1. Dong, J., et al., The impact of “long COVID” on menstruation in Chinese female college students and the intervention of acupuncture. Medicine, 2024. 103(6): p. e36818.
2. Sakurada, Y., et al., Clinical characteristics of female long COVID patients with menstrual symptoms: a retrospective study from a Japanese outpatient clinic. J Psychosom Obstet Gynaecol, 2024. 45(1): p. 2305899.
3. Li, K., et al., Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age. Reprod Biomed Online, 2021. 42(1): p. 260-267.
4. Maybin, J.A., et al., COVID-19 and abnormal uterine bleeding: potential associations and mechanisms. Clin Sci (Lond), 2024. 138(4): p. 153-171.
5. Pourmasumi, S., et al., Effects of COVID-19 Infection and Vaccination on the Female Reproductive System: A Narrative Review. Balkan Med J, 2023. 40(3): p. 153-164.
6. Wang, J., et al., The role of macrophage polarization and associated mechanisms in regulating the anti-inflammatory action of acupuncture: a literature review and perspectives. Chin Med, 2021. 16(1): p. 56.
7. Yang, Y., et al., Observation on efficacy and underlying mechanism of cheek acupuncture on ovulation induction for infertile women with PCOS: Case series. Medicine, 2024. 103(10): p. e37370.
8. Whitmont, R.D., The Human Microbiome, Conventional Medicine, and Homeopathy. Homeopathy, 2020. 109(4): p. 248-255.
9. Bellavite, P., et al., Immunology and homeopathy. 1. Historical background. Evid Based Complement Alternat Med, 2005. 2(4): p. 441-52.