Wait, is this Supposed to Happen?

    In March 2020, I wrote a brief blog post about how health inequities exacerbated by COVID-19 were also prevalent in the menstruating community. At that time, very little information was known about the virus and its biological implications so I used a sociological perspective to tackle this relationship. Now, almost a year later, I would again like to explore the ways in which COVID-19 has impacted menstruation, but with a biological lens. Although hygiene practices have since been established and first-generation vaccines are being distributed, there still remains a lot of uncertainty about the long-term and various effects of the virus. As the virus spread over the course of last year, patients openly shared their experiences and associated medical issues that arose with their infection. Hundreds of publications, both scientific and not, have explored the symptoms people associated with their COVID-19 experience. Dr. Maria Cohut wrote one such article on the MedicalNewsToday website discussing one of the lesser known bodily changes associated with COVID-19 infection: uncharacteristic menstrual cycle fluctuations. 
    Before diving into Dr. Cohut’s article, let’s begin with some general information about the average menstrual cycle* for anyone who may be unfamiliar with the whole process. A single menstrual cycle lasts 24-38 days during which a reproductive-aged person’s body prepares for a possible pregnancy. The first 1-7 days are marked by bleeding, which is when the uterine lining sheds after the body experiences a drop in hormones after the corpus luteum, which would otherwise support a developing fetus, is expelled from the body. The remainder of the cycle consists of the follicular, ovulation, and luteal phases, all of which are categorized by different hormone fluctuations and bodily changes to prepare for zygote implantation. Now, let’s focus on the beginning portion of the menstrual cycle, famously known as a period. In addition to a week of light to heavy bleeding, menstruators often exhibit a slew of premenstrual symptoms (PMS) including bloating, fatigue, increased appetite, cramps, mood changes, backaches, and headaches. Even for a standard, healthy individual, the menstrual cycle is subject to some irregularity depending on hormonal changes, stress, or other external factors. This is where COVID-19 comes into play. Again, the full extent of the virus’s biomedical influence is not known yet but Dr. Cohut looked at cases in which patients with long COVID-19** experienced previously uncited irregularities with their menstrual cycles. The interviews and Dr. Cohut’s analysis do not suggest a direct causation, but an intriguing correlation of the virus’s impacts on the menstruating body.
    Throughout the article, Dr. Cohut lists several women*** who experienced late or missing periods, an unusual amount of heavy blood clots expelled from the body, and exacerbated PMS symptoms. Each of the interviewees described their cases as having been especially abnormal as they all noticed these changes after COVID-19 infection and often in conjunction with their persisting symptoms. One of the patients explains that these changes occurred in spite of her consistent birth control use**** for the past ten years. The combination of these issues can be incredibly frustrating and often interfere with a person’s quality of life. The people had to readjust their schedules to accommodate for new onsets of cramps and headaches while controlling vicious upper respiratory symptoms during their long recoveries. 
    Unfortunately, with COVID-19 and its associated troubles being so young in the scientific world, there are not many direct interventions for patients experiencing these menstrual complications. Dr. Cohut’s article brings up a relevant point about the research being done to understand COVID-19. Although this is the first pandemic the world has seen in a century, the impact of other viruses and illness on the menstrual cycle is not often studied. The menstruating population makes up a large portion of the world, so in retrospect, should these effects not be an important field of research? As I have mentioned in other posts, the menstrual cycle is a reflection of a person’s internal health, and with a disturbance like a viral infection, people should know to expect associated menstrual changes. Just as COVID-19 showed us that socioeconomic and access inequities continue to impact menstruators, the virus also shows how the periods are not exempt from the impact of a viral infection. As a virus modifies the body, it modifies the respective functions and states of normality associated with it. The scientific community should take this gap in knowledge as a lesson to expand the biomedical research about how sickness may lead to menstrual and hormonal changes. In doing so, the menstrual community would not have to search for answers to determine whether the disruptions to their normal cycles are a part of the viral course or a sign of greater issues.  


​Sources:​​

• https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstrual-cycle#:~:text=The%20four%20phases%20of%20the,increase%20the%20chance%20of%20pregnancy.
  
• ​https://www.medicalnewstoday.com/articles/long-covid-and-periods-the-unspoken-impact-on-female-well-being 

 

*Menstrual cycles and the idea of an “average menstrual cycle” differ between individuals and their circumstances. Information used in this context directly came from the Better Health Channel website linked above.
** Long COVID-19 is the term given to patients who experience COVID-19 associated symptoms for longer than the common 2-week period of active symptoms.
*** Only women were interviewed in this article. This does not mean people who do not identify as women cannot also menstruate or are not subject to the same complications as described in the article or in this blog post. 
**** Birth control, depending on the type, often regulates the menstrual cycle and can help decrease PMS symptoms and heavy bleeding during periods