What We Know (So Far) About COVID-19 and Your Menstrual Cycle

After several months of sheltering-in-place and quarantine self-care, it’s clear that the coronavirus (COVID-19) is here for the long haul. Yet, as a relatively novel virus, there’s still a lot unknown about how it affects our monthly periods.

To better understand the link between the two, we spoke to Dr. Kimberly Langdon, M.D., an OB/GYN based in Ohio and a medical advisor for Medzino Health. Here’s the lowdown:

COVID-19 can cause period changes.

While it’s true that COVID-19 could disrupt your period, it’s important to note the same can be said for any sickness. The reason? Illness can affect your body’s ability to normally ovulate, according to Langdon.

As you might already know, the menstrual cycle is split into four phases: the menstrual phase, the follicular phase, ovulation, and the luteal phase. Every phase is governed by a series of specific hormonal changes.

Ovulation typically occurs about halfway (14ish days) through your cycle. This phase is marked by a rise in luteinizing hormone (LH), which triggers the release of an egg. But if the egg remains unfertilized, it doesn’t implant itself into the uterus lining—causing the uterus to shed the egg and lining via muscular contractions (cramps). The result is your period.

However, during a bout of illness (like COVID-19), your body becomes physically stressed. This messes with the hormonal changes necessary for normal ovulation, causing a delay in ovulation (or none at all). In turn, your period is late or even MIA.

Period Pain is Not Normal

A mild COVID-19 infection likely won’t damage your reproductive system.

According to Langdon, COVID-19 can allegedly affect any organ. That’s because it can cause a cytokine storm, “an overzealous immune response [that can lead to] vessel wall damage,” she explains. However, with mild infections, it’s unlikely to cause “any damage to the blood flow to the ovaries, uterus, pituitary gland, or hypothalamus—the last two [of which] are in the brain and are responsible for initiating egg recruitment for ovulation,” she shares.

Abnormal periods and pandemic stress are totally a thing.

Make no doubt about it: Living through this pandemic has been one heck of a stressful experience. The rapid outbreak of the virus—coupled with the country’s economic downturn—has paved the way for anxiety, worry, and loads of stress.

<<READ MORE: How Stress Affects Your Period>>

This can lead to period changes, just like physical illness. Again, “the basic underlying problem with stress [and menstruation] is due to the impact it has on ovulation,” explains Langdon. “It can easily disrupt the normal cycle” by interrupting the hormonal changes needed for normal ovulation function.

To top things off, high levels of stress (*cough*pandemic*cough*) can increase the risk of dysmenorrhea, a.k.a. super painful periods. Ugh.
Pandemic Stress
And if you’re trying to conceive (TTC)? Take note: According to a 2016 article in Journal of Biomedical Science, higher levels of stress hormones (like cortisol) can reduce estradiol, a type of estrogen. This can decrease the quality of the oocyte, or immature egg, potentially causing reproductive issues like difficulty conceiving. 

If you’re TTC and feeling uber stressed, consider chatting with a mental health professional during these difficult times. It may also help to hone in on relaxation techniques, like yoga and meditation

COVID-19 symptoms might be worse during your period.

Around the web, folks with COVID-19 have reported experiencing worse symptoms when Aunt Flo shows up. And while it’s still unknown how menstruation specifically affects the severity of COVID-19 symptoms, there’s some scientific merit behind this relationship.

According to an article in the American Journal of Obstetrics & Gynecology, it’s common for medical conditions to become exacerbated during menstruation. This typically occurs during the luteal phase (just before your period) and menstrual phase (your actual period), when estrogen is an at all-time low. Coincidentally, “estrogen has been [found] to influence immunity by affecting the development of white blood cells,” says Langdon. In other words, it can regulate the immune system and how your body handles disease.

In theory, the plummet of estrogen during the luteal and menstrual phases may explain why COVID-19 symptoms flare up during people’s periods. Nevertheless, more specific research is necessary to confirm the link.
period depression

You might be more likely to get infections before or during your period.

The changes in estrogen throughout your cycle—along with its relationship with immunity—may also affect your risk of infections.

Before ovulation, during the follicular phase, “you’re less susceptible to infections due to higher estrogen levels,” says Langdon. From an evolutionary standpoint, this makes a lot of sense; it’s your body’s way of making sure you’re in tip-top shape to release an egg and have sex (and therefore, fertilize the egg).

It’s a different story after ovulation, during the luteal phase. As mentioned earlier, estrogen decreases in the luteal phase and is at “the lowest level on the first day of menstruation,” says Langdon. In turn, you may be more vulnerable to infections during this time.

Again, there isn’t any research on menstruation and COVID-19 risk. It’s also still important to stay safe and follow CDC guidelines for protecting yourself—no matter what phase you’re in.

There’s still a lot to learn about how COVID-19 affects the menstrual cycle. In the meantime, (please) pay attention to any period changes, even in the middle of pandemic. Many health care providers, including gynecologists, are currently offering virtual appointments for their patients.

At the end of the day, the healthier the better! Among the many benefits of Marea’s PMS Elixir is boosted immunity. Our science-backed formulation includes many powerful antioxidants that support immune health - Vitamin E, Selenium, Vitamin C, Vitamin D, Zinc, and B complex vitamins.

About the Expert: Dr Kimberly Langdon M.D. is a retired obstetrician/gynecologist with 19 years of clinical experience. Beside obstetrics, she specialized in gynecologic diseases such as menstrual disorders, vaginitis, infertility, menopause, contraception, pelvic pain, sexually transmitted infections, and minimally-invasive surgeries. She is currently a medical advisor at Medzino Health, a digital health company based in Austin, TX.

REFERENCES:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107848/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194613/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315337/

https://academic.oup.com/epirev/article/36/1/104/566554/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812655/

ABOUT THE AUTHOR
Kirsten Nunez
Learn more about Kirsten at k-nunez.com.

17 comments

Moderate Covid19 infection from mid December 2020 with subsequent pneumonia into January. No menstrual cycle at al since early December. Age-49 (cycles were “spot on regular prior to infection)! Any input…I’m NOT pregnant. Is this a confirmed scientifically proved side effect??

Linda McConnell March 15, 2021

i currently have covid-19, although no symptoms anymore, and it’s already been 14 days since i tested positive, but i’m still not negative. I’m currently 5-6 days late to my period and that hasn’t happened to me since I was a teenager! I’m 24 now and my periods have been regular for a a few years. what struck me the most, is the amount of cramps i have and the usual pre-period pains i usually suffer from, including headaches, irregular bowel movement and earaches (yes that’s a thing!!), and i still see no signs of my period showing up. how strange?

sarah March 15, 2021

Today I started my period and I also have covid (Day 3 of covid) I just had horrible cramps and all the sudden I started to have diarrhea. I’ve never had this bad of diarrhea before while on my period. Covid is definitely doing something to my period and I don’t like it.

Emma March 15, 2021

I was negative for Covid back in December 29 but tested positive Jan 2. Anywho I usually have my periods at the end of the month beginning another month. Forbes my Dec period came Nov, 29th. My Jan period was supposed to come around Dec 29. But that’s when I was experiencing symptoms of Covid. Fast forward Jan 13 I got my period it ended Jan 20. So it’s February where is my period? Also, I overthink things

Aura March 15, 2021

I have recovered from covid (about 3 weeks ago) and I expected my period 5 days ago and still nothing. I’m definately not pregnant. Would love to know if anyone has had the same? I.e. very delayed or missed completely? My periods are normally like clock work so I am a bit concerned it wont come back!! I am 26 y.o. and TTC in the next 6 months!! thanks xx

Abbie March 15, 2021

I had covid-19 at the end of my period during October, I usually have regular every 4 weeks. However since having Covid I haven’t had any periods!

Lottie March 15, 2021

Sandy….I have experienced exactly the same, since having covid-19 huge clots, never before experienced. I found this forum looking for an explanation for that very issue. Good to know i’m not alone with this, I was starting to think it wasn’t related to covid-19 and perhaps I had another health issue.

Crystal March 15, 2021

My period came a week earlier than normal and it lasted for 8 days and it normally only last 4-5. It was thinner than normal but more than normal. My fiancé tested positive on Thursday and I haven’t been tested. I get headaches sometimes but nothing to bad. My period is the main thing I’ve noticed that’s different. Do you have any ideas why

Hilary March 15, 2021

My period came a week earlier than normal and it lasted for 8 days and it normally only last 4-5. It was thinner than normal but more than normal. My fiancé tested positive on Thursday and I haven’t been tested. I get headaches sometimes but nothing to bad. My period is the main thing I’ve noticed that’s different. Do you have any ideas why

Hilary March 15, 2021

I had covid back in October, I am 44 and think I am perimenopause. I had painful ovulation and heavy painful periods before covid. My period did worsen since and ovulation pain worse . But i am now 5 days passed the date for me to ovulate and showing symptoms that I have no estrogen. I obviously have to give it months to see what happens but I’m wondering if covid has caused this.

Faye March 15, 2021

about 4 days ago I tested positive for covid being the first day my symptoms started. today was day 1 of my cycle. i am encountering the WORST cramps of my life that won’t go away. this is the absolute most horrible pain i have ever been in my life. on top of that, this is the heaviest it has ever been. wish me luck :(

samantha March 15, 2021

I tested positive for covid Sunday the 24th. I started my period this morning and I feel the worst today as far as feeling hard to breath just so congestes in my chest.. blood pressure is a little high and I normally have normal bp. I have a 4 year old so it’s hard to rest. Husband is not staying with us he has to work. Prayers please. I’m praying for everyone affected with covid this mess is serious

Calli March 15, 2021

I tested positive for covid Sunday the 24th. I started my period this morning and I feel the worst today as far as feeling hard to breath just so congestes in my chest.. blood pressure is a little high and I normally have normal bp. I have a 4 year old so it’s hard to rest. Husband is not staying with us he has to work. Prayers please. I’m praying for everyone affected with covid this mess is serious

Calli March 15, 2021

I first starting having Covid-19 symptoms on January 13, on Sunday January 17 I tested positive for Covid-19. I started my period on January 15, it’s now day 12 and I still have cramps and spotting. I noticed this time around I was having more cramps and very bloated. I spend 5 days in the hospital with pneumonia. Still recovering now, it hasn’t been the easiest. I’m 41 yr old Hispanic.

Mayra March 15, 2021

Yesterday I began having covid symptoms but a week before that I experienced pms as normal until today (day1) i woke up with worsened symptoms and the worst cramps I have ever felt. Still experiencing them at this moment :(

Bryana January 27, 2021

My first period post covid has been the most painful and prolonged pain feeling like labour pains. The pain lasted a few days whereas in the past the pain is only on day one. I also had severe breast tenderness something I had not experienced in over 15yrs. I am a 41yr black African female.

Rumbi January 27, 2021

On Day 1 of my period, I woke up with an excruciating headache. Thinking it was because of my period, I didn’t think anything of it so I went to work. While at work I had the chills and in the afternoon a fever of 100.2. I rarely run a fever. I left work immediately for a rapid Covid test. It was negative. then, my husband tests positive and still have symptoms. the next day I test positive. Today is day 3 of my period. Several times today, I felt and heard a huge plop when on the toilet. I though my tampon had fallen out, but it wasn’t my tampon. I looked in the bowl and there were several large clots of blood and my tampon was still in. I am 51 years old and this has never happened to me before, the one difference is having Covid-19. I know they are related but I can’t seem to find anything on line. Would love to find out more. Take care.

Sandy January 18, 2021

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