Long COVID associated with longer and heavier periods

Embargoed until: Publicly released: 2025-09-17 01:00

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People with long COVID are more likely to experience longer and heavier periods, as well as increased bleeding between periods. Researchers surveyed 12000 people in the UK, comparing results from people with long COVID to those who had recovered from acute COVID or had never caught it. They also found long COVID symptoms worsened just before and during menstruation in a separate study of a smaller group of participants. Early findings suggest these changes may be due to inflammation in the uterus and disruption of hormones. The team notes larger, more representative studies need to be done, as their sample size was small and most participants were white.

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From: Springer Nature

Health: Long COVID associated with menstrual disruption

Long COVID is associated with abnormal uterine bleeding, but not impaired ovarian function, according to a paper published in Nature Communications. The study identifies potential mechanisms for this relationship that could inform future therapeutic targets.

People who menstruate have reported alterations to menstrual patterns during long COVID as well as changes in symptoms of long COVID across the menstrual cycle. However, this relationship has not been well characterised in studies that include a cohort of people without long COVID.

Jacqueline Maybin and colleagues investigated long COVID and menstruation in UK populations. They surveyed approximately 12,000 individuals to compare menstrual characteristics in people with long COVID (1,048), acute COVID (1,716), or controls that have never had COVID (9,423). In addition, they prospectively studied long COVID symptoms across the menstrual cycle in a cohort of 54 women. Results showed that long COVID was associated with increased menstrual duration, menstrual volume and bleeding between periods.

The authors also found that symptoms of long COVID increased in the peri-menstrual phase (which includes the 2 days before menstruation and all subsequent days of menstruation), suggesting a two-way relationship between long COVID and menstrual disturbance. To probe the effect of long COVID on ovarian and endometrial function, the authors sampled 10 people with long COVID and healthy controls. The preliminary results suggest that COVID-related menstrual disturbance was associated with inflammation within the endometrium and disrupted regulation of the hormone androgen. Importantly, there was no indication that long COVID is associated with significant loss of ovarian function.

This research is limited by the relatively small cohort size and representativeness of its populations, the authors note. Future work should replicate findings in larger, more diverse populations and explore therapeutic strategies.

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Journal/
conference: Nature Communications

Research:Paper

Organisation/s: University of Edinburgh, UK

Funder: Funding for this work was provided by Wellcome Fellowship 209589/Z/17/Z (J.A.M.), Royal Society of Edinburgh R47180 (J.A.M.), Wellbeing of Women RTF1103 (M.W.), ESRC grant ES/P000649/1 (G.K.), MRC grants: G1002033 and MR/N022556/1 (Centre for Reproductive Health). Competing interests: H.O.D.C. has received clinical research support for laboratory consumables and staff from Bayer AG and provides consultancy advice (all paid to the institution; no personal remuneration) to Bayer AG, PregLem SA, Gedeon Richter, Vifor Pharma UK Ltd, AbbVie Inc. and Myovant Sciences GmbH. H.O.D.C. has received royalties from UpToDate for an article on abnormal uterine bleeding. J.A.M. has provided consultancy advice (with no personal remuneration) to Gedeon Richter and is a program director at Wellcome Leap. None of these CoI relates to the work described in this manuscript. The remaining authors declare no competing interests.

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