Having COVID-19 was linked to a slight, temporary change in menstrual cycle length similar to changes seen after COVID-19 vaccination, according to a study of self-reported data from a menstrual tracking app.
People who experienced COVID-19 had a 1.45-day adjusted increase in cycle length during COVID-19 infection compared with the three cycles before infection (95% CI 0.86-2.04), while those who were vaccinated against COVID-19 had a 1.14-day adjusted increase in cycle length after being vaccinated compared to previous cycles (95% CI 0.60-1.69).
Although both those changes were more than the 0.68-day decrease in cycle length seen in the control group of people who were neither vaccinated nor reported to have COVID-19, the vaccinated and infected groups did not differ significantly from each other.
And for both groups, the cycle changes disappeared by the next cycle, reported Alexandra Alvergne, PhD, of the Institute for Evolutionary Sciences at Montpellier University in France, and co-authors published in Obstetrics & Gynecology.
“The change in cycle length was minimal and limited to only the cycle of either illness or vaccination,” commented Pamela Berens, MD, an ob/gyn at the McGovern Medical School at UTHealth Houston, who was not involved in the study. “[This research] might provide some reassurance to patients who are concerned about the impact of COVID-19 or vaccination on their cycles.”
Study co-author Alison Edelman, MD, MPH, of the Oregon Health & Science University School of Medicine in Portland, said this research contributes a large dataset on COVID-19 and menstrual cycle changes, which has received less attention compared with the scrutiny around COVID-19 vaccination.
“We wanted to come back around to COVID-19 infection and see if that affected the menstrual cycle in similar ways,” Edelman said.
Ultimately, the menstrual cycle changes “were small in magnitude and not clinically significant at the population level,” her group concluded.
However, a small proportion of people did have a clinically significant change of more than 8 days. That proportion was higher for individuals with COVID-19 than for those in the vaccination or control groups (9.7%, 6.3%, and 6.9%, respectively), the authors noted. “COVID-19 vaccination at least 3 months before the onset of COVID-19 symptoms was protective for COVID-19–associated changes in cycle length,” they wrote.
Next steps for researchers involve figuring out why COVID-19 infection causes changes in menstrual cycles.
“People want to know when things change and why they change,” Edelman said adding that the findings are another tool for counseling patients and giving reassurance that “for the majority of individuals things get back to normal pretty quickly. And if they don’t, they should be talking to their healthcare provider.”
Researchers collected data from period tracking app Clue, as well as from surveys on COVID-19 vaccination and infection. About 13% of people who saw the survey in the Clue app clicked on the link, which is on par with other in-app surveys. Participants who consented gave prospective access to their menstrual cycle data. The survey asked about COVID-19 vaccination status, COVID-19 history, age, BMI, and country of residence.
In all, 6,514 people from 110 countries (half from the U.S.) met inclusion criteria and were included in the study. The sample included five menstrual cycles per person, totalling 32,570 cycles.
Participants were organized into three categories: a control group of 421 people who had no history of COVID-19 vaccination or infection, 1,450 who were vaccinated but never had COVID-19, and 4,643 who had COVID-19, further broken into vaccinated and unvaccinated. People who used hormonal contraceptives between 2019 and the survey were excluded, as were people older than 45, and anyone who didn’t give consistent data. If a user flagged a cycle as abnormal, researchers removed it (n=10,788).
Initial COVID-19 symptoms occurred from January 2020 until the end of June 2022. COVID-19 vaccinations first began on Dec. 11, 2020, and were recorded through the end of July 2022. Researchers tracked within-user change in menstrual cycle length.
The fact that research relied on self-reported data from app users was a key limitation, although the authors also noted that self-reports of COVID-19 symptoms were fairly accurate earlier in the pandemic when data collection occurred.
Other limitations included the likelihood of asymptomatic cases of COVID-19 in the control cohort, and the inability to determine how specific variants could have different effects on menstrual cycles.
Rachael Robertson is a writer on the MedPage Today enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts. Follow
Disclosures
Research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institutes of Health Office of Research on Women’s Health.
Edelman reported receiving honoraria and travel reimbursement from the American College of Obstetricians and Gynecologists (ACOG), WHO, and the CDC as well as receiving royalties from Up to Date, Inc. Other authors reported working and consulting for Clue for BioWink. One also consults for GmbH in Berlin. One author’s institution receives research support from Merck/Organon.
Oregon Health & Science University (OHSU) receives research funding from the OHSU Foundation, Merck, HRA Pharma, the Bill & Melinda Gates Foundation, and NIH, for which Edelman is the principal investigator.
Berens had no conflicts of interest.
Primary Source
Obstetrics & Gynecology
Source Reference: Alvergne A, et al “Associations among menstrual cycle length, coronavirus disease 2019 (COVID-19), and vaccination” Obstet Gynecol 2023; DOI: 10.1097/AOG.0000000000005343.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
