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Delayed Period After COVID Shot? It's the Same With COVID-19 Infection – Medpage Today

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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.

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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