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Women's Health


COULD THE COVID-19 VACCINES IMPACT MENSTRUATION? EXPERTS DISCUSS

The experts hope that understanding this side effect will help people to be
better prepared for heavier or earlier menstrual flow after their doses.


Could the COVID-19 vaccines affect menstrual cycles? Researchers are interested
in finding out.TODAY Illustration / Getty Images
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April 12, 2021, 10:02 AM EDT / Source: TODAY
By Meghan Holohan

After Katharine Lee received her COVID-19 vaccine, she and a colleague chatted
about their side effects. Because they worked in a medical school, they received
their shots early and felt this might be a good opportunity to understand the
experience.

While they expected injection site pain and to maybe spike a fever, they both
noticed a symptom that they had not expected: their menstrual cycles changed. As
Lee began talking with other people who menstruated, she heard that they also
experienced periods that came earlier, felt heavier or just seemed abnormal.




“The menstrual cycle is a really flexible and dynamic process and it responds to
a lot of different things in life like stress, physical or mental or immune
changes,” Lee, the post-doctoral scholar in the public health sciences division
at the Washington University School of Medicine in St. Louis, told TODAY. “The
menstrual cycle is supposed to respond and adapt.”



Lee informally talked to colleagues and friends about their periods and some
observed differences.

“A number of people said they noticed their cycles were just a little weird,”
she explained. “But attributed it to maybe the vaccine or maybe it was
perimenopause.”

She reached out to her grad school professor, Kathryn Clancy, head of the Clancy
Lab at the University of Illinois, which focuses on women's health research. Lee
mentioned the irregular cycles and Clancy was interested. Then she received her
first dose.



“A little after a week after this first Moderna dose and I had never had a
period that was so heavy — not even in my 20s when I was having a really heavy
cycle,” Clancy said.

Clancy shared her experience on Twitter and people responded with their own
stories. Lee and Clancy realized they needed to gather this information in a
standardized way. So, they worked on a survey to do just that.

“A lot of people had noticed something but hadn't heard anything about
(menstrual changes) being a side effect,” Lee said. “So many things could impact
people's menstrual experiences. So, we just thought if this is a side effect of
… this type of vaccine it would be good for people to be prepared.”

Both researchers note that they are pro-vaccine and they’re conducting the
research to understand the full range of side effects.



“We need to do more work noticing when there are different effects for different
people, really, so that we can do a better job of (preparing for) these side
effects," Clancy explained. "If people know, for instance, this is going to make
you bleed more they're going to have more pads with them.”


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VACCINES AND MENSTRUATION

Experts say it’s unclear if past studies on past vaccines looked at whether they
impact menstruation. Clancy said it wasn’t until the National Institutes of
Health recommended balanced recruitment for drug trials in the 1990s that women
needed to be included in studies.

“We make a lot of assumptions about vaccines and side effects based off of data
that doesn't actually represent all bodies,” she said. “There are biological and
cultural effects to all sorts of different phenomena, and we really need to do
due diligence to study these."

The mechanisms behind how the COVID-19 vaccines might impact the uterus remains
unknown for now. While researchers do not understand how the vaccines — which do
not cause COVID-19 — might influence menstruation, they do have some
understanding of how having COVID-19 impacts menstruation. Research, mostly from
China, looked at that relationship.



“There are some studies that show that how the COVID virus actually enters the
human cells and these receptors are found in part the GI system, kidneys,
possibly the uterus, possibly the placenta,” Dr. Anar Yukhayev, an OB-GYN at
Long Island Jewish Medical Center, told TODAY.

Another study looked about 200 women with and without COVID-19 in China, that
found “about a 20, 25% of them has some kind of changes in their menses whether
the volume or the irregularity,” he said.

Yukhayev wonders if the inflammation that plays a role in the virus contributes
to the changes.

“Perhaps not the virus itself, but perhaps it is the antibodies and the
inflammation reaction that that that it's creating throughout the body,” he
said.



Dr. Gloria Bachmann noted that estrogen is involved with COVID-19.


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“Estrogen does (have an) impact on COVID so that there is sort of a connection.
It’s not a bad connection but it may be a connection that alters a period,” the
OB-GYN and director of the Women’s Health Institute at the Rutgers Robert Wood
Johnson Medical School told TODAY. “There’s no research yet. But I look at it in
terms it could potentially cause a menstrual irregularity that is not a
dangerous one or one that lasts for a long period of time.”

Estrogen often plays a role in heavy periods, early periods, skipped periods or
other changes.

“The hormone estrogen is involved in many, if not all, of the menstrual
irregularities,” Bachmann said.



Yukhayev urges people to talk to their doctors if they notice period changes and
are worried. Some people might want to take a pregnancy test while others might
be experiencing a change in menstruation for other reasons, such as fibroids,
endometriosis or polycystic ovarian syndrome (PCOS), especially if it is longer
lasting.

And Bachmann said that people should report any menstrual irregularities to
V-Safe, a health checker run by the Centers for Disease Control and Prevention
to monitor side effects of COVID-19 vaccines. Menstrual changes weren’t noted as
possible side effects during clinical trials but that could be because
participants simply didn’t notice them or this smaller group didn’t experience
them.

“It usually takes a while for all issues that might be associated with
medication or intervention to be known because you do need some time for enough
people to get it and to report it,” Bachmann explained. “(If it’s rare) it
doesn't come on the radar until there's a lot of people who have gotten the
intervention.”

Changes seem to be short-lived. While the data hasn’t been analyzed from the
survey, Lee noted that anecdotally people have shared that their menstrual
irregularities only seem to last for the cycles following the shots.



“It's two doses that are generally going to land for most people into different
cycles. So, you might end up noticing the disruption for more than one cycle,”
she said. “We're pretty sure it's a very short transient thing.”

People interested in participating in the research survey can do so here.

CORRECTION (April 12, 2021 3:59 p.m. ET): An earlier version of the article
identified Katharine Lee as being a post-doctoral scholar at the University of
Washington School of Medicine. She is at Washington University School of
Medicine in St. Louis.

CORRECTION (April 15, 2021 8:56 a.m. ET): An earlier version misspelled
Katharine Lee's first name.


Meghan Holohan

Meghan Holohan is a contributing writer who covers health and parenting for
TODAY.com. She enjoys cooking, yoga, reading, music and walking her two rescue
dogs. Follow her on Twitter to see her recent stories.

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