As we pass the three-year mark of the pandemic, there’s still a lot about the coronavirus (SARS-CoV-2 infection) that we have yet to fully understand. However, as more and more science emerges, we’re getting an increasingly clearer picture — and become more adept at prevention and treatment.
One emerging area that scientists are currently digging deeper into is the relationship between Covid and menopause, including:
- How to differentiate between similar Covid and menopause symptoms
- What role menopause plays in the risk of Long Covid
- Whether Long Covid can cause early menopause
Here’s what we know (and don’t know) to date:
Is it Long Covid or is it menopause…help!
According to the World Health Organization, Post-Covid-19 Condition (also known as Long Covid) is classified by lingering symptoms that last for at least two months and cannot be explained by an alternative diagnosis. Symptoms may also fluctuate or relapse over time.
As if women don’t have enough to deal with…recent studies have found that Long Covid skews heavily female at 82.8%. What’s more, the average age is 46.5 years — right when most women are in perimenopause (the 8-10 years prior to menopause, the average age of which is 51).
Given the overlap, it’s often difficult to differentiate between symptoms that are attributable to menopause and those attributable to Covid, including:
- Brain fog
- Poor quality sleep
- Difficulty concentrating
- Joint and muscle aches/pains
- Heart palpitations
This may cause perimenopausal and menopausal women to be misdiagnosed with Long Covid, especially since many healthcare providers treating long-haul Covid don’t always ask about menopause 🤦♀️ (see below for more).
It may also mean that if you’ve had Covid, your symptoms may not necessarily be related to menopause but rather, Long Covid. (If this sounds muddy and confusing, it’s because it is!).
The potential link between Long Covid, hormones & changing menstrual cycles
In a study of 460 women with Long Covid, 62% reported that their symptoms were worse on the days before their periods (when estrogen levels are at their lowest). This led researchers to speculate that Long Covid symptoms may in part be the result of:
- Disturbances in ovarian hormone production
Including estradiol (the most prevalent form of estrogen) and progesterone, two of our key sex hormones.
- Altered chronic inflammatory response due to sex-based immunomodulation
In non-science speak: long-term inflammation due to sex-based changes in the body’s immune system being activated or suppressed.
And while 70% thought that their Long Covid symptoms could be attributed to perimenopause or menopause, a whopping 84% had never been asked by a healthcare professional about this, emphasizing the importance of being proactive and bringing it up during your appointment. 🙋♀️
Can Long Covid cause menopause?
Menopausal hormones impacting (or overlapping with) symptoms of Long Covid is one thing, but causing it? 🤔
Women’s health research in this domain is very preliminary, but some medical professionals hypothesize that Covid-19 may affect women’s ovaries more than other common infections due to the pathogen’s ability to bind to what’s called the angiotensin-converting enzyme 2 receptors (or ACE2 for short), which are located in high concentration in the ovaries. As a result, estrogen levels may decrease, triggering a more sudden (or severe) perimenopause or menopause experience.
Gynecologist Traci Kurtzer is one of the few menopause specialists in the country working on the possible ties between long Covid and menopause.
As she explains: “I’ve been experiencing absolutely a change in the number of women I’m seeing with earlier menopausal symptoms, and the severity of symptoms being quite a bit more intense than it used to be. And I’m seeing menopausal women who have been menopausal for years and stable, whether on hormones or not, starting to have symptoms again.”
Understanding the protective effect of estrogen
Retrospective studies have found that men have a higher risk of severe (and sometimes fatal) outcomes from Covid-19 infections, leading researchers to suspect that estrogen may play a protective role due to its anti-inflammatory effects.
In fact, a May 2022 study revealed that women who received hormone replacement therapy (HRT) within six months of a recorded Covid diagnosis had a 78% lower overall mortality rate than those who did not take estrogen.
Important: this does NOT mean that HRT is the magic cure for all menopausal and postmenopausal women. Also, it’s worth noting that it may not have been HRT alone that reduced Covid-related mortality, but rather the fact that women who were on HRT were simply different in their overall health than those who were not (including cardiac and metabolic markers, as well as rates of obesity, which are directly related to Covid complications). But it IS something to be discussed with your healthcare provider to better understand how to mitigate risk factors not only for potential long-term effects of Covid-19, but also osteoporosis, heart disease, type 2 diabetes, and other conditions that postmenopausal women are at risk of developing.
Looking for a specialized Long Covid clinic? Refer to this article from sciencenews.org, which features an interactive map with facilities by state. And for more information on the available Covid vaccines, refer to vaccines.gov.
Elektra is closely monitoring evolving research on the link between Covid and menopause, so continue checking back in! We’ll be sharing knowledge and breaking down new developments as they emerge.
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