- Post-CovidWomen and COVID
- Disruption of the menstrual cycle
- Sexual dysfunction
- If I have symptoms after a SARS-CoV-2 infection, when will I get better again ?
- Female fertility
- Is COVID more severe in men or in women ?
- If I want fertility treatment, should I delay it ?
- Is there a treatment to get back to normal ?
- Social impact
Disruption of the menstrual cycle
The majority of women observe no change in their menstrual cycle following a COVID infection. However a recent study conducted with 127 SARS-CoV-2 positive women showed that 16% reported changes in their menstrual cycle. Of these 16%, 35% experienced a longer cycle (>35 days), 10% experienced lighter menstrual flow whilst 20% reported a heavier flow or prolonged bleeding (>7days), and 20% experienced more painful periods. There is currently no way to know whether these disturbances are due to the stress caused by the symptoms of the illness or by the virus itself.
In the general population, a decrease in sexual desire among 45% of women and increased pain during intercourse were observed following the pandemic. However, it is impossible to say whether this decrease is due to the infection, the stress caused by the infection or the stress caused by the pandemic in general.
If I have symptoms after a SARS-CoV-2 infection, when will I get better again ?
If your menstrual cycle is disrupted, studies show that it will settle down after 2 to 3 months.
If you experience persistent loss of sexual desire or exacerbated premenstrual syndrome, it is important to see a specialist about your mood. These symptoms could be caused by the emotional stress due to the COVID-19 pandemic.
Fertility depends on many variables (sexual desire, regularity of menstrual cycle, egg quality, ovarian reserve, integrity of the uterine cavity and condition of Fallopian tubes). Owing to its oxidative stress properties, COVID-19 could theoretically affect egg quality. However, this has not been proven. There is no difference in the anti-Müllerian hormone (AMH) level, which reflects the ovarian reserve, and level of sex hormones in women who have had COVID-19. There is no effect on the uterine cavity or Fallopian tubes.
Is COVID more severe in men or in women ?
Although men are more often affected by severe COVID during the acute phase of the infection, and have higher mortality rates, the female sex is associated with a higher risk of persistent symptoms after infection by SARS-CoV-2. Geneva cohort studies of people who had not been hospitalized showed that the female sex was associated with 1.4 times the risk of persistent symptoms after COVID-19 infection, 1.4 times the risk of fatigue, 1.5 times the risk of breathlessness and 1.6 times the risk of headaches. Women also appear to have more muscle fatigue, sleep disruption, depression and anxiety.
If I want fertility treatment, should I delay it ?
Current studies do not show any impact on treatment in terms of pregnancy, miscarriage or live birth rates. For in vitro fertilization (IVF), there appears to be no effect on egg quality, fertilization rate, pregnancy rate or birth rate.
Some studies have shown a slight decrease in the number of embryos obtained. We know that COVID-19 increases oxidative stress, and some medical teams therefore recommend delaying medically assisted reproduction procedures for 3 months. However, follicular fluid and eggs have been analysed and SARS-CoV-2 was not detected. Nonetheless, more and better-quality research will be needed to confirm these data.
Is there a treatment to get back to normal ?
There is not yet any specific treatment. You can take vitamins to boost your immune system and antioxidants like Coenzyme Q10, which could be beneficial for your ovaries, but there is no reliable scientific evidence to date.
The greater frequency of persistent symptoms after a SARS-CoV-2 infection in women than in men could potentially exacerbate the gender inequalities in society. As women are more frequently affected and more likely to suffer from post-COVID in the long term, they are likely to see a greater impact on their professional, social and family lives. Since women have traditionally taken on the role of caregiver for children and the family, they may also be forced to stop working or reduce their hours to look after children or adolescents affected by long COVID.
There are no contraindications to pregnancy in people with persistent post-COVID symptoms. To date, there is no link between persistent post-COVID symptoms and the likelihood of becoming pregnant. As pregnancy is a period that can be tiring in itself, post-COVID symptoms may be experienced more during this period. To find out more, you can read the information by symptom and discuss it with your primary care physician or gynaecologist.
Carp-Veliscu, A., “The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature”, International Journal of Environmental Research and Public Health, vol. 19, 984 (2022).
Kezhen Li, “Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age”, Reproductive BioMedicine Online, 2021.
Bechmann N et al., “Sexual dimorphism in COVID-19: potential clinical and public health implications”, The Lancet Diabetes & Endocrinology, vol. 10, No. 3 (March 2021), pp. 221—230, doi: 10.1016/S2213-8587(21)00346-6.
Phelan N, “The Impact of the COVID-19 Pandemic on Women’s Reproductive Health”, Frontiers in Endocrinology, vol. 12, 642755, doi: 10.3389/fendo.2021.642755.