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In a 2020 study collecting data on 1,031 menstruating women from the UK, 46 percent reported changes in their cycle since the beginning of the pandemic and 53 percent reported worse premenstrual symptoms (PMS). The women who reported changes in their cycle, including worsened PMS, more painful periods and reduced libido, were more likely to also experience low mood, stress and anxiety. What’s happening here – and is the pandemic all to blame?
The hormones progesterone and oestrogen decrease during menstruation, triggered by the corpus luteum on the ovaries breaking down due to the absence of a fertilised egg. PMS is caused by the change in these two hormones which in turn affect serotonin levels – the "happy hormone". The cause of more or less severe PMS in different women is down to different sensitivities in changing progesterone and oestrogen levels, rather than having different amounts of these hormones. Factors including stress, diet and exercise can impact this sensitivity. In the aforementioned study, a higher percentage of participants were of white ethnic background than is reflective of the UK population, meaning that the study may not accurately portray the experiences of all menstruating people during the pandemic, namely women of BAME backgrounds.
Research has shown that the Covid-19 pandemic has caused an increase in stress and anxiety in the general public, with people facing new problems such as loneliness, weight gain, job security, and a change in their diet and exercise. Endocrinological processes have shown to be highly sensitive to stress. The hypothalamic-pituitary-adrenal (HPA) axis increases the release of cortisol while the body is in fight or flight. Problems arise when this stress response occurs over a long period of time, causing unregulated cortisol levels which then suppresses reactions connected to ovulation, thus disrupting your usual cycle.
A study published in The European Journal of Contraception & Reproductive Health Care found that 44.4 percent of participants from over 15 countries had noticed changes in their menstrual cycle over the course of 2021. Another study focusing on women in sport, with participants ranging from “physically active” to “elite”, found that 52.6 percent noticed differences in their menstrual symptoms over lockdown. In agreement with previous studies, the participants also recorded changes in their mental state. One of the differences reported was an increase in lower back pain, which is caused by the walls of the womb contracting to facilitate the shedding of uterine lining. Much research points to stress worsening our perception of pain.
What happens to our periods after being infected with Covid-19? One study found that, of 177 hospitalised patients, 20 percent had a significant decrease in menstrual volume and 197 experienced a prolonged cycle. Interestingly, 99 percent of patients who reported changes returned to normal after 1-2 months.
Unsurprisingly, science is still playing catch up on the subject of female reproductive health, due to the many years of stigma surrounding menstruation. Patriarchal society has assured that records of menstruation have been omitted from other events of mass stress in human history. The effects of the Covid-19 pandemic will continue to be researched for decades after the fact, and while studies have shown that most of the effects on female reproductive health are transient, this can only be confirmed years into the future.