29-year-old Ana completed her Pfizer / BioNTech vaccination schedule in June, and has since had the two heaviest menstrual periods of her life. They were always longer compared to those of her friends, but since she received the doses she noticed that “there is something different”.
Like her, several women around the world have seen changes in their rules. According to an article by The country, There are women who have had alterations in their periods —from larger to delayed— but also in their breasts: some saw their size increased, sometimes just one.
Are these undescribed side effects of COVID-19 vaccines in women? Unfortunately, accurate information is not available at this time, but at least it is being studied.
“Since the beginning of the vaccination campaign, dozens of women throughout the world have reported changes in their menstrual cycles after receiving one of the doses,” says Antonia Muñoz, gynecologist at the UC CHRISTUS Health Network. Among the alterations reported, “more abundant menstrual flows, menstrual delays, more painful cycles and breast pain are described.”
An ongoing investigation is that promoted by Laura Baena, midwife and professor at the University of Granada, in Spain. It is called “Effect of vaccination against SARS-COV 2 on the menstrual cycle of women of childbearing age (EVA Project)”, and it arose as a result of a survey posted by one of her colleagues on social networks, which was answered by more than 5 thousand women. An important part of them suffered irregularities in their menstruation.
As Baena commented to the site Univadis, the participants would be searched until the end of the summer in European lands, that is, during the last week of September, because precisely during those dates “the women of the 18 to 50 year-old range will be vaccinated” on that continent.
Andrea Von Hoveling, a gynecologist at Clínica Santa María, explains that “it has been known for a long time that stress itself can be a cause of menstrual disorder.” Even in the middle of the pandemic period and before the vaccinations, “many alterations regarding bleeding were already reported.” In part, it is due to the same changes and traumas that the virus and confinement produced, such as “changes in habit, diet, uncertainty and frank anguish at certain times.”
“Most likely, the disorder observed with immunization has a similar explanation, because there is no component in vaccines that has been identified as a disruptor of the hormonal axis”, points out the also delegate for Chile of the Ibero-American Network of Sexual and Reproductive Health (REDISSER).
“The menstrual cycle is one of the most important physiological processes in women’s health, and its alteration may be due to an early sign of another pathology,” warns Muñoz.
As the gynecologist from UC CHRISTUS Health Network explains, the female menstrual cycle “is generated by a harmonious synchronization of hormonal pulses produced by the woman’s brain, which stimulate the pituitary to synthesize the hormones FSH and LH, at a frequency and adequate amount to get to stimulate the ovaries ”.
In turn, “the hormones estrogen and progesterone are synthesized, allowing the menstrual cycle with their adequate levels, generating ovulation and subsequent endometrial desquamation, when the cycle has not been fertilized by a sperm”, he points out.
Something important about this process is that “it can be affected by multiple endocrine, environmental, psychological factors, chronic pathologies, lifestyle habits, exercise, medications and more,” adds Muñoz. Unfortunately, “there is a lack of studies in this area that allow us to understand the universe behind the menstrual cycle of women.”
It is not news that women have had to fight for spaces and for equity in various areas, and just as there is a lack of progress in terms of provision or equality in salaries, it also happens that menstruation has been largely omitted as a field of research.
“Rarely is menstruation and its changes considered in health studies of any kind,” says Von Hoveling, who is also director of the SOCHEG (Chilean Society of Endocrine-Gynecology). For instance, “pregnant women tend to be excluded from any investigation due to the fact that they are pregnant ”.
“Menstrual health and experiencing menstruation with dignity is something that is not considered a state expense in practically any country in the world,” he warns. “That in vaccine studies not asking about the menstrual cycle seems to be one more sign of the same.”
Enriqueta Barranco, one of the gynecologists and academics who is collaborating with the EVA Project research, pointed out that “there is not enough information to explain what is happening to women,” because the protocols for inclusion in clinical trials of vaccines have ‘a tremendous lagoon’ regarding gender criteria ”, as communicated The country.
In addition to the study by the University of Granada, Muñoz mentions that in the pharmacovigilance monitoring of the Spanish Agency for Medicines and Health Products (AEMPS) side effects of Moderna, Astrazeneca, Comirnaty and Janssen vaccines were recorded from the start of vaccination until July of this year.
“In their report they describe that 77% of side effects occur in women, and among them 759 cases of menstrual disorders were reported, out of a total of 20,162,833 doses administered to women between 18 and 64 years old.”
“On the other hand, the UK government reported about 2,200 reported cases of menstrual alterations after vaccination against covid-19 “, it complements. “It is also about abnormal menstrual bleeding, pain, engorgement and delays in the period.”
Dr. Victoria Male, a reproductive immunologist at Imperial College London, in an interview with BBC she said that “some postmenopausal women, and people taking hormones that stop their periods, have reported bleeding.” In his medical opinion “he is inclined to suspect that there may be a physical reaction.”
Although there is a lack of research in this field, and that this possible link is not yet proven, reproductive specialists emphasize in the same article that “these changes are not a cause for concern” and although “painful or unexpected periods can be distressing, they are not a sign of any long-term damage. “
An example of this is that vaccines such as influenza or the human papillomavirus can alter the menstrual cycle. In any case, this is temporary and there are no associated long-term side effects.
“There is nothing to suggest that this menstrual disorder has future implications for fertility or ovarian function,” concludes Von Hoveling. For the same, “the greatest risk continues to be covid-19 disease ”. The call he makes is “to be vaccinated calmly and simply observe the bleeding.”
“If ongoing studies will show in the future that there is a link between the vaccine and short-term changes in the menstrual cycle, this should not be a reason to avoid vaccination,” Muñoz supports. Like Von Hoveling, emphasizes that “the benefit of the vaccine greatly outweighs the risk of suffering any of these symptoms.”
“Both menstrual alterations and breast engorgement would be considered mild and transitory side effects, which should not cast doubt on the effectiveness of vaccination to prevent covid 19,” he details.
If you’ve been vaccinated against COVID-19 and notice a pattern of change in your periods, UC CHRISTUS Health Network gynecologist says it’s important to “record your symptoms on a menstrual calendar and watch your periods for 3 menstrual cycles.”
“If the alteration is temporary and does not remain in the rest of the cycles, they should not worry,” he assures, but if you notice “a persistence of these alterations for more than 3 cycles, it is important that you consult your gynecologist, because it could be another disease that is manifesting itself and that we must study. “
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