Women with long Covid experience longer, heavier periods compared with those never infected with the virus, new research suggests. The severity of long Covid symptoms also fluctuates at different points in the menstrual cycle, becoming more severe around the time of each period.The findings demonstrate the complex relationship between menstrual health and long Covid, a condition which affects about 30 per cent more women than men, experts say.Long Covid is particularly prevalent in women of reproductive age. Anecdotal reports previously pointed to disruption to periods, but research has been limited by a lack of menstrual health data collected during the pandemic.Scientists from the Universities of Edinburgh, Montpellier and Oxford examined data from an online UK survey of more than 10,000 women between March and May 2021. The sample included more than 1000 women with long Covid, 1700 who had recovered from acute Covid infection and 9000 never-infected individuals. Women with long Covid reported heavier, longer periods and more bleeding between periods than those who hadn’t been infected with the virus. Those who had recovered from a short-term Covid illness experienced less disruption to their periods.The research team next examined the impact of different stages of the menstrual cycle on long Covid symptoms, using an app to track daily symptoms in 54 women for three months. Long covid symptoms – such as brain fog, dizziness and breathing issues – were most severe during or just before or after their period, with women reporting that their symptoms eased after the expected time of ovulation.Hormone and inflammation levels were also measured in a smaller number of women, with and without long Covid, using samples of blood and tissue from the lining of the uterus. Heavier, longer periods can result in iron deficiency. Given the symptoms that those with long Covid are already enduring, it is essential that we rapidly identify menstrual disturbance and have effective treatments to prevent iron deficiency and its associated fatigue, weakness and shortness of breath. This study is the first step towards specific treatments for menstrual disturbance in women with long Covid and may also lead to new treatments for long Covid symptoms that are tailored for women. Dr Jackie Maybin Reader and Consultant Gynaecologist at the University of Edinburgh’s Centre for Reproductive Health and NHS Lothian Women with long Covid had a higher level of the hormone 5α-dihydrotestosterone – an androgen, or male hormone, which is also present in females at lower levels – than those without the condition. Androgens support the creation, migration and survival of stromal cells – a type of tissue cell – within the uterus lining, which is shed during menstruation. An increase in these hormones could help to explain heavier menstrual bleeding in those with long Covid, experts say.Levels of progesterone and oestradiol – hormones produced by the ovaries – were similar in those with and without long Covid, indicating that long Covid does not significantly affect ovarian function. Higher levels of inflammation were found in the blood of those with long Covid around the time of their period. This may also contribute to problematic bleeding and influence symptom severity during menstruation, scientists suggest.The link between menstrual health and long Covid must be considered during the development of diagnostic tools for the condition, as symptoms and biological markers may change across the menstrual cycle, the research team say. The study, funded by Wellcome, the Royal Society of Edinburgh, Wellbeing of Women and UKRI, is published in the journal Nature Communications. The potential bidirectional relationship between long COVID and menstruation Behind the scenes: researching long COVID and menstruation Tags CRH Publication date 16 Sep, 2025
