Long COVID and women in perimenopause are not a good match.
Research in the last two years has uncovered a disturbing connection between women who are already in perimenopause and Long COVID. The Long COVID attacks their ovary function and exacerbates menopausal symptoms.
Dr. JoAnn Pinkerton, a UVA Health menopause expert, is UVA Health’s division director of Midlife Health and executive director emeritus of the North American Menopause Society.
“What we know is Long COVID is happening more frequently in women with perimenopause,” Pinkerton said in a media call Friday morning.
Women in perimenopause who contract Long COVID often get their symptoms confused.
Pinkerton said research reveals that Long COVID affects the ovaries and causes decline in estrogen reserve. As a result, Long COVID lengthens the symptoms of perimenopause, including fatigue, brain fog and hot flashes.
“This is a really hard time for women when they have fluctuating hormones,” Pinkerton said of perimenopause.
Research revealed that chronic inflammation caused by Long COVID lengthens symptoms. Long COVID is happening more in women with perimenopause. Pinkerton said research found that 50 percent of women with Long COVID experienced changes in their periods for six months if they were already in perimenopause.
Worth noting is the fact that 84 percent of the women had not been asked if they were in perimenopause.
The symptoms of Long COVID and perimenopause can mimic each other. Pinkerton suggested that women track their menstrual cycles and then talk to their doctors about their symptoms.
“That’s going to help the doctor start to say: ‘what’s going on?’”
Menopause is defined as no menstrual cycle for at least 12 consecutive months. Women in perimenopause may skip a cycle periodically before experiencing no cycle.
Pinkerton said that Long COVID may affect hormone changes in women because the virus affects ovaries that are already going into perimenopause. COVID does not cause perimenopause, but may be contracted and exacerbate a woman’s symptoms.
The discovery is exciting for physicians and researchers because it may help to determine if estrogen can be used to treat Long COVID in perimenopausal women. Hormone therapy is often used to treat menopausal symptoms.
Pinkerton said that women in perimenopause who have contracted Long COVID should also consider lifestyle choices to combat symptoms: avoid carbohydrates and sweets before menstrual cycles, exercise and get at least seven hours of sleep every night.
“All that’s going to help ovarian function,” she said.
According to Pinkerton, evidence does not yet suggest anything an individual who has contracted COVID-19 can do to prevent Long COVID. She suggested taking care of yourself by staying hydrated, resting when you can, and exercising when your energy returns. UVA has a Long COVID clinic, and women in perimenopause should seek the care of a specialist.
“The most important piece is to recognize that women in their 40s and 50s are being diagnosed with Long COVID,” Pinkerton said of what physicians can do. She said physicians should not dismiss a woman’s symptoms as Long COVID if she is missing menstrual cycles.
COVID symptoms include rapid heart rate, brain fog and extreme fatigue. They are not symptoms of menopause.
The research connecting menopause and Long COVID is enabling physicians to learn more about menopause.
“It’s going to bring attention to perimenopause, which is this hidden time for women,” Pinkerton said. Perimenopause is often overlooked by researchers.
Studying the ovaries in relation to Long COVID may help humans learn more about ovary function.
“We want women to have good ovary function,” Pinkerton said. A decline in ovary function and estrogen puts a woman into menopause. Estrogen prevents bone loss, lessens heart disease risk and lengthens a woman’s life.