COVID has affected countless aspects of our lives. For many people who menstruate, one of the pandemic’s effects has been on periods. People have reported changes to their menstrual cycles after having COVID, from the timing of their period, to its duration, to bleeding (a heavier or lighter flow).
Meanwhile, many people have reported changes to their menstrual cycles after COVID vaccination. The largest study yet on this topic has just been published, finding that 42% of people who regularly menstruate reported a heavier period after COVID vaccination.
The researchers, based in the US, launched an online survey in April 2021, which was advertised through multiple channels, including TV news, Twitter, blogs and radio. The survey asked for demographic information and included questions about people’s periods, from symptoms to timing and bleeding duration.
It also asked about COVID vaccination status. For this analysis, all participants had been fully vaccinated, meaning they had received two doses at least 14 days before completing the survey (boosters were not yet available at the time). Most participants had received either the Pfizer or Moderna vaccines.
The results are based on responses from 39,000 people who regularly menstruate or who have done so in the past. The latter group could include people who have been through menopause, people receiving gender-affirming treatment, or people using hormonal contraceptives that suppress menstruation.
The study excluded anyone who had had COVID.
In the group who regularly menstruate, 42% reported a heavier period after their vaccine, 44% reported no change, and 14% reported a lighter period.
In the second group, two-thirds of post-menopausal participants and people on long-acting reversible contraceptives (such as IUDs and implants) reported breakthrough bleeding after COVID vaccination. Over one-third of those on gender-affirming treatment (which eliminates menstruation) experienced breakthrough bleeding.
What has other research found?
Other studies have also found changes in periods following vaccination.
For example, a study of almost 4,000 participants in the US found that after a second vaccine people started their period on average just over half a day later than expected.
A Norwegian study of more than 5,500 people found that over 7% of participants experienced heavier and longer periods after receiving their first COVID vaccine dose.
Similarly, a study of 2,269 women in the Middle East and north Africa found that women reported menstrual irregularities such as longer periods and longer cycles (more time between periods) after vaccination.
Reports of cycle changes after vaccination is not a new phenomenon. A 1913 study showed heavier bleeding after typhoid vaccination. Similarly, a 1982 study on hepatitis B and a more recent one on HPV found changes to menstrual cycles following vaccination.
We don’t yet fully understand the biological mechanism behind cycle changes linked to COVID vaccines. But changes to menstrual cycles usually stem from one of two routes: hormones or inflammation. A vaccine works by provoking the immune system to react to exposure to a disease, which can influence inflammation.
As the study didn’t find any differences between users of hormonal contraceptives (such as the pill) and non-users, the authors suggest the mechanism is likely to relate to inflammation rather than hormones.
The authors also suggest that menstrual changes could be due to the effect of the immune system on the uterus. In particular, the inflammation sparked by the vaccine could affect the uterine lining, leading to breakthrough bleeding. But this requires more research.
Whatever the case, changes to menstrual cycles after vaccination are short-lived. For most, cycles should return to normal within a few months.
Some things to keep in mind
While the effect of vaccines on periods is not an area that has traditionally attracted a lot of research, the issue has been brought into the spotlight by the scale and speed of the COVID vaccination campaign. Because more people are having similar symptoms at the same time, this leads to more attention and more research.
It’s important to note that this study cannot conclude that the vaccine causes menstrual changes. While it shows associations, to establish a causal link, we would need a clinical trial (so, to follow people who did and didn’t receive a COVID vaccine over a longer period of time). Indeed, the authors stress the importance of including questions about menstrual cycles in future vaccine research.
Further, the way participants were recruited in this study means the results should be interpreted with caution. People who saw changes in their period after vaccination might have been more inclined to respond to the survey, which could have skewed the results. Most of the participants were also white, so the results may not apply to racially diverse groups.
This research should provide an impetus for further study and raise awareness of menstrual changes as a possible side-effect of COVID vaccination. The public should be made aware of possible side-effects, not because they’re dangerous, but because people need to know what to expect.
Just as you might have a painkiller on hand to take if you develop a headache after vaccination, some people may want to be prepared with extra menstrual products. Knowing what to expect could be especially useful for people who are no longer menstruating but may experience breakthrough bleeding following vaccination.
Gabriella Kountourides does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
JMIR Neurotechnology, published by JMIR Publications, welcomes submissions from researchers, clinicians, caregivers, and technologists that explore novel…
JMIR Neurotechnology, published by JMIR Publications, welcomes submissions from researchers, clinicians, caregivers, and technologists that explore novel diagnostic and treatment tools for neurological disorders, particularly those leveraging the potential of neurotechnology.
Credit: JMIR Publications
JMIR Neurotechnology, published by JMIR Publications, welcomes submissions from researchers, clinicians, caregivers, and technologists that explore novel diagnostic and treatment tools for neurological disorders, particularly those leveraging the potential of neurotechnology.
The scope of the journal includes but is not limited to:
Neuroradiology
Advancements in neurosurgery
Innovative diagnostic tools and techniques
Cutting-edge neurotechnology for therapeutics
Data sharing and open science in neurotechnology
Code transparency and reproducibility
Neurorehabilitation
Cognitive enhancement
Challenges and ethical considerations
Neuroimaging and brain-machine interfaces
Neurotechnology and artificial intelligence (AI).
For a limited time only, JMIR Neurotechnology is offering a 50% APF discount on all manuscripts accepted for publication with the use of an active promo code. For more information, please visit https://neuro.jmir.org/about-journal/article-processing-fees.
Please visit our website for more information on submission guidelines and the peer-review process.
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About JMIR Publications
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fMRI study finds correlated shifts in brain connectivity associated with overthinking in adolescents
COLUMBUS, Ohio – A new study from The Ohio State University Wexner Medical Center and College of Medicine, University of Utah and University of Exeter…
COLUMBUS, Ohio – A new study from The Ohio State University Wexner Medical Center and College of Medicine, University of Utah and University of Exeter (UK) substantiates previous groundbreaking research that rumination (overthinking) can be reduced through an intervention called Rumination-focused Cognitive Behavioral Therapy (RF-CBT). In addition, the use of fMRI technology allowed researchers to observe correlated shifts in the brain connectivity associated with overthinking.
Credit: The Ohio State University Wexner Medical Center
COLUMBUS, Ohio – A new study from The Ohio State University Wexner Medical Center and College of Medicine, University of Utah and University of Exeter (UK) substantiates previous groundbreaking research that rumination (overthinking) can be reduced through an intervention called Rumination-focused Cognitive Behavioral Therapy (RF-CBT). In addition, the use of fMRI technology allowed researchers to observe correlated shifts in the brain connectivity associated with overthinking.
Study findings are published online in the journal Biological Psychiatry Global Open Science.
“We know adolescent development is pivotal. Their brains are maturing, and habits are forming. Interventions like RF-CBT can be game-changers, steering them towards a mentally healthy adulthood. We were particularly excited that the treatment seemed developmentally appropriate and was acceptable and accessible via telehealth during the early pandemic,” said corresponding author Scott Langenecker, PhD, vice chair of research in the Department of Psychiatry and Behavioral Health at Ohio State, who started this project while at the University of Utah.
RF-CBT is a promising approach pioneered by Ed Watkins, PhD, professor of experimental and applied Clinical Psychology at the University of Exeter. It has been shown to be effective among adults with recurrent depression.
“We wanted to see if we could adapt it for a younger population to prevent the ongoing burden of depressive relapse,” said Rachel Jacobs, PhD, adjunct assistant professor of psychiatry and behavioral sciences at Northwestern University who conducted the pilot study in 2016.
“As a clinician, I continued to observe that standard CBT tools such as cognitive restructuring didn’t give young people the tools to break out of the painful mental loops that contribute to experiencing depression again. If we could find a way to do that, maybe we could help young people stay well as they transition to adulthood, which has become even more important since we’ve observed the mental health impact of COVID-19,” Jacobs said.
In the just published trial, 76 teenagers, ages 14-17, with a history of depression were randomly assigned to 10-14 sessions of RF-CBT, while controls were allowed and encouraged to receive any standard treatment. Teens reported ruminating significantly less if they received RF-CBT. Even more intriguing, fMRI illustrated shifts in brain connectivity, marking a change at the neural level.
Specifically, there was a reduction in the connection between the left posterior cingulate cortex and two other regions; the right inferior frontal gyrus and right inferior temporal gyrus. These zones, involved in self-referential thinking and emotional stimuli processing, respectively, suggest RF-CBT can enhance the brain’s ability to shift out of the rumination habit. Notably, this work is a pre-registered replication; it demonstrates the same brain and clinical effects in the Utah sample in 2023 that was first reported in the Chicago sample in 2016.
“For the first time, this paper shows that the version of rumination-focused CBT we have developed at the University of Exeter leads to changes in connectivity in brain regions in adolescents with a history of depression relative to treatment as usual. This is exciting, as it suggests the CBT either helps patients to gain more effortless control over rumination or makes it less habitual. We urgently need new ways to reduce rumination in this group in order to improve the mental health of our young people,” Watkins said.
Next, the researchers will focus on demonstrating the efficacy of RF-CBT in a larger sample with an active treatment control, including continued work at Ohio State, Nationwide Children’s Hospital, University of Exeter, University of Utah and the Utah Center for Evidence Based Treatment. Future directions include bolstering access to teens in clinical settings and enhancing the ways we can learn about how this treatment helps youth with similar conditions.
“Our paper suggests a science-backed method to break the rumination cycle and reinforces the idea that it’s never too late or too early to foster healthier mental habits. Our research team thanks the youths and families who participated in this study for their commitment and dedication to reducing the burden of depression through science and treatment, particularly during the challenges of a global pandemic,” Langenecker said.
This work was supported by the National Institutes of Mental Health and funds from the Huntsman Mental Health Institute and is dedicated to researcher Kortni K. Meyers and others who have lost their lives to depression.
# # #
Journal
Biological Psychiatry Global Open Science
DOI
10.1016/j.bpsgos.2023.08.012
Method of Research
Randomized controlled/clinical trial
Subject of Research
People
Article Title
Rumination-Focused Cognitive Behavioral Therapy Reduces Rumination and Targeted Cross-network Connectivity in Youth With a History of Depression: Replication in a Preregistered Randomized Clinical Trial
Article Publication Date
27-Oct-2023
COI Statement
Edward R. Watkins reports royalties from a treatment manual for RF-CBT published by Guilford Press and licensing of RF-CBT for Internet treatment packages. Sheila E. Crowell is a co-owner of the Utah Center for Evidence Based Treatment, an outpatient psychotherapy practice that is unrelated to this work. Scott A. Langenecker reports
consultant payments from Stony Brook University, Penn State University, and Johns Hopkins University (unrelated to this work) and payments from the Center for Scientific Review (unrelated to this work) and part ownership of Secondary Triad, Inc. (unrelated to this work). All other authors report no biomedical financial interests or potential conflicts of interest.
Republicans and Democrats both have misconceptions about the energy sector, with the former often downplaying climate change and the latter misunderstanding oil industry operations.
Oil prices are determined by global supply and demand, not by individual oil companies; thus, claims of oil companies causing inflation or gouging prices are misplaced.
Implementing policies like windfall profits taxes on oil companies doesn't address the root issues of supply and demand, and it's essential for policymakers to have a comprehensive understanding of the energy sector for effective governance.
Good energy policy starts with a good understanding of energy issues. But both major political parties have glaring blind spots when it comes to understanding the energy sector.
Let me preface this column by noting that I am a registered Independent. I have major disagreements with both political parties, and I strive to approach issues from a completely objective viewpoint.
I think Republicans get it mostly wrong when it comes to climate change, and the importance of transitioning to alternative energy. But they seem to understand the current critical role of fossil fuels in the economy, and they mostly get it right when it comes to supporting nuclear power.
Democrats never seem to understand how the oil industry works. For example, look at the list of Democrats who signed onto the “Big Oil Windfall Profits Tax” introduced last year by Senator Sheldon Whitehouse (D-RI). In announcing the bill, Senator Whitehouse said it would “curb profiteering by oil companies and provide Americans relief at the gas pump.”
The bill was cosponsored by Senators Jeff Merkley (D-OR), Elizabeth Warren (D-MA), Bernie Sanders (I-VT), Richard Blumenthal (D-CT), Tammy Baldwin (D-WI), Sherrod Brown (D-OH), Jack Reed (D-RI), Ed Markey (D-MA), Cory Booker (D-NJ), Michael Bennet (D-CO), and Bob Casey (D-PA). Congressman Ro Khanna (D-CA-17) introduced the legislation in the U.S. House of Representatives.
In addition to claims of price gouging, this same cast of characters has sometimes blamed oil company profits for inflation.
These politicians do not seem to understand that oil companies don’t control prices. Oil is the world’s most valuable commodity. Oil prices are set by buyers and sellers in global markets, based on supply and demand expectations.
Firms like ExxonMobil produce such a small share of the world’s oil they couldn’t move prices much if they wanted to. They benefit from high prices, but don’t set those prices. If they did, prices would never fall.
Saying profits cause inflation confuses cause and effect. It’s like saying hospitalizations cause car crashes. It is true that a car crash can result in hospitalization, but hospitalizations do not cause car crashes. If you believe the latter — and you try to address the problem by focusing on the hospital — you are working on the wrong problem.
Likewise, high profits in the oil industry and inflation are both caused by high oil prices. But high oil prices are caused by supply and demand factors.
Outside of rare circumstances, it’s impossible for oil companies to gouge you, because they don’t set the price. An example of true price gouging would be if a local gas station that sets its own prices doubled them when supply is ample. But Chevron earning more from high global prices set by markets is normal capitalism. That’s how the entire global commodity markets work.
I can only imagine that in the minds of some politicians, executives of Big Oil are meeting in smoke-filled boardrooms, rubbing their greedy hands together, and deciding to raise prices because Russia invaded Ukraine. But that’s not how any of this works.
If politicians want to address oil prices, they need to address the supply side and the demand side. When politicians propose windfall profits taxes on oil companies, intending to give rebates to consumers, it might sound good, but it doesn’t address the core issue.
High prices should signal consumers to use less energy, but rebates would diminish the price signal — which wouldn’t alleviate pressure on demand. On the supply side, punitive taxes on oil companies might sound appealing, but that’s less money that can be allocated to projects, which affects future supplies. Former Venezuelan president Hugo Chávez learned this lesson the hard way, and Venezuela is still paying the price.
Some have expressed outrage that oil companies are using record profits to buy back shares or pay special dividends to shareholders. But it’s common for companies, not just in the oil industry, to buy back shares or pay dividends when profits are high. It’s a part of how our capitalist system works. If companies can issue shares, they should be able to buy them back.
For consumers worried about high oil prices, there are options. You can invest in an oil company. Thus, when oil prices rise, so do your shares. Or consider switching to an electric vehicle to reduce your reliance on fossil fuels.
In conclusion, understanding energy issues is crucial for effective policymaking, yet both major political parties often exhibit significant misunderstandings of the energy sector. By understanding the complexities of the energy sector, policymakers and consumers alike can make informed decisions that contribute to a more sustainable and economically sound future.
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