Evidence map›Paper›PMID 40957873›Full record

ArticleNature communications2025

The potential bidirectional relationship between long COVID and menstruation.

Jacqueline A Maybin, Catherine Walker, Marianne Watters, Natalie Zm Homer, Joanna P Simpson, Cara Robb, Douglas A Gibson, Luna Jeanjean, Hilary O D Critchley, Gabriella Kountourides and 2 more

Abstract read
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jacqueline A MaybinCentre for Reproductive Health, University of Edinburgh, Edinburgh, UK. jackie.maybin@ed.ac.uk.ORCID http://orcid.org/0000-0003-1560-2840
Catherine WalkerCentre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
Marianne WattersCentre for Reproductive Health, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0002-2763-3815
Natalie Zm HomerMass Spectrometry Core, Edinburgh Clinical Research Facility, Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0002-9262-2098
Joanna P SimpsonMass Spectrometry Core, Edinburgh Clinical Research Facility, Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0002-0939-8487
Cara RobbCentre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
Douglas A GibsonCentre for Reproductive Health, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0002-9949-1983
Luna JeanjeanISEM, University of Montpellier, CNRS, IRD, EPHE, Montpellier, France.
Hilary O D CritchleyCentre for Reproductive Health, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0003-1913-4044
Gabriella KountouridesSchool of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK.
Zuzanna OlszewskaSchool of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK.
Alexandra AlvergneISEM, University of Montpellier, CNRS, IRD, EPHE, Montpellier, France.ORCID http://orcid.org/0000-0002-3151-9919

Funding

RCUK | Medical Research Council (MRC) G1002033, MR/N022556/1Royal Society of Edinburgh (RSE) R47180Wellbeing of Women RTF1103Wellcome TrustWellcome Trust (Wellcome) 209589/Z/17/Z
6 · The paper itself

Abstract

Women have reported menstrual changes following SARS-CoV-2 infection and variation in long COVID symptoms across the menstrual cycle. We examined (i) whether COVID is linked to abnormal uterine bleeding (AUB), (ii) if long COVID symptoms vary with the menstrual cycle, and (iii) potential underlying mechanisms. Here we show long COVID was associated with AUB in a UK population. When compared to those never infected (n = 9423), long COVID participants (n = 1048) reported increased menstrual volume, duration and intermenstrual bleeding, while those who recovered from acute COVID (n = 1,716) reported minimal menstrual disruption. Long COVID symptoms examined in 54 women across the menstrual cycle revealed that severity was highest during the perimenstrual and proliferative phases. Serum and endometrial analysis revealed higher serum 5α-dihydrotestosterone and lower endometrial androgen receptors in long COVID versus no COVID. Other ovarian hormones showed no significant differences. Serum cytokine profiling indicated increased menstrual inflammation with long COVID and immune cell aggregates were observed in menstrual endometrium. In conclusion, long COVID was associated with AUB but not impaired ovarian function. Differences in peripheral and endometrial inflammation may contribute to AUB and long COVID symptom severity. We anticipate our findings will instigate exploration of new therapeutic strategies for women with long COVID.

Indexed as

COVID-19MenstruationMenstruation DisturbancesAdultCytokinesEndometriumFemaleHumansMenstrual CycleMiddle AgedPost-Acute COVID-19 SyndromeSARS-CoV-2United KingdomYoung AdultCytokines

Identifiers

PMID40957873
PMCPMC12441152

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.