• COVID-19
• Infectious Disease
• Life Stages
• Uniquely Female

Clearing Up Questions On COVID-19 Vaccines And Menstruation, Fertility, Pregnancy

As the COVID-19 vaccine has been scrutinized from just about every health angle, some women have asked the question: Does the vaccine affect menstruation — even after menopause? Some doctors are advocating for more research on the subject, a CNN story reported.

The National Institutes of Health recently announced that it’s spending $1.67 million to help five research teams study the potential effects of COVID-19 vaccines on menstruation.

Premier Health Now asked obstetrician/gynecologist Andre Harris Sr., MD, FACOG, chief medical officer for Atrium Medical Center, to shed light on why changes might occur and how lasting they’re likely to be.

“Currently, any evidence of changes seems to be based on word of mouth from primary care doctors hearing it from patients,” Dr. Harris says. “There was no mention of it in the original Pfizer and Moderna studies, although those were more focused on symptoms seven days out.”

Dr. Harris points out that it’s important to understand a “normal” menstrual cycle in medical terms. If there’s been a change in timing, color, or heaviness of flow, he asks his patients how long they’ve noticed the change.

“If the change has only occurred for one month, we need to wait and see if it becomes a pattern,” he tells patients. “The bigger question to ask is whether the vaccine could change the cycle permanently. Nothing I’ve seen in my office or in the medical literature thus far suggests that.

“The vaccine is meant to stimulate the immune system. The mRNA in the vaccine doesn’t enter the cell nucleus and change the DNA. It’s producing a protein that triggers the immune system to work harder, and that can affect a woman’s cycle for a month, but generally not longer than that.”

He notes that there are other reasons a woman may experience a temporary change in her menstrual cycle: for example, stress related to the pandemic or other life issues, or infection from the virus that causes COVID-19. He thinks it’s a good idea to do further research but is reassured so far that nothing major has surfaced.

Post-Menopausal Bleeding And Fertility Issues

Regarding vaginal bleeding in post-menopausal women following a COVID-19 vaccine, Dr. Harris says, “I can’t imagine a vaccine could increase the estrogen in a woman’s body enough to cause a bleeding episode. Sometimes when you get a vaccine or start a new medicine and some other medical issue comes up soon after that, there could be a correlation, but it also could be just a coincidence.”

He says that with post-menopausal bleeding, he would be much more concerned about conditions such as endometrial cancer. Dr. Harris strongly advises any woman who has post-menopausal bleeding to be evaluated by a physician.

For women in their child-bearing years, he reaffirms that many women participating in the original Pfizer and Moderna studies subsequently got pregnant in the months after receiving the vaccine. “One study group showed women who received the vaccination at various times of their menstrual cycles. There is nothing in the medical literature to attach the vaccine to infertility,” Dr. Harris emphasizes. “With more than 185 million Americans vaccinated, if there was a significant issue, I think we would have seen it by now.”

Vaccine Recommended For Pregnant Women

Dr. Harris also encourages women who are pregnant to get the vaccine. “Any viral infection in pregnant women is a big issue,” he says. “We saw this with H1N1, when many pregnant women were hospitalized with respiratory distress. Pregnancy depresses the immune system, and that potentially puts two people’s lives in danger.”

The American College of Obstetricians and Gynecologists recommends that pregnant women should get the vaccine at any stage of pregnancy. “We’re not giving a live virus, just producing an immune response. And the unborn child gets passive immunity from the mom,” Dr. Harris explains.

For anyone still hesitant about the COVID-19 vaccine, Dr. Harris tries to frame the discussion in a different way: “If we had an illness right now that was primarily killing children and making them severely ill, most of us would say parents were neglectful if they didn’t get their children vaccinated against that illness. In our current situation, people are making decisions that affect their own lives — but they’re also affecting others’ lives in their families and communities.”

Dr. Harris recommends the Centers for Disease Control and Prevention for the most up-to-date and reliable COVID-19 information. “Why not trust the experts who have devoted their lives to this and whose passion is public health?” he asks.

Andre Harris Sr., MD, FACOG, obstetrician/gynecologist, Chief Medical Officer, Atrium Medical Center