The vaccination roll out has seen menstruation reports to the yellow card scheme, which is the system to report adverse effects of any medication or treatment in the UK. “Common side effects of covid-19 vaccination listed by the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) include a sore arm, fever, fatigue, and myalgia. Changes to periods and unexpected vaginal bleeding are not listed, but primary care clinicians and those working in reproductive health are increasingly approached by those who have experienced these events. “More than 30 000 reports by 2 September 2021, across all covid-19 vaccines currently offered”. (1)

The Science Media Centre on the 21st June 2021 stated that “It is vanishingly unlikely that vaccination, including Covid-19 vaccination, would have this effect, and women should not be worried that vaccination might cause problems with their periods” (2). Another report from the International Journal of Epidemiology suggests that menstrual disorders are extremely common, in its explanation to the yellow card scheme.

I have no doubt that there are “challenges”.  “Studying menstrual cycle features is challenging. Normal variation exists within women over the lifespan and between women in relation to characteristics such as history of infertility, body mass index (BMI) and exercise. In addition, menstrual cycle features such as volume, pain and PMS symptoms are subjective “(3). But my concern is that women do not go to their healthcare provider about their menstruation cycle unless they are experiencing a different pattern. Women know.

One report from the School of Medicine in Chicago found that “More than half of respondents to an online survey reported changes in their menstrual cycles during the pandemic, including differences in premenstrual symptoms and in the time between cycles and the duration of their bleeding”(4). Changes can be accredited to stress of the pandemic, as “It is well-known that stress can cause changes in menstrual cycles, and these changes range from shorter or longer periods to heavier or lighter bleeding, and may cause women to skip or miss a period altogether,” said study author Nicole Woitowich”.

There has been more media coverage, that may highlight menstruality to all with campaigns such as #periodpoverty, the Scottish product free provision, Red Tent Movement facebook groups and resources for online education. The University of Edinburgh has highlighted that when women have irregularities or “problems”, they know. They know the difference between ‘Typical and problem periods’ (5). The author and obstetric Doctor, Michel Odent writes in Primal Health (Ch9) that our bodies and our cycles are also intrinsically linked to our external world as well as the internal. Our stresses and strains are influential to our cycle. How can you measure tiredness as a quantity measurement? One person’s levels of tolerable activity are different from another. This is why comparisons are not as scientific as science would like. This is why we have not engaged in parameters of normal Michel Odent says, “what is normal health and how is that measured?” (6).

More recently the American Society of Gynaecologist rate the menstrual cycle as a “vital sign” in health. “ACOG and supported by the American Academy of Pediatrics (AAP) advises health practitioners to consider periods as the “fifth vital sign” — meaning menstruation is as important a health indicator as changes in body temperature, pulse, breathing rate, and blood pressure (7). Other countries are participating in further investigations, such as The Institute of Public Health in Norway. They monitored 6000 women, and are now going on to research a cohort of 60,000 participants.  In this study they state that in most (vaccine) cases, the changes were transient and returned to normal in the next cycles. Here in Norway the reporting system has gone on to formulate a research study. The findings of this study will be vital to all pharmaceutical companies and all countries rolling out programmes in the future, as well as Women’s Health around the world. (8). (Menstrual changes following COVID-19 vaccination – NIPH (fhi.no)

1.(www.bmj.com/content/374/bmj.n2211).

2.(www.sciencemediacentre.org/expert-reaction-to-mhra-yellow-card-reporting-relating-to-periods-after-covid-19-vaccines

3. http://www.academic.oup.com/ije/advance-article/doi/10.1093/ije/dyab239/6447179

4 .www.usnews.com/news/health-news/articles/2021-10-04/pandemic-stress-altered-many-womens-menstrual-cycles

5.www.ed.ac.uk/centre-reproductive-health/news/2021-news/menstrual-health-animation

6. Michel Odent 2007 Primal Health Chapter 9

7. http://www.elemental.medium.com/doctors-think-your-period-should-be-a-fifth-vital-sign-5b882c864783

8 (Menstrual changes following COVID-19 vaccination – NIPH (fhi.no)