On the “sidelines” of the Covid-19 pandemic, a lesser-discussed drama is slowly playing out. Lesser-known because it’s a “girl thing”.
Covid vaccines caused panic around the world, as droves of women began reporting mysterious menstrual cycle changes to their care providers: irregular, short, long, or skipped cycles, and unusually heavy menstrual bleeding.
These phenomena caused anxiety and fear that these changes could be dangerous and long-term. There was no research to prove safety while health organizations like the WHO, CDC, and ministries of health around the world recommended that all women get vaccinated, including those who were pregnant and breastfeeding. No one even thought to include questions about menstrual cycle irregularity in a checklist given to thousands of people who participated in the vaccine clinical trials.
Adding insult to injury, physicians and gynecologists routinely dismissed the symptoms and side effects and their patients felt undermined and ridiculed. They were told their complaints were benign, normal and nothing to worry about.
Some doctors took to the media to reassure women the shots were safe and necessary. They all told the same story: When a vaccine interrupts a regular cycle, it compounds emotional stress, just like other stressors which can disrupt the menstrual cycle, such as illness, travel, diet, or medications. A doctor should have the wisdom and honesty to tell the truth, that they don’t know what it means because there isn’t enough data.
Unraveling untold truths
It took two American anthropologists sharing their own period havoc stories in the New York Times to create an outpouring of thousands of others sharing their experiences. These researchers are now following 140,000 people in an open study that began by chance on social media.
Then there was another round of media frenzy when it was discovered that two of the vaccines were associated with increased blood clotting. Some experts had to hide behind their shame and embarrassment as they admitted that for millions of hormonal birth control users, the risks for blood clotting are 100 times higher, more serious and life-threatening than the covid vaccines!
Some medical journals noted the paradox but the silence around the issue was deafening; it was just another small example of how women’s bodies and hormonal health are marginalized.”
Not surprisingly, the dictate to vaccinate was met with suspicion and opposition. Poor public health messaging and a streamlined approval process for authorizing emergency use of the vaccine left many people anxious and distrustful about the vaccine and the health system. That created a fertile ground for panic, misinformation, and conspiracy theories that the vaccine interferes with pregnancy, causes miscarriage, fetal death, and infertility. Many months later, millions of people are still refusing the jabs. As many countries now brace for the fourth wave of infections, the situation invites us to reflect on the problematic relationship that women, doctors, and western culture each have with periods and menstrual blood.
Narrow perceptions of the menstrual cycle
Periods are largely viewed as a nuisance and an inconvenience. They still arouse stigma, shame, and embarrassment. Furthermore, they are narrowly viewed as relevant or important when it comes to pregnancy, fertility and childbearing, but ignored in the larger context of hormonal balance and overall health. An estimated 20-30% of all female adolescents and adults experience menstrual and hormonal imbalance (endometriosis, PCOS, PMDD), menstrual and sexual pain (dysmenorrhea), infertility and other conditions.
Experts debate these conditions but still have no real answers about their causes and cures. They have been treating the symptoms of these problems with the same hormonal birth control pills for decades. Not exactly “progress,” is it?
The pandemic has reinforced the reality that we are all guinea pigs in this grand experiment and we must surrender to a lack of control and uncertainty about what lies ahead. We cannot expect answers to many of our questions. But this does not excuse what feels like a form of gaslighting by gynecologists who undermine their patients and play down menstrual cycle changes. There is nothing more demeaning and unjust than having your symptoms dismissed by your care provider.
Just this week, the CDC announced that based on follow-up data, it is indeed safe for pregnant women to be vaccinated, after months of confusing public health messaging. The risk of complications from Covid far outweighs the risks of the vaccine, even during pregnancy.
The National Institute of Health (NIH) issued a statement last week on their website, encouraging researchers to study the effects of the covid vaccine on menstrual cycle changes. While these updates are welcoming for some, they are perceived as “too little too late” for others.
We know the vaccine is effective in preventing serious illness, hospitalization, and death, but in terms of women and their cycles, we still don’t know if the vaccine causes any long-term effects. Don’t we all know someone whose periods are still “abnormal,” even though they are 4-6 months post-vaccine? The situation is not expected to change physicians’ behaviors, but it just might change some women’s attitudes about their bodies and the value of their cycles, driving home the message that women’s health issues and menstrual problems are important and need to be acknowledged and addressed. We all know someone who’s cycles became disrupted and are still irregular following the vaccine, but it’s unclear who is monitoring their situation.
If men had periods
Imagine a world in which every fourth male suffers from monthly abdominal pain, hormonal fluctuations, mood swings, and other discomforts which interfere with daily functioning. Imagine that men needed to ask for sick days each month because their symptoms are too debilitating. Would men accept the notion that their situation is common and symptoms treatable with hormonal medications (that can wreak havoc with their libidos), with no real cure on the horizon?
I know what you’re thinking: If men had period problems, medical science would have solved them decades ago. It is truly appalling that doctors still know so little about the menstrual cycle and how our hormones impact the body-mind connection and overall health.
Why aren’t menstrual cycles getting the attention they deserve?
Our culture has for too long bred shame, indifference, apathy, and stigma that trivialize our periods and experiences. It is time to wake up, stand up and make our voices heard. It is time to call out physicians and scientists alike, for not taking our complaints and symptoms seriously.
That menstrual (and sexual) pain have been normalized by modern medicine and often thought to be a psychological problem is not only repugnant- it is sexist and misogynist to the core.
That gynecologists “treat” most irregular cycles and hormone imbalances with artificial hormonal birth control is an inadequate non-solution for real health problems.
We have a lot of work to do to ensure that all girls and women have basic knowledge and tools for understanding and monitoring their cycles. The health system is not going to change until we, women and people with periods, change our relationship to our bodies and cycles, understand what they mean and why they matter.
When half the human race becomes empowered, body-positive, and confident about their periods, and understands how they work, then there will be a shift. When the other half of the human race learns to respect, honor and value the menstrual cycle, attitudes will change and lead to more shifts. Just because we have access to health care does not mean we are getting proper attention and quality care. We have to demand more of ourselves and of others because we deserve better.
Redefining the menstrual cycle as a vital sign of health
The pandemic gave us a reason to talk about periods, so let’s get it straight. Our cycles and hormones are important. Regular ovulation and cycles are a vital sign of overall health as they affect nearly every organ and tissue in the body. Just like body temperature, blood pressure, heart rate, and respiratory rate, Irregular and abnormal cycles are a sign that something is wrong. It will surprise many to learn that people with irregular cycles from an early age actually have a higher risk of premature death!
Perhaps gynecological care needs to be held accountable and reframed as a potential medical abuse of power against women and those that identify as women, in the same way the #metoo movement reframed the power dynamics which define the sexual exploitation of women. Gender discrimination, harassment, bias, traumatic experiences and abuse are alive and kicking within the halls of health care. If the Covid-19 pandemic is a global wake-up call to rethink how we live, work and thrive, then our health needs demand higher priority, resources, and solutions.
A global pandemic helped put our menstrual cycles “on the table.” Now it’s time to “flip the table” and change the discourse, one woman and one period at a time.