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    Breakthrough bleeding or menstrual symptoms after COVID vaccine

    Why do some people report menstrual symptoms after COVID-19 vaccine and who are at greater risk of breakthrough bleeding post-vaccination? A new study reveals

    A new study reveals risk factors associated with menstrual symptoms or breakthrough bleeding post-COVID vaccination.

    According to fresh findings from an online poll conducted by researchers at Washington University in St. Louis, many persons who do not normally menstruate experienced severe breakthrough bleeding or other period symptoms after getting the COVID-19 vaccination.

    This is the first study to look into vaccine-related breakthrough bleeding in males who take testosterone or other drugs that suppress menstruation.

    The study focuses on those who identify as transgender, nonbinary, or gender-fluid, among other gender identities. Previous research on COVID-19 vaccine-related menstruation symptoms has been focused on cisgender (cis) women, or those whose gender identity corresponds to the female gender given to them at birth.

    “It’s important to examine the impacts of COVID-19 vaccination on menstruation and breakthrough bleeding in people who are not cis women because they are too often left out of the discussion,” says Katharine Lee, first author of the study.

    “I hope that this study adds to the increasing evidence that maybe we should include periods as part of vaccine research more broadly. Our findings also underscore the importance of including gender-diverse people when we study parts of biology that are closely linked with sex-based reproductive physiology like periods.”

    Researchers have previously observed that after receiving a COVID-19 vaccine, some people with regular or predictable menstrual cycles notice changes in the timing or symptoms of their periods, albeit these changes are usually transient and there is no indication that fertility is harmed.

    Lee and colleagues looked examined a subgroup of replies to an online survey on menstrual experiences following immunization to see whether there were any insights particular to persons who don’t usually menstruate.

    The researchers found 552 persons who indicated they took testosterone or other gender-affirming hormones and did not regularly menstruate among over 160,000 survey respondents. The majority of the respondents (84 percent) chose multiple gender categories, with 460 identifying as transgender, 373 as man or man identified, 241 as non-binary, and 124 as genderqueer/gender non-conforming.

    After receiving the COVID-19 vaccination, one-third of the respondents reported breakthrough bleeding, 9 percent reported chest or breast discomfort, and 46 percent reported other symptoms associated with menstruation, such as cramps and bloating. Anxiety, despair, gender dysphoria, panic attacks, and suicide ideation were among the poor mental health effects reported by some respondents in the survey’s open-ended text fields in reaction to their period symptoms.

    In general, the effects of COVID-19 vaccinations on menstruation experiences have not been studied in clinical trials. As a result, these possible side effects are not listed in the vaccine safety information given to patients.

    “I hope that discussing these findings openly allows people to know that this could be a side effect so they can prepare appropriately,” adds Lee. “This is especially important given the fact that some people described mental health outcomes like anxiety, depression and suicidal ideation as responses to unexpected breakthrough bleeding after vaccination.”

    A better understanding of potential menstrual side effects, according to Lee, will help address the requirements of medically underserved populations, such as gender-diverse people, as well as lessen vaccine apprehension.

    In a preprint on medRxiv, the research team reported results from a different subset of the same poll.

    Source: 10.1101/2021.10.11.21264863

    Image Credit: Getty

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