Periods and vaccines: Teaching women to listen to their bodies

Most people probably know more about the cycle on a washing machine than the one that got us all here. I’m talking about the menstrual cycle (again).

It’s true that we’ve made major gains in shedding some of the menstrual stigma in recent years but there is still a lack of awareness and interest in the cyclical lives of 26% of all people on Earth. There are real consequences to this.

For a start, menstrual education is still reduced to two things: the management of a period and how to control our capacity to reproduce. No one explained that the hormones of the menstrual cycle weren’t just for making babies and that my cycle hormones shape who and how I am. I didn’t know, that far from being an unpredictable rollercoaster (that I would internalise as constant feelings of being too much or not enough), that there was a pattern to the emotional landscape of my month, that there were predictable phases to the cycle that could be harnessed. That it was ok to feel differently from week to week.

At a tender age, I learnt that my body was a problem to be fixed, with pads, tampons and soon enough with the pill. I believed I was safest while my cycle was disarmed. Until I was ready for a baby, what was the point in having one at all or so I thought? The truth is, without ovulation, we have no hormones and therefore no cycle at all. I wonder, would I have been so eager to reject ovulation in favor of the pill during my teens and twenties had I known of this?

I didn’t know that there were short and long-term protective health benefits to ovulation that taking the pill would eliminate. I didn’t know it was common to feel depressed and flat while taking it. I felt crazy. Instead of cultivating care and curiosity for my young body and what it could do, I leant not to trust it.

This disregard for menstrual cycles extended to the scientific community such that until the 90’s, clinical trials for new drugs weren’t required to include women at all.

Because menstrual cycles were seen as too complicated, men were considered the biological norm.

It seems that even amid a growing movement of awareness and appreciation for menstrual cycles, this default male setting still persists.

When thousands and thousands of women and menstruators reported changes to their cycle after taking the Covid vaccine, their concerns were initially dismissed by the medical fraternity. Women were waved away and stress was cited as the probable culprit for the mostly temporary changes.

It is true that stress can wreak havoc on a cycle — and who hasn’t felt stressed in new ways since the arrival of the pandemic? But the real kicker, was that there was no proof to speak of; important early clinical trials investigating the side effects of the Covid vaccine failed to consider the impacts on women’s menstrual cycles. This glaring omission at such a critical juncture is menstrual stigma still in action. That women were dismissed before being asked about their experiences after the vaccine is an indictment into how far we haven’t come.

Women were dismissed before being asked about their experiences after the vaccine is an indictment into how far we haven’t come.

In the absence of due diligence, people worried and concerns for post vaccination fertility also proliferated, risking confidence in the vaccine unnecessarily.

Vaccines work by creating an immune response which can cause the body stress. It stands to reason that there might be side effects to our cycles when our immune system is triggered. The latest research was funded by the NIH and published in Obstetrics and Gynecology. It was confirmed that while changes were (on average) minor and temporary, it was true: there was an impact. After looking at three cycles before and after vaccination, on average, the impact on cycle length following vaccination was just under a day.

For people who had both shots within one cycle, the average cycle length extension was 2 days and of these people, there were 10% who experienced cycle delays of 8 days or more. All of these changes were reported to have been resolved within two subsequent cycles and there was no effect found on the length of the bleed itself. Obviously within all of the experiences that create averages, the range for individuals could be considerable but with variations of up to 8 days considered to be within the realm of a normal cycle, these results are generally reassuring. Furthermore, in another study with more than 2000 couples there was no difference found in fertility when comparing unvaccinated and vaccinated couples. Conversely, a Covid infection was associated with a temporary decline in male fertility. So far so good.

Research like this is a positive step after a bungled start and authors of the menstrual study have called for more investigation into how the Covid-19 vaccination could affect other aspects of menstruation such as pain and changes to the bleeding itself. Going forward, bigger sample sizes that also include menstruators with more varied experiences are important.

With access to information and the stains of stigma beginning to fade, women and menstruators are learning to listen to their bodies and to speak up about their experiences. To be wary of doctors who prescribe the pill to fix a period when it merely masks underlying issues. To demand better than the average wait time of eight years to receive an endometriosis diagnosis and subsequent treatments. Weary of being disregarded when it comes to our health, we are finally beginning to trust ourselves. As Lisa Hendrickson-Jack explains in ‘The Fifth Vital Sign’, the menstrual cycle gives us important insights and is a critical marker of our overall health, just like heart rate or body temperature. Understanding your menstrual cycle is basic body literacy that is crucial to wellness.

The changes to menstrual cycles may be no more significant than a sore arm, but that doesn’t mean we don’t deserve to know about them. Small changes can still be significant to people hoping to plan or avoid a pregnancy, for instance. We need vaccines to combat Covid but we also need to be informed.

If there are any silver linings to be had during Covid it’s that we know that the old ‘normal’ wasn’t working for many of us.

Women’s health has long been overlooked, under-researched and under reported and now perhaps the new normal is to consider women’s health from the outset.

Hopefully it will be for the future we are carrying.

Normalise asking people about their cycles whether you are a researcher, a doctor, a partner or even a friend. Normalise noticing your own cycle and how you feel throughout the month. Normalise expecting better.

Lucy Peach, day 28 and vaccinated.