bloody hell

Maybe It’s Moderna, Maybe It’s Menopause

Photo: Eva Marie Uzcategui/AFP via Getty Images

A few weeks ago, my exceptionally regular period was so late that I took a pregnancy test — and I had my tubes tied after my second kid.

I’ve been polling friends and receptive acquaintances about their own periods and, turns out, things are weird. I’ve heard about super-heavy periods, nonexistent periods, puzzling weight fluctuations, increased acne, and new chin hairs. A friend who rarely gets a period because she has an IUD had breakthrough bleeding. Another called her doctor to discuss perimenopause because her cycle was suddenly so erratic.

My theory: It’s a side effect of the COVID-19 vaccine.

Of course, a personal anecdote and the self-reported experiences of about 20 cisgender women, mostly white and in their 30s and 40s, doesn’t exactly count as science. But it’s all we’ve got. None of the vaccine trials asked participants to report menstrual changes following vaccination, and even if they had, correlation is not causation. Whether you’re talking unusually heavy periods, constipation, or headaches, it’s very difficult to conclusively link any symptom to vaccination. At this point, though, there is a strong public perception, in the U.S. and in the U.K., that there is some kind of period weirdness afoot, and that COVID-19 vaccines could have something to do with it.

To be clear, this isn’t really about the vaccine, which, by the way, we all would get again. This is about the way we talk about women’s real concerns about their bodies, and the conversation around periods and the vaccine is getting real gaslight-y.

When I read about periods in news stories and on well-respected health websites, including ones belonging to official agencies, someone always suggests that what this really might be all about is stress. While there is evidence that stress has an effect on menstruation, there’s an undeniable undertone of condescension here. It’s coded, you-might-be-a-little-crazy language that summons the idea that women are overly emotional and unstable, especially when it comes to that time of month.

“Menstruation in general is … probably the most undermined and distrusted and mythologized of, I would say, all human body functions,” Elinor Cleghorn, author of Unwell Women: Misdiagnoses and Myth in a Man-Made World, told me over Zoom. “There’s the most amount of projected fantasies and fictions and fears. Menstruating, throughout history, has always been very intertwined with emotionality.”

Medicine has a long history of telling women who report physical symptoms that it’s all in our heads. This experience is even more common, and more dangerous, for women of color, nonbinary folks, and people in fat bodies. Talking down to people and denying their experience of living in their own bodies delay diagnosis and treatment and drives us to the more deeply woo-woo aspects of wellness culture, to become anti-vaxxers, to distrust medical professionals. I almost didn’t pitch this story because I worried about encouraging vaccine hesitancy. But after talking to Cleghorn, it became clear that not talking about it is part of the problem. (I also couldn’t let it go that paying attention to women’s pandemic stress seems to be a priority only when it’s a convenient way to dismiss our concerns.)

The distrust born of refusing to fully engage with the question of how a new vaccine might affect female bodies by failing to track menstrual changes post-vaccination in clinical trials and instead pointing to a psychosomatic cause for period weirdness not only enrages women like me, it actually fuels the vaccine hesitancy it seeks to avoid. “That’s where misinformation conspiracy germinates and grows from; that’s where you go from delayed, irregular periods to your uterus falling out on the clinic floor,” Cleghorn said, referring to a conspiracy theory cited by Naomi Wolf, who has been suspended from Twitter for spreading anti-vaccine misinformation.

So what do we know about what is actually going on with menstrual cycles and the vaccine? I asked Michelle Gerber, a midwife and naturopath with a family practice in Los Angeles, what she has been seeing. “I absolutely have a small but not insignificant portion of my female patient population experiencing menstrual changes after receiving the COVID vaccines,” she told me in an email. “Usually it has been either a heavier period or an irregularity in timing. In almost all cases, it has been relatively brief — two to three cycles.”

We also know that even though vaccines have been documented as affecting menstruation for more than 100 years, the vast majority of clinical trials testing new vaccines or drugs still do not track menstrual changes. A 1913 paper about a typhoid vaccine evolved in the same way that the conversation around COVID-19 vaccines has — it was only after a large number of women reported changes that medicine deemed menstruation worthy of study. “It is not unheard of for some people to respond to some other vaccines in this way — it’s documented in vaccine literature,” Gerber wrote. “It is thought to be an inflammatory response.”

At least two studies are gathering data on periods and the vaccine. Two scientists, whose questions arose in a very similar fashion to my own, started their own research project after one of them tweeted about her own period weirdness and it went viral. Another study at the University of Arizona began this past May, specifically tracking self-reported menstrual experience in a subset of participants in a larger, longer-running study of the effects of the pandemic on health. “We have about 600 women in this reproductive cohort and we’re following them for a variety of things, so we’re collecting saliva to measure cortisol, we’re collecting dried blood spots to measure anti-Müllerian hormones, which is a marker of ovarian reserve,” Leslie Farland, an assistant professor in the department of epidemiology and biostatistics at the University of Arizona, told me over a video call.

Just as every woman I asked about their period told me that even if they’d known the vaccine could fuck with their cycle, they still would have gotten it, every scientist I interviewed for this story made sure to stress the importance of vaccination. “What we do have good research on is the influence of the COVID-19 vaccine, and women trying to conceive, as well as pregnant women,” Farland told me. “What we know from that research is there is no indication that the COVID-19 vaccine influences fertility and there is no indication that there are adverse events attributed to the vaccine in pregnancy.”

Here’s the real thing: Without research, without including menstrual changes as a potential side effect in clinical trials of all kinds, we deny people with periods access to information about their bodies and to fully informed consent. “Women are just not trusted to make decisions and not trusted to have clear, unbiased, straightforward information,” Cleghorn said. “It’s like we’ll have an overly emotional reaction to it.”

Throughout the pandemic, risk assessment has become a new and necessary skill that none of us actually wanted to learn. We’ve weighed where and when and what kind of mask to wear. Whether our vacation, wedding, or desire to see friends and family is worth it. We’re trying to figure out whether or not to quit our stupid jobs. Parents are currently tearing our hair out over the potential risks of yet another bananas school year. All of these decisions require us to consider several different variables, values, and information sources against one another — and yes, menstruators are doing it, too.

I don’t need absolute certainty. The past 18 months have forced me to get down with ambiguity. I just want to hear some data about how many people experienced period weirdness and how long it typically lasted. The questions about whether my cycle is all out of whack isn’t some kind of opening for anti-vaxx sentiment. What I want is for modern medicine to treat women, and everyone else, as fully human people who can handle making decisions and whose bodies aren’t medical oddities but the status quo and deserving of research. Oh, and to know when I might be able to stop carrying a DivaCup everywhere I go and rotate the white jeans back into my closet.

Maybe It’s Moderna, Maybe It’s Menopause