Across the world, hundreds of millions of people who menstruate have gotten COVID-19 vaccines. In Nova Scotia, considering that more than half the population identifies as female, it’s possible that most of the 1.3 million vaccinations injected so far have gone to people with uteruses. And yet the effects of COVID vaccines on menstrual health may not have been studied during clinical trials.
But now that the vaccines are in widespread use, there’s plenty of anecdotal evidence that women are experiencing side effects that men don’t have to consider. (Women and trans men and some non-binary folk are having uterus-related side effects, that is, which cis men don’t have to consider.)
The Coast heard from nearly two dozen Atlantic Canadians about their experiences, which include changes like heavier flow, missed or early periods, spotting, increased cramping and even ruptured ovarian cysts.
“It tried to start early twice this week,” says Haligonian Hannah Shackleton in an interview seven days after her second COVID vaccine. “And I've had cramping and some very interesting emotions, I’m feeling a little off.”
“I got my second at the end of June, and a few days later, I experienced some heavy spotting,” says Maggie Archibald, a Halifiax woman who’s been trying for years to diagnose her menstrual irregularities. “I wasn't sure if this was just spotting or if my period was acting up again and it was another period I was having.”
“I'm on the Depo-Provera shot, which stops me from ovulating, AKA I don't get periods anymore,” says a 23-year-old PEI woman. “I am however currently having a period after having got my second dose three weeks ago.”
“It would be great to have more information, even if it’s just to say, people that are menstruating might feel symptoms differently, or they might feel symptoms during their first cycle afterwards.”
A few Canadian and American health jurisdictions have listed menstruation questions in FAQs, like Hamilton, Ontario and Immunize BC. The NACI guidelines mention menstruation twice (appendix D), but only related to the timing of getting pregnant after the Johnson & Johnson vaccine, which isn’t available in Canada.
In the US, the CDC has a question on its “myths and facts” page explaining that “your menstrual cycle cannot be affected by being near someone who received a COVID-19 vaccine.” (Apparently the period proximity puzzle is a popular claim in anti-vax circles.)
But the side effects of menstrual cycle changes aren’t listed anywhere in Nova Scotia’s public health information, nor the informed consent process for vaccines, nor the info sheets given to people post-vaccination. And they’re not being studied. “Changes to the menstruation cycle as a result of the vaccine are not being tracked by the province at this time,” says Marla McInnis, media relations advisor for the province, in response to questions from The Coast about the matter.
Halifax resident Kelly O’Brien says she knew in advance thanks to online research that the vaccine may affect her next period. “I’d seen Jen Gunter commenting that vaccines can sometimes affect your menstrual cycle and they were starting to see people reporting things with the COVID vaccine, so I was aware of it beforehand,” she says in a phone call. “But I didn’t expect things to be as dramatic as they were.”
If it weren’t for doing her own research, O’Brien wouldn’t have known why her period started five days early. “I had AstraZeneca at the beginning of May, so my cycle shortened from 28 to 23 days after that,” she says. “It was very heavy.”
It’s not surprising to anyone who specializes in menstrual health that people are forced to find their own information about period problems. “The majority of people don't want to talk about periods all the time,” says Dalhousie University professor of social work and psychology Taq Kaur Bhandal. “It could be that general overarching patriarchy that's slowly dying, but still persistent, in terms of not discussing the importance of the menstrual cycle.”
Bhandal is also the author of Self-Care Down There, a book about vaginal health, and her research is centered on connecting ancestral trauma and menstruation.
“It’s been about four years in this particular field, doing research particularly at the intersection of decolonization and anti-racism and menstrual cycles,” Bhandal tells The Coast in a phone call from her Halifax home. “Revitalizing ancestral knowledge related to menstrual cycles, while also keeping up to date with the biomedical research on the topic as well.”
The professor and menstrual health expert got into the field after going off hormonal birth control and learning to chart her own cycle, something that was hard to find information on, even though as Bhandal says “it’s one of the vital signs. It’s often referred to as the fifth vital sign of health. But in control trials and research, there hasn’t been very much consideration of gender and sex in the past.”
This idea of menstruation as a taboo subject is being perpetuated with the COVID vaccine rollout, as it’s clearly not top-of-mind for vaccinologists.
“Since it started, I've heard a very, very wide range of stories, all the way from, you know, worst-case-scenario to then nothing really happened or nothing changed,” Bhandal says. “So it's all been quite anecdotal, just because research takes time, and we're all still going through it.”
The vaccine’s effects on menstruation can present themselves in different ways, but seem to be mainly confined to the first menstrual cycle after a vaccine.
“If they got their shot potentially before they ovulated, their body might have said that was not a good day, it would have waited a bit longer, and therefore their full cycle would have been longer from one period to the next,” says Bhandal. “Or their body might not have ovulated at all, in which case, they might see a shorter cycle.”
These changes were reflected in the emails, phone calls and DMs that people shared with The Coast.
“I actually ended up being on my period when I got my shot, my first one, and it totally stopped,” says Abby Tucker, a Halifax woman. “I was two days in so it definitely shouldn’t stop, and it just disappeared and then it never came back.”
“I expected to feel sick and gross after my vaccine. I didn’t think I needed to go to Costco and buy a box of super tampons. I feel like people were definitely unprepared for this.”
When Tucker got her second shot six weeks later, she had a different menstrual response—spotting for the eight days leading up to when her period was expected to start. “The spotting was super-abnormal for me. That doesn't happen,” she says. “I’m on hormonal birth control, which is supposed to stop that from happening.”
Tucker is thankful she could talk to her roommate, who had gotten the shot a few weeks before her. “I knew from her experience that her first period after her vaccine was a hot mess,” she says. Right away, Tucker came to the conclusion that the vaccine must be what was affecting her menstrual cycle. “I didn't change my routine. I didn't change my fitness levels. I haven't changed my stress levels. Nothing is different in my life,” she says. “So it's got to be the vaccine.”
For Sara R., it took longer to make the connection because she only expected the typical vaccine reaction that people are talking about—fatigue and arm pain.
“I didn't really have any reaction to it, just a bit of a sore arm, except for two weeks later, my period was twice as heavy and basically lasted an extra two days,” she tells The Coast. “I didn't really connect the dots too much, to be honest, I just thought it was a weird one-off.”
Her second shot was the same. “I usually have a quick cycle. Most people's cycles are a month, mine is usually three and a half weeks. So they were coming at the usual time, but the intensity of it was quite shocking,” says Sara.
It was then that she decided to ask her friends if they’d experienced anything like that, and they all had similar stories. “I actually went straight to my group chat with my friends and was like, OK, is it just me, or what's going on here?” she says. “And all my girlfriends basically were in the same boat as me.”
Bhandal says the varied reactions may depend on where people are in their cycle, or on other external factors. “It's hard to sort of parse out the different aspects of it, because stress in any shape or form can impact our menstrual cycle,” Bhandal explains. “It could be stress related to the pandemic in general, the mental health impact of it, it could be related to the stress of going to get a vaccine.”
Hannah Shackleton says she’s sure the vaccine is responsible for her cycle changing. “I 100 percent think it is, because I have had no other changes. It's like, it's literally never changed. It's always been the same. Even with all the pandemic going on.”
She did research online in health groups in advance to learn more. “A lot of people in the US, because they were vaccinated first, were saying that they were noticing a lot of changes in their menstrual cycle, so I looked into it more from them,” she explains.
Kelly O’Brien says she wasn’t overly worried, but she is concerned for others who may not know why their period is acting up. “They should be aware that it can happen. just to be prepared. Just so they don't worry that it's for some other reason,” she says.
O’Brien says it’s not something that should be kept hush-hush in 2021. “We're moving into an age where it is more acceptable to talk about these things,” she says. “People aren't as uncomfortable with these topics. And women are being more vocal about what goes on.”
With all the information the government puts out there about adverse vaccine events and potential side effects, it’s a bit curious that menstrual cycle changes aren’t included.
“I checked my paperwork that they gave me when I got my vaccine. And that's not a side effect that's listed anywhere,” says Abby Tucker. “It was a headache, upset stomach vomiting, like all of the regular symptoms that come on the back of the Tylenol bottle, but nothing about periods.
“I actually went straight to my group chat with my friends and was like, OK, is it just me, or what’s going on here? And all my girlfriends basically were in the same boat as me.”
“I expected to feel sick and gross after my vaccine. I didn't think I needed to go to Costco and buy a box of super tampons. I feel like people were definitely unprepared for this.”
It could’ve helped people like Sara R. feel better if they knew what was happening to their bodies. “I feel a lot of the vaccine symptoms are catered to cis male bodies. So I think it would be great to have more information, even if it's just to say, people that are menstruating might feel symptoms differently, or they might feel symptoms during their first cycle afterwards,” she says. “I think that would be reassuring for a lot of people to know it is just temporary.”
Bhandal agrees that as long as the changes are indeed “temporary” and only effect one cycle after getting your vaccine, there’s no reason to worry. “The real concern might be if it's a persistent thing, and folks maybe haven't gotten their period, in like three, four cycles, that is something of concern,” she says.
“I'm kind of surprised they haven't pushed anything out,” says Hannah Shackleton. “It's strange to me that they haven't, they're so gung ho on symptoms and feeling good, but god forbid they talk about periods.”
Bhandal, like everyone The Coast spoke with, thinks it would be a good idea to add menstruation changes to the list of side effects. “Just give people a heads up that that might be the case, they just might experience either a longer, shorter cycle or maybe more heavy flow,” she says.
While the province has yet to list menstrual cycle changes among the potential side effects on the informed consent form all vaccine recipients have to sign, there is a study in the United States that people worldwide can submit their experiences to. The study was started by doctor Kate Clancy after a tweet about menstrual changes related to the vaccine went viral.
Until scientific information emerges from such studies, menstrual cycle changes likely won’t be added to the list of potential vaccine side effects. But Bhandal says even without medical experts backing up people’s anecdotes, people should take “radical rest” for both their period and their vaccine.
“I’m giving everybody full permission to do that,” she says. “Because as we reopen, as people go to get their second dose, we want to make sure that our bodies are rested, and we're honouring them. So that would be my advice, is to take a self-care day, or four.”
Update: On August 30, 2021, the National Institutes of Health in Maryland, US awarded a total of $1.67 million to five different institutions, including Harvard Medical School, to study possible links between menstruation and vaccination.
Correction: A quote in this story has been removed to reflect that having a period does not necessarily mean someone has ovulated.