SFEBES2023 Oral Poster Presentations Reproductive Endocrinology (4 abstracts)
Abnormal uterine bleeding (AUB) and COVID-19: investigating associations and potential mechanisms
Marianne Watters 1 , Alexandra Alvergne 2 , Catherine Walker 1 , Cara Robb 1 , Hilary Critchley 1 , Gabriella Kountourides 3 , Argentieri Austin 3 , Gemma Sharp 4 , Zuzanna Olszewska 3 & Jacqueline Maybin 1
1Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom. 2CNRS, University of Montpellier, Montpellier, France. 3School of Anthropology & Museum Ethnography, University of Oxford, Oxford, United Kingdom. 4University of Exeter, Exeter, United Kingdom
Women with COVID-19 and Long COVID (symptoms >4 weeks) have reported AUB. We investigated (i) the association between COVID-19/Long COVID and AUB and (ii) ovarian sex hormones across the menstrual cycle in women with Long COVID. Two studies were completed with ethical approvals and consent. Firstly, a retrospective online survey ‘The Covid-19 Pandemic and Women’s Reproductive Health’ was conducted March-May 2021 with UK participants >18 years old (n =26,710). Those who had menstruated in the last year (n =12,579) were asked about menstrual frequency, regularity, volume, duration and grouped by COVID status. Multivariable analyses adjusted for hormone use, pre-exiting gynaecological conditions, socioeconomic status and multiple comparisons. Previous acute COVID-19 (n =2017) or Long COVID (n =1048) resulted in an increased relative risk of reporting frequent vs. normal cycles (<24 days) (OR=1.3[1.06-1.6], P=0.01 and OR =1.27[1.01-1.59], P=0.03 respectively), subjectively heavier vs. normal flow (OR=1.38[1.17-1.63], P=0.0001 and OR=1.94[1.59-2.36], P<0.0001) and prolonged duration (>8 days) (OR=1.65[1.08-2.54], P=0.02 and OR=2.26[1.46-3.51], P=0.0003) when compared with no COVID (n =9423). COVID-19 vaccination alone was not associated with AUB. Secondly, women with Long COVID (n =10), regular menstrual cycles (24-38 days) and no exogenous hormone use provided peripheral blood samples +/- endometrial biopsies during the proliferative, secretory and menstrual phases. Control samples were collected before December 2020, matched for age and parity. Comparing serum from those with Long COVID and controls, there were no significant differences in estradiol, progesterone or testosterone across the cycle measured by ELISA/Immunoassay and LC-MS/MS. In endometrial tissue from those with Long COVID vs controls, PGR, PGR-B, ESR1 and AR measured by qRT-PCR were not significantly different. COVID 19 and Long COVID were associated with increased reports of AUB. Long COVID did not significantly affect ovarian sex hormone levels in those with regular cycles and AUB in may result from localised endometrial dysfunction.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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