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Reports of menstrual cycles altered by the pandemic, as well as new research into other gynecologic and urologic issues related to COVID-19, resulted in this week's top trending clinical topic. Recently, both an article published in The Guardian and a preprint survey on the pattern and symptoms of the menstrual cycle suggested that the global pandemic has wreaked havoc on periods (see Infographic below). Some have reported the loss of their period whereas others have experienced increased cycle length, excessive and prolonged bleeding, and significant mood swings and irritability.
Experts believe that the changes are most likely the result of persistent stress as well as changing hormone levels. Some preliminary evidence has suggested that progesterone and estrogen may offer a protective effect against COVID-19. "Abnormal bleeding is the most common reason people present to the gynecologist," said Karen Carlson, MD, obstetrician and gynecologist at Nebraska Medicine. Carlson says she's seen a slight uptick in patients with these issues but points out that there might have been even more if the pandemic hadn't suppressed access to care.
In terms of COVID-19 and other gynecologic concerns, a new analysis of UK primary care data found that polycystic ovary syndrome (PCOS) is associated with a 30% increased risk of contracting SARS-CoV-2. Researchers behind the study published in the European Journal of Endocrinology say these findings highlight an "often overlooked and potentially high-risk population for contracting COVID-19." PCOS, which may affect as many as 16% of women, is also associated with a significantly increased risk for type 2 diabetes, nonalcoholic fatty liver disease, and cardiovascular disease, all of which have been linked to more severe COVID-19.
Men have also experienced specific pandemic-related health concerns. A recent study found that COVID-19 increases the risk of developing erectile dysfunction (ED) by nearly sixfold. The preliminary data also revealed that ED is a marker of increased susceptibility to SARS-CoV-2 infection, as men with ED are more than five times more likely to contract COVID-19. Researchers say that ED can be both a short-term and long-term complication of COVID-19.
The impact of SARS-CoV-2 on male fertility has also been the focus of much attention. A recent prospective longitudinal study found that COVID-19 adversely impacts several markers of inflammation and oxidative stress in semen. PhD student Behzad Hajizadeh Maleki, who is currently working at Justus Liebig University Giessen, Germany, led the study. Maleki said, "In men with COVID-19, markers of inflammation and oxidative stress in sperm cells were significantly increased by more than 100% compared to age-matched healthy controls." He added, "Pathways that facilitate sperm cell death were activated; and sperm concentration was reduced by 516%, motility by 209%, and sperm morphology was altered by 400%."
The list of potential impacts of COVID-19 continues to expand and now includes various gynecologic and urologic concerns, including so-called "pandemic periods," which is this week's top trending clinical topic.
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Cite this: Ryan Syrek. Trending Clinical Topic: Pandemic Periods - Medscape - Apr 16, 2021.