Long Covid Podcast

26 - Dr Jackie Maybin - Long Covid & Women's Reproductive Health

March 16, 2022 Season 1 Episode 26
Long Covid Podcast
26 - Dr Jackie Maybin - Long Covid & Women's Reproductive Health
Long Covid Podcast
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Show Notes Transcript

Episode 26 of the Long Covid Podcast is a chat with Dr Jacqueline Maybin, Senior Clinical Research Fellow and Consultant Gynaecologist at the MRC Centre for Reproductive Health at the University of Edinburgh. She is doing research into Long Covid and womens reproductive health funded by the royal society of Edinburgh.

We chat about the studies that she is currently involved in - one that is currently at the analysing stage, and 2 that are actively recruiting - one UK-wide, and one a small tissue-based study in the Lothian area.

It's a fascinating topic and I hope you are able to take something from it. If you're interested in participating, links are below (feel free to ping me a message if you're stuck)
 
Links:
UK-wide study (currently recruiting) www.tinyurl.com/long-covid-womans-health-study
"Healthy optimal periods for everyone" menstrual health website www.ed.ac.uk/hope
Posters for both recruiting studies are on the Podcast Research Page HERE

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(music - Brock Hewitt, Rule of Life)

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The Long Covid Podcast is self-produced & self funded. If you enjoy what you hear and are able to, please Buy me a coffee or purchase a mug to help cover costs.

Transcripts are available on the individual episodes here

Share the podcast, website & blog: www.LongCovidPodcast.com
Facebook @LongCovidPodcast
Instagram & Twitter @LongCovidPod
Facebook Support Group
Subscribe to mailing list

Please get in touch with feedback and suggestions or just how you're doing - I'd love to hear from you! You can get in touch via the social media links or at LongCovidPodcast@gmail.com

**Disclaimer - you should not rely on any medical information contained in this Podcast and related materials in making medical, health-related or other decisions. Ple...

Jackie Baxter  0:00  
Hello and welcome to this episode of the long COVID Podcast. I'm really excited today to be talking to another Jackie, which is quite a rare thing for me. So, Dr. Jacqueline Maybin senior Clinical Research Fellow and consultant gynecologist at the MRC Center for Reproductive Health at University of Edinburgh. She's doing research into long COVID and women's reproductive health funded by the Royal Society of Edinburgh. I'm really looking forward to hearing about what she's been up to. So welcome to the podcast, Jackie.

Dr Jackie Maybin  0:30  
Thanks very much. Lovely to speak with another Jackie. 

Jackie Baxter  0:34  
So to start with, would you mind introducing yourself a little bit and explaining just a little bit about what you do? 

Dr Jackie Maybin  0:41  
Sure. So I guess my, my role is an academic gynecologist. So that means I spend about 50% of my time doing clinics for people with menstrual disorders, and menstrual problems, or running theater lists and doing surgery to try and help people who have problematic periods. And the other 50% of my time I spend in the laboratory doing research, trying to develop better ways to prevent problematic periods or better treatments for the people who do experience them. So I think I've one of the best jobs in the world, I get to hear firsthand from people what their problems are, and then have the opportunity in collaboration with the patients to take things back to the lab and really work out and see if we can get some new, better treatments for them. 

Jackie Baxter  1:32  
That's awesome. So you get to see both sides of it. 

Dr Jackie Maybin  1:35  
Yeah, I think it's it's a really nice position to be in. You're sort of bridging the two worlds. And it's yeah, it's very satisfying. 

Jackie Baxter  1:43  
That's amazing. So what drew you to long COVID? And to this study specifically? 

Dr Jackie Maybin  1:50  
Yeah. So pre 2020, I guess nobody was thinking about COVID, were they. So yeah, as I've said, My main research is based on sort of periods, problematic periods, making things better for people who experience them. And I guess COVID hit and long COVID became a big problem. And more and more, I was hearing in clinic, about people experiencing menstrual difficulties, hearing about it via the media, people talking about it on social media and the problems that they're having. And really, it's just something that as a gynecologist, I couldn't ignore and I felt I had some of the skills there to try and look into this a bit more. 

So a team of us got together to talk about it and decide what we could potentially do to look into this further, get some of the data. I think quite often menstral data just isn't collected. And if you don't have data, you don't know whether there's a problem, and you can't do anything about it. So a team of us from Oxford, Montpellier and Newson health, were talking about it and decided that we would try and get some data together to see if we can identify any areas where we can help. 

Jackie Baxter  3:05  
That's fantastic. And you've got this international team going on as well, which is quite cool. 

Dr Jackie Maybin  3:10  
Yeah, it's, yeah, it's a team of people who were interested in these kinds of problems before COVID. And then I think, as a researcher, you have to move and adapt and change to where the problems are. And I guess that is the big strength of being a clinician and a scientist is that when people come through in clinic and present with a new problem that you've never heard before, then that's a real opportunity to do some research into a new current area. So we have to respond and adapt to the world around us. And I think this is a really good example of, of doing that, and trying to get some answers to a new problem. 

Jackie Baxter  3:52  
Yeah, fantastic. And this kind of new online world that we now live in, it makes distance so much less important, doesn't it? 

Dr Jackie Maybin  4:01  
Yeah, absolutely. So I mean, it's, you know, the sort of grassroots effects of social media as a real positive, I think. There's many downsides to social media, but there's so many strengths. And I think that, you know, international grass roots voice saying, this is a problem that needs addressed. We do listen to that as researchers and we hear it. So it's well worth people talking about these things online. And I'm a big advocate for talking more about menstruation. Because when you talk about it, you realize what typical and problematic is, it allows us to do more research, get more funding and ultimately improve treatments for people. 

Jackie Baxter  4:39  
Yeah, it's interesting, isn't it? Because even now in what are we 2022 it still seems to be a bit of a taboo topic to talk about. 

Dr Jackie Maybin  4:47  
It is. And it's, I mean, I think it's just so wrapped up in history and you know, how things were in the past. There's a there's a big fallout from that. Things have definitely moved on. I mean, women in general aren't banished from society when they're menstruating, which is fantastic. But I think we should be aiming higher than that. And I think it's, you know, it's different people have different cultural values. And some people like to be discreet about menstruation. And I think that's fine. But I don't think anybody should be ashamed. And I think it's, it's really important that we have frank, honest, open conversations about periods, so that we can do the research and make things better and people know when to attend for help. I think a lot of people are suffering in silence with these kinds of things, because they're not spoken about. So I for one was really pleased to hear that women and people who menstruate on social media, were making some noise about the impact of COVID on their periods. I think that's really powerful and only going to be a positive thing for people in the future.

Jackie Baxter  5:55  
Yeah, for sure. Absolutely. So could you explain sort of what does the study do? And how does it work?

Dr Jackie Maybin  6:03  
Yeah, so we, as I say, sat down. And we're having a conversation with people from really different areas. So the group in Oxford & Montpellier are anthropologists, so they study human behavior, and try and they've got a health aspect as well with that. But their expertise is very different to mine as a gynecologist, and the people that I'm working with in Bristol, Gemma Sharp is an epidemiologist, so she's interested in the numbers and the figures and the public health and how that influences health and menstruation. So I think the real strength of the team is we've all got different areas of expertise. And the team in  Newson health are menopause experts. So everybody was bringing different things to the table. 

And we sat down and thought about how best to look at some of these problems. And the team in Oxford had already set up a study, which is now closed, but many people have taken part in it looking at the pandemic, and menstruation and reproductive health. And from that really nice survey, they're starting to look at a lot of different features, how the pandemic versus having acute COVID versus long COVID can impact on reproductive health. So we're looking at a lot of the data for that. And we've put together a manuscript that has looked at vaccination and periods and that kind of thing. So there's lots of different work going on with that study that has now closed to recruitment, but we're dealing with the data and churning through that. 

And the two other sort of arms of the study, I guess, are a survey that's open at the moment looking at the menstrual cycle, and documenting when people are bleeding, and then looking at the symptoms of long COVID and matching that up against the menstrual cycle to see if there's any connection there. So that study is open for recruitment. There are some quite specific inclusion criteria, which means you have to meet certain things before you can take part in the study. And one of those is that you have to have regular-ish period, which will I know exclude a lot of people with long COVID. And that can be very frustrating. But I think for the scientific question that we're asking, for this particular study, it's really important that people have slightly regular periods so that we can tell from their documentation electronically, where they are in their cycle and make some of the analysis more robust. 

But that's a study where people do it all online. And we asked them to complete a short questionnaire, about COVID, vaccination, their symptoms, a lot of demographic details to allow us to analyze the study properly and make sure we've got a representative group of the population. It's a UK wide study. So after completing the questionnaire, then people will get emailed with a daily questionnaire, which is very short, just asking if they're menstruating or not, if it's light, heavy or spotting, or normal, and then asking about a standardized set of symptoms that people can mark the severity of them. So it's a very quick and easy daily survey to complete. But we're hoping women will do it for two to three months, allowing us to assess two to three menstrual cycles. And I think it'll give us really powerful data about long COVID symptoms and the menstrual cycle. 

You know, it's not an easy thing to take part in, it is over a couple of months. I appreciate that people with long COVID have a lot of other things on their plates. But from the people that we spoke to when we were designing the study, I think they're just so keen to get information about this that I hope people will be able to help us and take part in this because I think it'll give us really powerful data that will hopefully influence how we can treat and manage people with problems. So that's the app-based study. 

And then we've got a smaller Lothien based study. So for people in the southeast of Scotland, we're asking people with long COVID and regular menstrual cycles if they would be happy to attend on three occasions throughout their menstrual cycle. So once in the proliferative phase when estrogen levels are high, once in the secretory phase after the egg has been released from the ovary, and then once during a period, and we're asking them to provide a blood sample, and an optional biopsy of the lining of the womb, which is a procedure that starts a bit like a smear test, and it's a very fine straw that goes through the neck of the womb and takes a little scraping. It can be uncomfortable. But most women manage fine without any anesthetic, in an out-patient setting, but I've made it optional, because if you know people aren't keen on that portion of the study, it's fine to come along and give a blood sample. But you know, if people are happy to give us the biopsy, it gives us really useful data about how it's affecting the lining of the womb. And the lining of the womb is what comes away during a period. So it's the real critical organ that we need to study to see if Long COvid is having an effect. 

And we've got a nice bank of tissue from people before the COVID pandemic hit, that we can compare the sort of hormone levels, the lining of the womb and see if there's any differences between people with long COVID and people who've never had COVID, or at the time of the samples, had never had COVID. So it's quite a small study, we've kept it quite local at the moment. But I think there's a real opportunity to look at some of the biological features and really drill down into the mechanisms that are causing problems for people with long COVID and their menstruation. 

So we're really keen to hear from people if they want to take part. So it's a lovely team of research nurses who are all excellent and very experienced and very approachable, and helping with the study and be really happy to hear from people and talk them through it. And tell them a bit more about it. And people can it's very much an optional thing whether people want to take part, but we're very happy to discuss it with people. And we have an information sheet on our menstrual health website that people can look through the information and see if they'd like to take part.

Jackie Baxter  12:23  
fantastic. And I'll definitely put links to all of that in the show notes. So if there's anybody that's listening, and they think that this might be something that they're interested in, then they'll hopefully know where to go. But yeah, I mean, that's really interesting that you've got the different different arms as you described it, because you've got all these kind of different ways in

Dr Jackie Maybin  12:42  
Yeah, I guess it's I mean, it's, there's a bit of a dearth of data here, you know, menstrual health has maybe forgotten about a little bit, and we're really trying to address that and just get the information that then we can build upon in the future to develop better treatments. So they're quite preliminary studies, but I think they're absolutely necessary to give the foundations for more treatment-based studies in the future. And you know, we're really interested in the impact of COVID on periods, and also the impact of the menstrual cycle on long COVID. So we've set up this sort of set of studies to look at all different aspects of it and just get as much detail and information as we can.

Jackie Baxter  13:24  
Yes, exactly. Because once you've got the information, then you can sort of try and work out what to do, I guess?

Dr Jackie Maybin  13:32  
And I think it's, it can be slightly frustrating for some people if they're not able to take part in some of these studies. But, you know, we've had to be quite specific to get some robust scientific data at this stage. But we're very much hopeful that, you know, people who have irregular bleeding and postmenopausal bleeding will be able to help us with different studies in the future in this, we hope this is just the start of things, to collect that initial data to then have more information and design the future studies in a better way.

Jackie Baxter  14:04  
Yes, because it's someone I interviewed before. And they said that it's all just pieces of the puzzle. That you don't you don't have the full picture until you have all the pieces. But you've also got to start somewhere.

Dr Jackie Maybin  14:14  
Exactly. And it's, you know, yeah, we have to start small and get the first bit and then build on that rather than trying to do everything. I think if you try to do everything at the start, you end up getting no answer at all. And you have to - it's frustrating for us as researchers, because we want to do everything straightaway. But, you know, when we first discussed the studies, there was lots of ideas floating about and, you know, we were designing huge studies, and then we had to take a step back and say, No, we need this answer before we do this bit, and then we need this answer before we do this, but it was building it up gradually and making sure that we get the right information to do the right studies. You can get a bit carried away and overenthusiastic and then you end up with incorrect data, so we have to do it scientifically and logically.

Jackie Baxter  14:57  
Yeah, that's definitely yeah. Have you been Working with patient groups, while you've been setting up the study as well?

Dr Jackie Maybin  15:03  
Yeah, so we've had great support from the long COVID support groups, you know, different people have been involved at different stages - with the sample best study where we were collecting blood samples and biopsies of the lining of the womb, we had fantastic input from the long COVID Scotland group. The patient information sheets and all of the consent forms and the legal aspects of the study all went to that group. And I mean, hats off to them. I don't know how these people who are experiencing these awful symptoms are dedicating the time to help us with this research. But we're incredibly grateful that they do. And they give us some fantastic feedback about the study design and the wording of the information sheets and everything before it even went through the ethics boards and that kind of thing. So they were fantastic at helping us to just kind of tweak the study design to make it a wee bit more accommodating for people with long COVID To take part. 

And we're constantly changing as we go, you get approvals for these studies, but things can evolve and change even throughout the study. So we're very much coming with listening ears, because we don't know so much about long COVID. And the people who are experiencing it are the experts. So we're always happy to hear from people and answer any questions. And we're very open to changing the format and design to make it suit people.

Jackie Baxter  16:28  
Yes, that's awesome that you're listening. Because I mean, there's definitely been a few studies that you've looked at and thought, Oh, I'm not sure patients looked at this, because I don't think they're really asking the right questions. Which is really frustrating.

Dr Jackie Maybin  16:40  
Yeah, I mean, the questions have to come from the patients, you know, I think, as a clinical researcher, I don't really come up with very many ideas. The patients come up with it, because they ask me a question. And I say, I don't know the answer to that. And what I what I love about my job is that, you know, as a straightforward clinical doctor, when you say, I don't know, you can feel very frustrated. And it's very hard for the doctor as well as the patient. 

Whereas now I say, I don't know, but do you want to help us look into this? Do you want to help try and answer that question? That's a brilliant question. And we don't have the answer. So you're performing research alongside clinical practice gives you that, you know, that amazing opportunity to work with people and do the stuff. And the patients are just amazing. I mean, I think they're really driving the research that we're doing in the lab. And I think that's how it should be.

Jackie Baxter  17:35  
Yeah, that's awesome. Yeah, I don't know. But

Dr Jackie Maybin  17:38  
let's find out. 

Jackie Baxter  17:40  
Yeah. So like, how many participants have you got for these two different arms of the study that are currently - and are you still looking for more?

Dr Jackie Maybin  17:49  
Yeah, they're both those those two current studies are both open and actively recruiting. The tissue based study where we're collecting tissue and blood samples, it's called the Ergo study, it's actively open for recruitment. We've had amazing people taking part in helping us out. Fantastic, I think we're looking for probably five to 10 more women to take part in that - it's quite a it's a smallish study, but it's quite specific. So it's not easy to recruit for. But if people are have regular ish periods, and have long COVID we would be really keen to hear from them. It's usually people who are not taking hormonal contraception so that we can see the natural cycle at this point, I think in the future, that we'll look into that more widely, but at this point, that's people who are not taking hormones with a regular ish cycle, who are experiencing long COVID. So please do get in touch if you meet those criteria, we'd be delighted to hear from you and that would be so useful for our research. So, that is more you need to be able to access either need to be able to come in to either the Royal Infirmary of Edinburgh or East Lothian Community Hospital. So, you know, that sort of limits that a little bit, because we are not expecting people to travel huge distances for it. But if you if you live in the Lothians area, and meet the criteria, please get in touch. And more details are on the website. So you can have a look just we're equally happy just to have a phone call and chat it through with you. 

Jackie Baxter  19:23  
Awesome. And the app based one is that sort of unlimited?

Dr Jackie Maybin  19:26  
so that the app or study will be open for another few months as well. And we're actively recruiting for that. That's something that people can just check out themselves online. And I can provide the link to that. And women can go and look and there's a series of questions and answer the questions and see if they want to take part and if they meet the criteria. We're wanting to get as many people as possible to answer that study and it's not quite as strict the criteria so people can be on hormonal contraception as long as you're having regular ish menstrual bleeding. 

And, yeah, it's as many as possible, we're hoping in the 1000s. For that study, rather than 10-20 people, we're hoping to get as many people as possible so, and the more people we've got, the more robust the data is. And I'm really keen that we have representation from all aspects of society. So if you don't identify as female, that's okay. If you're on hormones, that's fine. We'd like to see people from diverse backgrounds in terms of ethnicity. And it's really important that we're covering all aspects of society and not just one particular group. So there's a bit of a call out to anybody who wants to take part, please do consider it. 

Jackie Baxter  20:48  
Awesome. I mean, I can certainly confirm that it's very user friendly as well, because I signed up and yeah, it was, it was really straightforward. 

Dr Jackie Maybin  20:56  
Good, I'm glad - we spent a lot of time trying to make it as user friendly as possible, because I think it's always difficult. And it's a balance between doing the perfect scientific study and doing something that's actually manageable, particularly with people who have these horrific symptoms. So it needs to strike a bit of a balance. And it's always nice to hear that it's user friendly. We've tried to do our best with that, whilst keeping it scientifically sound.

Jackie Baxter  21:23  
Yes, absolutely. Because if it was like a three hour survey every day, then nobody is going to do that.

Dr Jackie Maybin  21:28  
And we've tried to really limit that because - and feedback from you know, the long Covid groups was very, very strong with that. So we've done our very best. I don't think it's perfect. It's it's really hard, but to make things perfect, but we've done the best that we can, 

Jackie Baxter  21:43  
yeah, fantastic. So you said with the app based study, you're tracking symptoms for sort of two to three months? So do you get to analyze those results at that point?

Dr Jackie Maybin  21:56  
Yeah. So I think the ideal thing is to analyze the results when we've got the full set of data, we may perform some interim analysis, just to check that things are going well. And there's nothing we need to adapt or change on the survey. But we'll be analyzing the results at the end whenever we've got all of the data together. And I guess it's going to take a few months for that to come through. If people are recruiting now. And we're going to analyze their symptoms across two or three months, I expect that it'll be sort of six months to eight months until we're doing the proper analysis and getting all of the results together. But again, we want it to be as robust as possible. So it's better to take that wee bit of extra time. And do it properly

Jackie Baxter  22:45  
yes, definitely. Because there's no point going through all of this, if it's not going to be worth anything in the end.

Dr Jackie Maybin  22:50  
I mean, I think I'm impatient to get results for this. And I want them yesterday, and I'm sure everyone suffering from long COVID wants them two years ago. But you know, it's that it's that balance between getting the right answer and doing it properly. And taking that just bit of extra time to get the results out that are actually really useful.

Jackie Baxter  23:09  
Yeah, definitely. So the Ergo study, so the more localized one, because that's a smaller study, does that mean you'll get data sooner? Or is it just because it's more complicated?

Dr Jackie Maybin  23:19  
Yeah. So well, in a way, Yes. And in a way No. So the Ergo study, because we're taking samples, what we're planning to do with those is, you know, they're anonymized and taken across to the laboratory, and then we need to do laboratory research. So we're going to measure sort of ovarian hormone levels in the blood, looking at some of the immune cells and seeing if they're different in the blood compared to people without COVID. And then looking at the biopsies of the lining of the womb, and looking at some of the receptors for the hormones, looking at some of the features of the lining of the womb, and that all takes a little bit of time. 

I've got an amazing team in the lab, who work really hard. And what we're doing at the minute is making sure all of the laboratory protocols are optimized. So we have to make sure that they're all working properly. And that, you know, we're fine tuning all of their concentrations of all the reagents and making sure we're really ready to go whenever these really precious samples come through. So again, we'll wait until everyone is recruited and do those final experiments, as you know, all together in a very scientifically robust way, making sure that there's no differences between the samples because of when we do the runs and things so it's better scientifically to do them all at once. 

So we're working really hard in the background so that whenever all the samples are collected, we can process them as quickly as possible. But naturally, that does take a wee bit of time to process all of that stuff too. So where the app-based study is more computer based analysis and you know can be done relatively quickly, once the data is collected, the laboratory tests can take a bit of optimization and tweaking to get them right too. So I think the results will be available relatively soon, once with the samples are collected. But, you know, it'll take a few months again, just to do to do it properly. 

But that study, because it's slightly smaller, I don't think we're going to get really definitive data from that, I don't think we'll be able to say 100%, that this is what's going on. It'll give us really useful data to then drive and design and get funding for the big studies that could potentially give that definitive data. So I have to be very realistic and not mislead anyone. This is preliminary pilot data. I think it'll be extremely useful. But it might not provide 100% definitive answers at this stage.

Jackie Baxter  26:01  
Yes. But it will give you the the opportunity, hopefully, to then know where to go for the definitive data.

Dr Jackie Maybin  26:07  
Exactly. It will mean that we can just design the studies better knowing that we've got some preliminary data typically.

Jackie Baxter  26:15  
Yeah, that's fantastic. So you mentioned the other arm of the study that has finished? Is there any results from that? At the moment?

Dr Jackie Maybin  26:26  
Yeah. So the the team in Oxford and Montpellier, led by Dr. Alverdne, are really driving that study forward. They designed the study, they organized it, they put it out with input from the rest of the team. They're analyzing that data from a number of different perspectives to answer a number of different questions. It was a very broad survey of the pandemic and reproductive health. And the real strength of that is then we can answer lots of different questions based on the results that came through. So people were fantastic at filling that out. 

And the first sort of question that we asked, in response to the sort of documentations and testimony of women who have experienced difficulties and menstrual problems following vaccination, we asked the question, you know, in this study population, did vaccination affect the menstrual cycle. So that's the first batch of analysis that we've done. And we've, I think, from our data, - the study wasn't designed to assess that, which is a downside, but also a big plus. Because, you know, if you're specifically asking about it, sometimes women can recall things because they're super aware of it and asking about it. And sometimes, you know, people will say, with the best of intentions, pass it to their friends who are also experiencing the same problems, and then that can slightly bias your results. So the nice thing about this study is the study wasn't designed to answer that specific question. But that means that the risk of bias is slightly lower. 

And I think we find that about 80% of people didn't experience any particular menstrual problems following vaccination. But about 20% of people did - the 20% who did experience changes in their menstruation, it was very varied in what they experienced. Some people had irregular bleeding, some people bled for longer, some people, their period didn't come, some people it came too often. So it was a range of changes that people reported. But I think that's really useful information. And, you know, there was some sign that people who were using hormonal preparation perhaps had less disturbance of their menstruation than people who weren't using contraceptives. 

And so this is all really useful information when counseling women about vaccination, what to expect afterwards, there may be some temporary disturbance to menstruation. But it doesn't seem to be a long term effect. And for 80% of people, there's no big impact of vaccination. So that was very reassuring with that study, although we acknowledge that 20% of people still did get some changes. We didn't see anything particularly worrying with that, which was good. So that's very reassuring in terms of vaccination and counseling people and that kind of thing. 

So the next areas that we're looking at are then more specifically about COVID and long converges, and the impact of having that and the impact of menstruation and vice versa. So, we're churning through, there's lots of exciting research questions and lots of really great work to be done. We just had a meeting to prioritize which areas we should focus on. And Dr. Alverdne has been speaking to the long COVID support groups to try and prioritize what to focus on as well. So it's been a very team effort, and I think there'll be some really exciting data coming from that soon.

Jackie Baxter  29:54  
Awesome. Like you say if it's a very big study, then it is going to take time to sort of crunch through all this stuff, isn't it?

Dr Jackie Maybin  30:02  
Absolutely, absolutely. I guess the thing to say is, we'd love to hear from people. And please do look at our website and some of the studies that we've got going on and give feedback where you feel it's appropriate. If there's anything you feel we're missing. We always like to hear from people. And we'd be really grateful if anybody does want to take part in our research. I just think it's, it's really upsetting to hear the symptoms that people are getting with long COVID. And there's lots of work needs done in the area. I mean, I think menstruation and COVID is one small bit. But I hope that we're starting to get some data through to move things forward.

Jackie Baxter  30:40  
Absolutely. That's amazing. Well thank you so much for giving up your time to chat to me today. It's been really fascinating to hear about the study, and maybe you'll come back and talk to me again, once you've got your results. 

Dr Jackie Maybin  30:52  
I'd be delighted to

Jackie Baxter  30:54  
That would be awesome. So thank you so much. 

Dr Jackie Maybin  30:57  
You're very welcome. Thanks for having me.

Transcribed by https://otter.ai