Epic Mini: Menopause and Long Covid

In this epic mini, I share my personal battle with COVID-19 and the potential benefits and impacts of Hormone Replacement Therapy (HRT) or Menopause Hormone Therapy (MHT) for menopausal women in managing COVID-19 symptoms.

This episode highlights how estrogen and HRT may help mitigate severe COVID-19 symptoms in postmenopausal women, emphasizing estrogen's role in enhancing immune response and reducing inflammation.

I  address the overlap between menopause and long COVID symptoms, discusses the challenges of misdiagnosis, and emphasize the importance of empowering women with knowledge to advocate for their health.

I also touch on holistic approaches to complement hormone therapy, such as nutrition, sleep management, and stress reduction.

Read more in my blog post  Long Covid and Menopausal Women: The Protective Role of Estrogen

References

1. Menopause and COVID-19
2. Menopause, cognition, hot flashes and COVID-19: is estrogen a fundamental piece in the puzzle?
3. Estrogen and COVID-19 symptoms: associations in women from the COVID Symptom Study
4. The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease
5. The COVID-19 Pandemic Impact on the Psychophysical Health of Post-Menopausal Women: A Cross-Sectional Study
6. Hormonal trends in patients suffering from long COVID symptoms
7. Menopause, cognition, hot flashes and COVID-19: is estrogen a fundamental piece in the puzzle?
8. Dr. Louise Newson Podcast

Transcript

Copy Transcript Copied

Speaker 0:00

Oh, I've been down and out with COVID, my listeners. you know, being the researcher and the lover of research that I am, I had to look into this. I had to explore the impact of COVID 19 on menopausal women and see if estrogen plays a protective role in that, specifically, you HRT perhaps. So that's what I did. Welcome back to another episode of All things menopausal. And today I am looking at that unique cross section between COVID 19, long COVID, and hormone replacement therapy or menopause hormone therapy, MHT. And if it does have any role in managing our symptoms. Okay, before we go any further, I will say my biggest prolonged symptom since I came down with COVID on June 12th. is this crazy incessant cough and heaviness on my chest. My family also had it, but for me, it's just lingering I was getting quite worried, but you know, I've done enough research into HRT and understanding its protective mechanism and anti inflammatory properties, but let's just go a little deeper into this, shall we? So, of course, I'm sure by now, COVID 19, the pandemic has affected everyone. Certain groups, however, are more vulnerable to severe outcomes, and among the groups are older women, post menopause women, in particular women, uh, with compromised immune system. But I thought, post menopausal, okay, yes. Recent research highlights the significant role that estrogen plays in mitigating the severity of COVID 19 symptoms on this unique demographic. So let's start with some background. And I did research, I have quoted research papers, all in the show notes as well. You can read some more about this in my blog post of the same name. And research is finding that postmenopausal women will experience more severe COVID 19 symptoms compared to their pre peri menopausal counterparts and also aged, matched men. For example, a study that was done by researcher Peter Frigo found that post menopausal women had longer hospitalization times and more severe disease courses. This increased severity is attributed to the decline in estrogen levels, which plays a significant role in our immune response. Interesting. Why is that? Well, estrogen is known for its immunomodulatory properties, meaning it can enhance the body's immune response to infections. Here's another research study done by a Ricardo Costiera. I'm sure I pronounced that wrong. And his colleagues that found that premenopausal women and those undergoing hormone replacement therapy showed slower rates of severe COVID 19 symptoms. The hormones, they help in mounting a stronger immune response, which is crucial in fighting viral infections like COVID 19. Okay. I've been on my own hormone replacement therapy, I would say for just Close to five months, if not more. And by the third month, I started to experience improved sleep and cognitive function. The brain fog had dissipated and my forgetfulness was less frequent. But when COVID hit, these symptoms came back along with other very similar symptoms to menopause. And we're talking the memory loss, the extreme fatigue, the headaches, and a general sensation that I was totally spaced out. However, this time it was far different in intensity. So I began to wonder then if my own HRT was a help or a hindrance. And here's what I found. It comes down to estrogen's influence on inflammation in the body. And I did a podcast about this not too long ago, menopausal inflammation, as well as a blog post. One of the critical aspects of COVID 19's impact on the body is our inflammatory response. But estrogen helps modulate this response by reducing the levels of pro inflammatory cytokines. See, cytokines, they're necessary. They help fight off infection and disease, and their role is also to send messages to coordinate the body's immune response for fending off attackers, such as the COVID virus. There was a study conducted by a team of researchers found higher estrogen levels were associated with lower levels of these pro inflammatory cytokines in the body, thereby, of course, reducing inflammation and potentially preventing severe respiratory complications. So if the research postulates hormone therapy is beneficial, it could be that what I'm experiencing, albeit It's worse than when I was first inflicted with the virus during the lockdown era, um, is actually far less intense than it could be if I wasn't on HRT. So it's pretty scary to think that those women who are not on HRT are being misdiagnosed for perhaps other ailments or altogether or for long COVID, um, or that her menopausal symptoms are being overshadowed by this virus. And just how intense could they be suffering? Long COVID, first and foremost, yeah, it's important to understand, is a condition where the symptoms of COVID, they will persist for weeks or months following an acute COVID infection. And this presents significant health challenges, respiratory issues for one. A long COVID is showing up on average in individuals who are 46 and a half years old. and 83 percent of them are female. This is findings from a study by Dr. Louise Newsome. She's one of the leading experts in the field of menopausal health. Love her. She also has her own podcast and I'll get that in the show notes. Her study also found in study in 2021 that 36 percent of the women reported disturbances in their menstrual cycles. So interesting, this overlap of symptoms between long COVID and menopause raises important questions about. just what the role of hormones are and the potential for misdiagnosis. These findings, they also highlight the necessity for healthcare professionals to consider hormonal changes when treating women with long COVID and proper diagnosis and management including, of course, HRT could significantly improve patient outcomes. I find that fascinating. I find this fascinating because it makes me think of those. Clinics that are focusing on long COVID, and that's good, that is definitely a good thing because of the fact that this virus continues to persist and is causing all kinds of health issues as a result But, just how much emphasis is being put on the long COVID and overlooking the fact that women at age 46 are right at, are right at. The average age for perimenopause. And then furthermore, it with that misdiagnosis or this overshadowing of the COVID virus and completely missing the symptoms of menopause altogether how much of a disservice are we providing in the healthcare system to menopausal women? And that's why I really want to help women empower women with knowledge so that they can advocate on their own behalf when they have to have those conversations with their doctors. And just kind of debunk those mistruths and unweave some of the, tangled, information around COVID and menopause. And how do I do that? Well, I turn to the research. For example, another article highlights that patients suffering from long COVID symptoms have a significant hormonal trends, including reduced estrogen levels, and that these hormonal imbalances could exacerbate the already challenging symptoms of long COVID. Oh, and it gets better. A study done by Alessandro Lamy highlighted that post menopausal women experienced heightened anxiety and depression during the pandemic. And of course, we all know that the pandemic's impact did extend beyond just our physical health and affected so much of our psychological well being. from, depression, anxiety, loneliness, uh, suicidal tendencies even. But when we look at it through the lens of menopause and the menopausal woman's experience, there has been enough findings to show that COVID 19 virus exacerbated the physical symptoms of menopause such as hot flashes and night sweats. Again, another argument that shows that estrogen replacement therapies are able to alleviate some of these physiological symptoms and psychological symptoms, emphasizing that the hormonal's overall protective role in the body shouldn't be dismissed, if you will, when treating long COVID. So just what is the overall role of hormone replacement therapy, particularly when it comes to fighting long COVID symptoms? Well, this is an area that still remains very active, And of course, it's only been a couple of years, so there's so much more research to come out of this. All that to say, we continue to move the yardstick on research. Science marches on, and while I personally am not here to preach HRT, as those decisions rest with my clients and their health care team, the evidence is clear that the benefits of hormone therapy far outweigh the risks. The truth is, Much of the negativity regarding HRT stems from the misinterpretation of the Women's Health Initiative, the WHI study in 2002, which led to a mass reduction in HRT use around the globe. But as a doula and a menopause champion, my aim is to empower women with information on leading research, credible data, and of course, reliable studies so that they can present their case to their health care provider and advocate for menopause symptom management strategies that improve quality of life. And that is the key right there. Quality of life as the gold standard in her personal care. But there are other holistic approaches to consider as an alternative or to complement HRT. And these include nutrition, movement, sleep management, and stress reduction. And I speak extensively to this in previous podcasts with guest experts, and in solo podcast episodes, and in several of my blog posts. So go check that out. But my last solo episode in particular focuses on inflammation and how addressing it goes a long way. in keeping the immune system in check. And while it may not fend off all viruses, it can aid in COVID symptom management. It certainly did for me. I kept committed to regular habits such as avoiding sugary foods and simple carbs, which our body tends to crave when we're feeling sick, and certainly alcohol. And I could advocate at great length on why we in menopause should not be consuming alcohol. Uh, staying hydrated, which alone merits a podcast episode of its own. And then of course, getting our nutrients and vitamins through good food sources, which are essential. to good health and gut health too. The gut, microbione and, maintaining immunity, strength and then of course, sleep and keeping cortisol levels manageable. And I have some great guest experts coming up in these summer months, to talk about. nutrition through our food sources, vitamins, nutrients, and I can't wait to share those with you. So stand by for that to come out in the next few weeks. So in conclusion, the research underscores the significant impact of menopause and estrogen on COVID 19 outcomes. in menopausal women and postmenopausal women. Estrogen's role in enhancing our immune response and reducing inflammation highlights its, the protective effects against severe COVID 19 symptoms. And the potential of HRT in managing long COVID symptoms offer promising avenue for supporting postmenopausal women. So as we continue to navigate these challenges, The findings that are from the research I looked into all in the show notes could inform targeted interventions and therapies to support the health and the vitality of amenopausal women and ultimately reduce the virus's overall burden on this unique demographic. Well, I hope you enjoyed another episode, a solo episode from me, Mary, your host on All Things Menopausal. And if you find these discussions helpful and insightful, well, flip me a note or podcast. And you can find that in the show notes to click to subscribe. goes a long way in producing these episodes, and bringing on some amazing guests. So until next time, my lovely listeners, love and light.