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[kittywells]

Hi, I need some advice. I am 2.5 months into Long Covid and my perimenopause symptoms, which worsened suddenly following acute covid, seem to be continuing and contributing to my overall ill health with long covid. I know we're really at the beginning of understanding the relationship between hormones and long covid, but there's definitely a link, and I would like to see if changing my HRT regime has positive effects. Any advice welcome as I would like to go to my GP as informed as possible, as she generally supports whatever changes I suggest trying, but I have to do the research myself... 

So here's my deal - been on sequential transdermal HRT for the last 5 years, first with FemSeven Sequi (which I loved) then with Evorel Sequi when no more FemSeven (didn't feel or sleep as well on it, but basically ok). I started with HRT at 43 due to really debilitating Peri symptoms which I won't go into too much here and which the HRT pretty much sorted. Now I'm coming up on 49, and my periods have really dropped off though they haven't exactly been like clockwork for years. I've only had my period once in the last year, in November.

Over the last 18 months I've noticed SIGNIFICANT decline in libido (I have none), energy and mood, though some of the latter is definitely down to being a single mother with 2 careers in the pandemic. My stress load has been high for years but running and weight lifting has helped me regulate stress, moods and sleep some. I've also noticed changes in my body during this time, despite doing the same amount of activity and same diet, I've started to collect visceral fat. Basically, I don't feel like myself and was mulling a big change in my HRT regime, like adding testosterone, and then covid and now long covid has thrown everything out of whack.

After getting a mild case of acute covid in March (I'm triple vaxxed) I noticed a huge flare in menopausal symptoms incl v frequent hot flushes, rampant insomnia, itchy skin, awful moods. The flushes and itchy skin settled down a bit once I switched to a low inflammation diet. I noticed that my insomnia was especially bad in the two estrogen only weeks of the patch so I started supplementing with progesterone cream at night in those weeks and then finally threw in the towel and have just been using my progesterone and Estrogen week patches continuously for the last month (I had pink discharge exactly once, the barest hint of a bleed, then nothing.) This helped sleep a bit but it's still worse than usual, and it's really important for my recovery from long covid to try and get good sleep, it makes such a huge difference to what I can do. I've been signed off work for six weeks and there's no way I'm going to be able to go back soon, just caring for myself and my kids is really hard right now. So I need every bit of help I can get.


My questions now are:

Do I need more estrogen - to help me recover from long covid?

Can I go back to FemSeven at least - it seems to be back?!

Is my body transitioning into proper menopause now? Should I switch to continous HRT?

What's the role of inflammation in long covid and how will HRT hormones affect this? Interesting that low inflammation diet seems to have helped my peri symptoms...

Should I try testosterone (have been considering this for a while, but maybe now isn't a good time with the long covid?) and if so which formulation? (I tend to tolerate transdermal much better than oral medications)

Apologies for the long post... if anyone is still reading this, thank you. I have searched on the forum for relevant threads but haven't found that much that addressed this stuff - yet it could be my brain fog preventing me from finding it 

[ATB]

Hi. There has been quite a few posts on long covid, covid vaccines, causing an issue with hormones and/or HRT. It’s definitely something quite a lot of women are noticing. I don’t think it lasts that long, and my thoughts would be that changing an existing estrogen & progesterone dose might not be necessary as your symptoms tend to settle within 6 months or so, just from what I’m reading and personal experience. I am also on testosterone, I went on HRT well after having covid so it didn’t affect anything. Testosterone has helped me a lot with fatigue, muscle building and body shape, ability to exercise, concentration, memory and brain fog type issues. Definitely worth considering looking at what your free testosterone is right now. Women are considered post menopause after 12 months of no periods at all- although it’s possible to get one again after that time so it’s not a precise thing.
I would also think it’s quite difficult to know exactly what long covid is, which symptoms are from that, perimenopause or just life stuff like not getting sleep and other minor illnesses affecting you, hay fever etc

[kittywells]

Thanks ATB, it's really encouraging to hear that this does settle down within 6 months or so for some women. YES! We are really in the dark here... so hard to know what is menopause, what is long covid, what is potentially both affecting each other or something else entirely. I suspect for all of us it's going to be a combination of different things that contribute to what we are calling long covid - a systemic experience. For me, hormonal disruption is one thread of this I can at least do something about, potentially, with some experimenting on tweaks to my HRT.

And your comments about testosterone also make me think that it's something I need to pursue. Think I may have to push for a full set of bloodwork, assuming free testosterone is something they can see on the NHS tests?

[sweettooth]

Hi kitty,  sorry to read of your struggles.  As ATB said covid & vaccines are affecting womens hormones.  I’m still not back to myself since jab and then Covid.
Not sure if 2.5 months is long enough to say you have long covid and the symptoms are very similar to hormonal issues caused by covid.

I’m post LC same time as you and I’m not right yet, it’s horrid, but I had these exact same symptoms before starting Estrogen. Same thing happened me after vaccine.   I have researched a bit and anti histamines plus low histamine diet helps plus certain vitamins….look on utube Dr Tina peers.  X

[kittywells]

Hi, thanks for the response sweettooth I really appreciate your help and your kind words. Guidelines differ from one organisation to another about when you can say you have long covid (some one month, some three etc), but at 2 months I was told I did and referred to the long covid clinic, so I'm just going by what my GP told me. I'd be overjoyed to be wrong here and to make a full recovery in the next couple of weeks but I've never experienced continued crushing fatigue like this and the trajectory with this and most of my many symptoms has been getting worse, not better

I have found Dr Peers' video too and thought it was interesting, thanks. Have had some response making some anti inflammatory dietary changes but I'm not up to following a mega strict eating regime right now, and antihistamines seem to interfere with my sleep (have tried both drowsy and non drowsy ones). I'm aiming to tackle the basics like sleep before I start with any additional treatments. It's a chicken and egg thing, I guess! Really sorry to hear you have been struggling too and hope you start to feel better soon.

[kittywells]

Update: been to doctor and she has agreed full blood tests to check hormone levels and thinks I may be low estrogen. Adding testosterone sounds promising too.

If anyone comes upon this thread looking for more insight on long covid and perimenopause, I found this Newsom Health Menopause podcast extremely helpful... before active treatment for long covid with stuff like antihistamines, the barriers to recovery need addressing and hormonal dysfunction is a big one (along with sleep problems, mood, overxtertion, overwork and poor gut health)

https://www.nhmenopausesociety.org/resources/podcast-episode-3-the-role-of-hormones-in-the-treatment-of-long-covid-with-dr-sarah-and-dr-paul-glynne/

[ATB]

Thank you for that link, I now have covid again so I’m hoping just as my HRT and meno symptoms are good that this doesn’t affect me too much! I got long covid first time, but not on HRT then

[sweettooth]

Thanks for the link kitty I shall read that👍 I hope you get better soon!
So sorry ATB to hear you have covid again and hope you make a speedy recovery!

[ATB]

Thank you!

[McPeri]

Very helpful link, Kittywells. Thank you!

[Marchlove]

Sorry to hear that ATB!
Do hope you feel better soon xx

[Rumbaba]

Hi kitty wells ( big country music fan?  )

I’ve just found your thread, I was searching because I have Covid for the first time, and it does feel like my hrt is not working at the moment.  So, it seems like it’s a thing?

I’m sorry to hear you have long Covid, that’s pretty tough especially when you are working and a single mum.  I’ve struggled with work , but my kids are grown up, so can’t imagine how difficult that is.

I will check out the link, I have had really bad digestive problems during Covid, and hay fever on top of that.


Thank you again, hope you are better soon

Rumbaba x

[joziel]

For long Covid, have a listen to the Dr Louise Newson podcast and look back at earlier episodes - she has at least one where she talks about long Covid and HRT/menopause.

The current thinking is that Covid affects the ovaries. And can stop them working so well and perhaps even speed up the progress of menopause if you're almost there anyway. Which means that your own ovaries will contribute less estrogen - and you may need more estrogen from your HRT to compensate.

That was my probably garbled understanding of it all anyway. The vaccine can similarly see the ovaries taking a hit, but they recover...

[kittywells]

Thanks @joziel - that Newsom podcast series is wonderful, isn't it? I've come to the same conclusion from listening back to all of those and others I mentioned below. That covid threw my hormones out of whack and probably advanced me toward full meno. I likely need more estrogen and to add testosterone to the mix.

Waiting to see what my latest blood test results say... have just rung the GP and they told me the hormones were 'normal' over the phone, so looks like I will need to book a telephone appt to even find out what that means

In the meantime have had to abandon sequential HRT for a while as I felt like utter death during the estrogen-only weeks and couldn't sleep. Have tried this two times and it does not work for me right now.  The conti patches are so much better for me right now, so I'm just going to use them until I'm at a different point in my recovery. No breakthrough bleeding at all so far but I've hardly had a period in the last year on evorel sequi, so wasn't expecting any.

[kittywells]

Thanks @rumbaba I am indeed a country music fan! And thanks so much for your kind words. Yes, this covid and hormones connection is definitely a thing! Too bad we have to figure it out ourselves most of the time, but we'll get there. Really hope your recovery goes well and your digestive problems clear up soon x