Is it the menopause or Long Covid? Middle-aged women suffer post-viral symptoms

Women are emerging as the group most likely to suffer from lingering post-viral symptoms, dubbed Long Covid, after an initial coronavirus infection. 

A study by National Institute for Health Research, has found that middle-aged, white women who had other conditions such as heart or lung disease or diabetes, seemed more vulnerable to the condition.

Over a thousand patients who had been discharged from hospital between March and November 2020 were quizzed about symptoms, and the results were analysed by researchers.

The study found that 70 per cent of coronavirus hospital patients had not fully recovered five months after being discharged, reporting issues such as exhaustion and cognitive problems.

This has led to some debate as whether hormones could play a role in how COVID-19 affects men and women. 

We already know women generally have better immune response than men. Research has indicated that oestrogen may lend a protective effect. 

Ute Seeland of Charité-Universitätsmedizin Berlin reported: ‘Pre-menopausal women are at a relatively high risk for SARS-CoV-2 infection, but the survival probability in this below-50 age range is significantly higher in women than in men. 

Some evidence has pointed to falling oestrogen levels leaving older women at increased risk from the disease. However, the latest research shows the relationship between hormones and Long Covid is more nuanced.

A small study led by Glasgow University found that women under 50 had higher odds of worse outcomes when compared with men and older participants – even among those who were previously healthy.

Dr Janet Scott, from the University of Glasgow-MRC Centre for Virus Research, said: "Our research shows that survivors of Covid-19 experienced long-term symptoms, including a new disability, increased breathlessness, and a reduced quality of life. 

'These findings were present even in young, previously healthy adults under 50, and were most common in younger females.'

Could autoimmune response explain why women are more affected by Long Covid?

We also know autoimmune conditions are also far more common in women - 80% of people who have autoimmune conditions are female.

Autoimmune disease occurs because the body’s natural defences attack the body’s own healthy tissue. 

One theory is, the body senses danger from a virus or infection, the immune system kicks into gear and attacks it. Unfortunately, this can cause or perpetuate illness.

It is possible that the downside of this immune response that gives protection against severe COVID-19, leaves women more likely to experience Long Covid.

Gene expression may also be part of the explanation. Previous research into autoimmune disease from The University of Michigan discovered that gene expression difference between the sexes that is associated with susceptibility to autoimmune disease. 

Given the fact that middle-aged women are at a high risk of developing Long Covid, many women may be left wondering whether they are ill, or simply menopausal.  While there is certainly an overlap in symptoms, some signs are quite specific.

Long Covid Vs The Menopause

Signs of Long Covid

• Extreme fatigue made worse by exertion
• Brain fog – an inability to concentrate
• Feeling breathless with a cough
• Chest pain and palpitations
• Headaches, pins and needles, insomnia 
• Stomach upsets, nausea and loss of appetite
• Psychological symptoms – depression, anxiety 
• Musculoskeletal symptoms – joint and muscle pain 
• Loss of taste and smell - known as anosmia 
• Phantom odours – smelling things that are not there (known as phantosmia)

Signs of the menopause

• Fatigue and memory problems
• Hot flushes and night sweats
• Irregular and/ or heavy periods
• Mood swings and anxiety
• Insomnia
• Vaginal symptoms, such as dryness
• Lack of libido
• Breast tenderness
• Headaches and joint pain
• Stomach problems
• Weight gain

Talking to your doctor about your symptoms is the first step to finding out whether symptoms are caused by Long Covid or the menopause.

Although hormone replacement therapy (HRT) has an excellent track-record in helping women overcome menopausal symptoms, the road to recovery for those who have Long Covid is less defined. However, experts believe good nutrition could be key.

Stephanie Moore, a clinical nutritionist has been seeing more patients with this condition in her practice, believes quelling inflammation is key to combatting the virus. 

In her blog Why Inflammation Matters in Times of Covid and Beyond, Miss Moore recommends ensuring the gut microbiome is kept in good condition. She says: ‘The gut bacteria need to be enhanced in number and variety to ensure good health and vitality.’

Miss Moore recommends eating a wide range of vegetables, beans, lentils, nuts, seeds and fruit, to make your gut microbes smarter, as well as other lifestyle strategies.

Find out more about Stephanie Moore and her practice at Lanserhof at the Arts Club.

Read more

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• How the COVID-19 virus infects you and others
• London clinics rise to COVID challenge