Higher serum 5α-dihydrotestosterone and lower endometrial androgen receptors seen in long COVID
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Sept. 17, 2025 (HealthDay News) — Long COVID is associated with abnormal uterine bleeding (AUB), but not with impaired ovarian function, according to a study published online Sept. 16 in Nature Communications.
Jacqueline A. Maybin, M.B.Ch.B., Ph.D., from the University of Edinburgh in the United Kingdom, and colleagues examined whether COVID is linked to AUB and whether long COVID symptoms vary with the menstrual cycle in a U.K. population: 9,423 never infected, 1,048 with long COVID, and 1,716 who had recovered from acute COVID.
The researchers found that long COVID participants reported increased menstrual volume, duration, and intermenstrual bleeding compared with those never infected, while minimal menstrual disruption was reported for those who recovered from acute COVID. On examination of long COVID symptoms across the menstrual cycle in 54 women, severity was highest during the perimenstrual and proliferative phases. Compared with no COVID, in long COVID, serum 5α-dihydrotestosterone was higher and endometrial androgen receptors were lower. No significant differences were seen in other ovarian hormones. Increased menstrual inflammation was seen with long COVID on serum cytokine profiling, and immune cell aggregates were seen in menstrual endometrium.
“Based on our findings, we recommend future investigation of specific treatments for AUB in those with long COVID, consideration of the menstrual cycle in future long COVID biomarker development, and a focus on female-specific treatments for long COVID,” the authors write.
Several authors disclosed ties to the pharmaceutical and medical technology industries.
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