>> Nam: DID THE COVID-19 VACCINE AFFECT YOUR MENSTRUAL CYCLE?
IT'S A QUESTION MANY WOMEN ASKED EACH OTHER QUIETLY AFTER THEY GOT VACCINATED.
IT CAME UP OFTEN ENOUGH, THAT RESEARCHERS TOOK UP THE QUESTION.
AND WHAT DID THEY FIND?
LET'S ASK, FROM LONDON, UK: VICTORIA MALE, WHO TEACHES REPRODUCTIVE IMMUNOLOGY IN THE
DEPARTMENT OF METABOLISM, DIGESTION AND REPRODUCTION AT IMPERIAL COLLEGE LONDON.
WELCOME >> Victoria: HELLO.
>> Nam: THANKS SO MUCH FOR BEING ON THE SHOW.
THIS IS SOMETHING THAT I THINK A LOT OF WOMEN HAVE BEEN TALKING ABOUT AND IT'S GREAT TO FINALLY
HAVE SOME ANSWERS TO THESE QUESTIONS.
SO THE NATIONAL INSTITUTES OF HEALTH, NIH, FUNDED INSTITUTIONS TO RESEARCH POSSIBLE LINKS
BETWEEN COVID-19 VACCINES AND CHANGES IN MENSTRUAL CYCLES.
WHAT DID THEY FIND?
>> Victoria: SO THIS WAS A REALLY BIG AND WELL-DESIGNED STUDY THAT USED DATA THAT WAS
FROM AN APP CALLED NATURAL CYCLES THAT PEOPLE ARE ENTERING INTO REALTIME TO TRY TO KEEP
TRACK OF THEIR FERTILITY.
IT LOOKED AT DATA FROM 2,400 PEOPLE WHO WERE VACCINATED AND COMPARED THAT TO DATA FROM
ALMOST 1,500 PEOPLE WHO WERE NOT VACCINATED AND ACTED AS A CONTROL GROUP.
AND THE STUDY FOUND THAT AFTER THE FIRST DOSE OF THE COVID VACCINE, THERE WAS NO DIFFERENCE
IN THE TIMING OF THE NEXT PERIOD.
BUT AFTER THE SECOND DOSE THERE WAS ON AVERAGE A LITTLE BIT LESS THAN HALF A DAY'S DELAY.
BUT THE PEOPLE WHO SAW THE BIGGEST CHANGE WERE PEOPLE WHO HAD BOTH DOSES IN THE SAME CYCLE
AND THEY ACTUALLY SAW MORE THAN TWO DAYS' DELAY TO THEIR NEXT PERIOD.
BUT, IMPORTANTLY, EVEN THE PEOPLE WHO HAD MORE THAN A TWO-DAY DELAY FOR THAT PERIOD,
THOSE PERIODS WERE BACK TO NORMAL WITHIN TWO CYCLES.
>> Nam: DO THE CHANGES ONLY APPLY TO PEOPLE WHO RECEIVED THEIR DOSE DURING THEIR CYCLE?
>> Victoria: WELL, EVERYONE IS ALWAYS SOMEWHERE IN THEIR MENSTRUAL CYCLE.
BUT, NO, IT WASN'T JUST PEOPLE THAT HAD THEIR VACCINE DURING THEIR ACTUAL PERIOD, THE TIME
DURING THEIR BLEEDING.
IT WAS REALLY PEOPLE, FOR EXAMPLE, IF YOU HAD YOUR PERIOD AND THEN MANAGED TO HAVE BOTH
DOSES BEFORE THE NEXT PERIOD, THESE ARE THE PEOPLE WHO ARE MOST AFFECTED.
>> Nam: DID IT MATTER WHICH VACCINE YOU WERE GETTING?
>> Victoria: IN THIS STUDY, THEY ONLY LOOKED AT PFIZER AND MODERNA.
THERE WEREN'T ENOUGH PEOPLE WHO GOT JOHNSON TO TALK ABOUT THAT.
BUT PFIZER OR MODERNA, IT MADE NO DIFFERENCE WHICH VACCINE YOU GOT.
>> Nam: I THINK FOR MOST WOMEN, DEPENDING ON WHAT'S HAPPENING AROUND YOU, IF YOU'RE
STRESSED, WE'VE BEEN IN A PANDEMIC FOR GOING ON THREE YEARS NOW.
THERE'S SO MANY THINGS THAT CAN HAPPEN THAT CAN CHANGE YOUR CYCLE.
SHOULD PEOPLE BE CONCERNED ABOUT THE DISRUPTION IN THEIR CYCLE OR THE BLEEDING PATTERN?
>> Victoria: I WOULD SAY NO.
ONE OF THE THINGS THAT THIS STUDY ALSO DID WAS IT LOOKED SPECIFICALLY TO SEE WHAT
PERCENTAGE OF PEOPLE SAW A CHANGE IN THEIR CYCLE OF MORE THAN EIGHT DAYS, WHICH IS THE
POINT AT WHICH WE WOULD START TO SAY, OH, THAT'S CLINICALLY SIGNIFICANT.
AND ALTHOUGH THE AVERAGE WERE WAY LESS THAN CLINICALLY SIGNIFICANT, A SMALL PERCENTAGE
OF PEOPLE DID SEE A CHANGE THAT WAS SIGNIFICANT.
BUT THAT WAS ACTUALLY ONLY A LITTLE BIT MORE THAN THOSE PEOPLE WHO MIGHT HAVE SEEN A
CHANGE IN THE UNVACCINATED GROUP.
AND I THINK THIS IS UNDERLYING FOR US JUST HOW MUCH PERIODS CAN VARY NATURALLY.
AS YOU SAY, THEY CAN VARY BECAUSE OF STRESS, WEIGHT GAIN, WEIGHT LOSS, ALL SORTS OF
THINGS.
SO THESE VACCINE MEDIATED CHANGES ARE QUITE SMALL COMPARED TO THE CHANGES THAT WE NORMALLY
SEE AND NOTHING THAT I PERSONALLY WOULD WORRY ABOUT OR THAT WOULD STOP ME GETTING MY
VACCINE, INDEED I HAVE HAD ALL THREE DOSES OF MY VACCINE.
>> Nam: THE CHANGES THAT DID OCCUR, ARE THEY TEMPORARY?
>> Victoria: YES, THAT'S RIGHT.
THE STUDY SPECIFICALLY LOOKED TO FIND OUT IF PEOPLE HAD GONE BACK TO NORMAL, AND IN THIS STUDY
THEY FOUND THAT PEOPLE HAD GONE BACK TO NORMAL.
EVEN THOSE WHO HAD A DELAY OF MORE THAN TWO DAYS HAD GONE BACK TO NORMAL WITHIN TWO CYCLES.
>> Nam: WELL, THERE'S BEEN A LOT OF CONVERSATIONS ONLINE ABOUT, YOU KNOW, PEOPLE FEELING
A BIT WORRIED ABOUT TAKING A VACCINE BECAUSE OF THE IMPACTS TO FERTILITY.
SO I WANTED TO TALK -- JUST SWITCH OUR CONVERSATION TO THAT.
IS THERE AN IMPACT ON FERTILITY?
>> Victoria: THIS STUDY DIDN'T LOOK AT THAT.
BUT ACTUALLY WE ALREADY HAVE A LOT OF EVIDENCE AROUND THE VACCINES AND FERTILITY.
SO EVEN IN THE CLINICAL TRIALS, THE PARTICIPANTS WERE ASKED NOT TO BECOME PREGNANT, BUT THEY
WERE BIG TRIALS AND ACCIDENTS HAPPEN.
AND SO THERE WERE ACROSS THE FOUR VACCINES THAT WE HAVE APPROVED IN THE U.K., 65
ACCIDENTAL PREGNANCIES.
AND THEY HAPPENED EQUALLY IN THE VACCINATED AND IN THE UNVACCINATED GROUPS, WHICH TELL
US THAT THE VACCINES AREN'T STOPPING PEOPLE GETTING PREGNANT IN A TRIAL SETTING.
NOW THAT THE VACCINES HAVE BEEN MORE WIDELY ROLLED OUT, WE ALSO HAVE REAL WORLD DATA.
SO WE HAVE FIVE STUDIES FROM IVF STUDIES WHICH SHOW IF YOU'RE GOING FOR IVF, IT MAKES NO
DIFFERENCE AT ALL TO THE CHANCE THAT THE IVF WILL SUCCEED WHETHER YOU'RE VACCINATED OR
UNVACCINATED.
WE ALSO NOW HAVE A REALLY LOVELY STUDY THAT FOLLOWED MORE THAN 2,000 COUPLES WHO WERE TRYING TO
CONCEIVE BETWEEN DECEMBER 2020 AND SEPTEMBER 2021, AND THIS STUDY ALSO FOUND THAT THERE WAS
NO DIFFERENCE IN THE CHANCE OF CONCEPTION IF THE COUPLES WERE VACCINATED COMPARED TO IF THEY
WEREN'T.
>> Nam: THAT'S INTERESTING.
BECAUSE I THINK THERE'S STILL, I GUESS, YOU KNOW, YOU SAID THAT THE CHANGES OCCURRED, THE
PERIODS WERE MAYBE LIKE TWO DAYS LATER.
IF YOU ARE TRYING TO GET PREGNANT -- I FOUND THIS OUT THE HARD WAY -- THERE'S ONLY A FEW
DAYS IN A MONTH THAT YOU CAN GET PREGNANT.
SO IS THAT SOMETHING THAT PEOPLE SHOULD KEEP IN MIND?
OR DOES THAT MAKE IT VALID FOR PEOPLE TO BE CONCERNED?
>> Victoria: WELL, THIS STUDY DIDN'T LOOK SPECIFICALLY AT WHETHER IN THE ACTUAL MONTH THAT
YOU GET VACCINATED, IT'S LESS LIKELY THAT YOU'LL GET PREGNANT.
WHAT I WILL SAY FROM MY OWN RESEARCH IS THAT I'VE SEEN AN AWFUL LOT OF PEOPLE GETTING
PREGNANT THE SAME MONTH THAT THEY GET VACCINATED.
SO IT DOESN'T SEEM TO BE STOPPING PEOPLE GETTING PREGNANT, EVEN IN THE SAME
MONTH.
BUT IF IT IS A CONCERN TO YOU THAT YOU MIGHT MISS YOUR FERTILE WINDOW, THE ADVICE IF YOU'RE
BEING VACCINATED IS THE SAME AS THE ADVICE TO EVERYONE ELSE, YOU KNOW, HAVE SEX, HAVE FUN, AND
HAVE IT OFTEN, AND THAT IS THE BEST WAY TO HIT THAT WINDOW.
>> Nam: WHAT ABOUT MEN?
DO WE KNOW IF A COVID INFECTION IMPACTS SPERM COUNT OR THE QUALITY OF THE SPERM?
>> Victoria: YES, WE DO, ACTUALLY.
SO THERE'S REALLY MOUNTING EVIDENCE THAT SUGGESTS THAT IF YOU GET COVID AS A MALE, YOU'LL
SEE A REDUCTION IN SPERM COUNT AND SPERM QUALITY, WHICH LASTS FOR ABOUT A COUPLE OF MONTHS.
AND THIS HAS BEEN BACKED UP BY THAT SAME STUDY OF 2,000 COUPLES WHO ARE TRYING TO CONCEIVE THAT
I MENTIONED.
THIS ALSO LOOKED AT THE EFFECT OF COVID.
AND IN THIS STUDY IF THE FEMALE PARTNER GOT COVID, IT ACTUALLY MADE NO DIFFERENCE TO THE CHANCE
THAT THE COUPLE WOULD BECOME PREGNANT.
BUT IF THE MALE PARTNER CAUGHT COVID, THEN THE COUPLE WERE LESS LIKELY TO CONCEIVE FOR 60 DAYS
AFTER HE CAUGHT COVID.
>> Nam: WHAT ARE SOME COMMON MYTHS CIRCULATING AROUND FERTILITY AND VACCINE?
>> Victoria: WELL, I THINK ONE OF THE REASONS THAT PEOPLE WERE CONCERNED ABOUT THIS WAS BECAUSE
IT WAS ONE OF THE VERY EARLY PIECES OF MISINFORMATION THAT CAME OUT IN DECEMBER OF 2020.
AND IT WAS PUT ABOUT THAT THE VACCINE WOULD, WHILE SIMILAR ENOUGH TO APPROACHING ON THE
PLACENTA, THAT THE IMMUNE RESPONSE, THE ANTIBODIES THAT YOUR BODY MAKES TO PROTECT YOU
AGAINST COVID WHEN WE GIVE YOU A VACCINE COULD ATTACK THE PLACENTA AND CAUSE A REDUCTION
IN FERTILITY.
BUT ALL THE EVIDENCE THAT WE HAVE THAT I'VE SPOKEN TO YOU ABOUT JUST NOW OBVIOUSLY TELLS
US THAT THAT'S NOT ACTUALLY HAPPENING BECAUSE IT DOESN'T MAKE A DIFFERENCE TO FERTILITY.
ANOTHER ONE THAT PEOPLE SOMETIMES WORRY ABOUT IS THAT THERE WAS A SLIGHT
MISINTERPRETATION OF A DOCUMENT THAT WAS SUBMITTED THROUGH THE JAPANESE REGULATOR BY PFIZER
WHICH LOOKED AT RATS AND MICE.
AND PEOPLE HAVE INTERPRETED THAT TO MEAN THAT THEIR VACCINE GETS TO THE OVARIES.
ACTUALLY, THAT'S NOT REALLY THE CASE.
BUT AGAIN, THE FACT THAT PEOPLE ARE GETTING PREGNANT JUST AS NORMAL AFTER THE VACCINE AND
ALSO SOME STUDIES THAT HAVE BEEN DONE PARTICULARLY IN IVF SETTINGS LOOKING AT OVARIAN
HEALTH AND OVARIAN FUNCTION AFTER VACCINATION, TELL US THAT IN PEOPLE GETTING VACCINATED
DOESN'T DO ANYTHING TO YOUR OVARIES.
>> Nam: I THINK ONCE A MYTH IS OUT THERE OR MISINFORMATION IS OUT THERE, IT CAN BE HARD FOR
PEOPLE TO FEEL COMFORTABLE, ESPECIALLY IF YOU ARE TRYING TO GET PREGNANT.
HOW WOULD YOU SUGGEST THAT PUBLIC HEALTH COMBAT THE MISINFORMATION THAT'S ALREADY
OUT THERE AROUND FERTILITY AND VACCINE?
>> Victoria: YEAH, THIS IS A REALLY TOUGH QUESTION, ACTUALLY.
BECAUSE I SPEND A LOT OF MY TIME THINKING ABOUT HOW WE TALK TO THOSE WHO ARE ALREADY PREGNANT
ABOUT GETTING VACCINATED BECAUSE THAT'S REALLY RECOMMENDED BECAUSE WE KNOW THAT COVID CAN
BE DANGEROUS IN PREGNANCY AND COVID VACCINATION CAN PROTECT YOU AGAINST IT.
AND FOR THAT GROUP, YOU KNOW, THEY'RE ALREADY SEEING DOCTORS AND MIDWIVES, SO WE HAVE THAT
TRUSTED MEDICAL PROFESSIONAL WHO IS HAVING REGULAR CONTACT WITH THEM.
FOR PEOPLE WORRIED ABOUT FERTILITY, IT'S A LOT HARDER.
THERE'S NO, YOU KNOW, REGULAR CONTACT WITH HEALTH CARE BECAUSE THESE PEOPLE ARE JUST GETTING ON
WITH THEIR LIVES.
THIS IS WHY I THINK WE HAVE TO TAKE THIS KIND OF DISCUSSION TO SOCIAL MEDIA, WHICH IS WHAT I
SPEND A LOT OF MY TIME DOING, AND ALSO TO BROADCAST MEDIA LIKE THIS.
AND I HOPE THAT, YOU KNOW, YOU AND ME HAVING THIS CHAT TODAY WILL MAYBE SET SOME PEOPLE'S
MINDS WHO HAVE BEEN WORRYING ABOUT THIS AT REST.
>> Nam: I'D LIKE TO READ A QUOTE FROM YOUR EDITORIAL WHICH WAS PUBLISHED IN BRITISH MEDICAL
JOURNAL.
YOU WROTE:
>> Nam: WHAT DID YOU MEAN BY THAT?
>> Victoria: WELL, SIMPLY THAT WE COULD IN THE CLINICAL TRIALS HAVE SAID, YOU KNOW, TO THAT
SUBSET OF THE TRIAL PARTICIPANTS WHO HAD PERIODS: WHY DON'T YOU TELL US IF YOU NOTED SOMETHING
DIFFERENT ABOUT YOUR PERIOD?
AND THE REASON THAT THAT WOULD HAVE BEEN SUCH A POWERFUL APPROACH IS BECAUSE WE HAVE AN
UNVACCINATED CONTROL GROUP WHO DIDN'T KNOW IF THEY HAD BEEN VACCINATED OR NOT.
WE ALMOST CERTAINLY MIGHT HAVE HAD SOMETHING AND A NORWEGIAN STUDY HAS FOUND SOMETHING LIKE
THIS WHERE, YOU KNOW, UP TO 40% OF PEOPLE IN A NORMAL CYCLE WILL NOTICE SOMETHING THAT'S A LITTLE
BIT DIFFERENT FROM THE USUAL, AND THAT'S OBVIOUSLY NOT TO DO WITH THE VACCINE BECAUSE THEY
HAD NOT BEEN VACCINATED.
IN CLINICAL TRIALS WE COULD HAVE SAID, OKAY, 40% OF PEOPLE NOTICE SOMETHING IF THEY'RE IN THE
UNVACCINATED GROUP AND MAYBE 42% OF PEOPLE NOTICE SOMETHING IN THE VACCINATED GROUP.
THAT'S A SMALL CHANGE.
BUT BECAUSE WE'VE GOT A REALLY GOOD CONTROL GROUP, IT'S A REAL CHANGE.
IF WE HAD ASKED IN THE TRIALS WE WOULD HAVE KNOWN THAT MORE THAN A YEAR AGO.
BUT BECAUSE IT WASN'T ASKED AS A QUESTION IN THE TRIALS AND BECAUSE THOSE PEOPLE DON'T
VOLUNTEER INFORMATION ABOUT THEIR PERIOD UNLESS YOU SPECIFICALLY ASK THEM FOR IT, WE
BASICALLY SPENT THE LAST YEAR PLAYING CATCH-UP.
AND I JUST HOPE THAT IN FUTURE CLINICAL TRIALS THIS ADDITIONAL BIT OF INFORMATION WILL BE
SOLICITED SO WE DON'T END UP IN A SITUATION AGAIN WHERE WE'RE PLAYING CATCH-UP TO FIND OUT IF
THERE'S AN EFFECT OF WHATEVER THE INTERVENTION IS ON THE MENSTRUAL CYCLE.
>> Nam: YOU KNOW, I THINK THERE'S A LOT OF FRUSTRATION FROM WOMEN BECAUSE IT SEEMS AS
IF THAT WAS AN AFTER-THOUGHT, YOU KNOW?
I THINK WHEN WE'RE TOLD TO GET OUR VACCINES, WE GET OUR VACCINES, AND THEN ALL OF A
SUDDEN WE NOTICE SOMETHING CHANGE TO OUR BODIES THAT WE WEREN'T ADVISED WOULD HAPPEN.
DO YOU THINK THAT MOVING FORWARD IT MIGHT BE HELPFUL FOR PEOPLE WHO HAVEN'T BEEN VACCINATED OR
ARE CONSIDERING GETTING VACCINATED TO SAY, "YOUR PERIOD MIGHT CHANGE IF YOU DO GET THE
VACCINE"?
>> Victoria: I THINK THAT THERE'S NOW ENOUGH EVIDENCE FROM THIS U.S. STUDY THAT WE'VE
DISCUSSED IN DETAIL AND ALSO THE NORWEGIAN ONE WHICH I'VE KIND OF TOUCHED UPON A BIT TO TELL
PEOPLE WHEN THEY'RE GETTING VACCINATED: YOU MIGHT SEE A CHANGE TO YOUR PERIOD.
IT WILL BE SMALL COMPARED TO THE KIND OF VARIATION YOU MIGHT SEE NORMALLY, THAT YOU ARE LIKELY
ACTUALLY TO NOT NOTICE ANYTHING AT ALL, BUT YOU MIGHT NOTICE SOMETHING.
IF YOU DO, IT'S SHORT-LIVED.
AND THE REASON I THINK IT'S IMPORTANT TO SAY THIS IS BECAUSE I SPEAK TO A LOT OF PEOPLE WHO
HAVE NOTICED, YOU KNOW, BIG OR LONG-LASTING CHANGES THAT HAPPENED AFTER THEY'VE HAD THE
VACCINE.
THE EVIDENCE SUGGESTS THAT THESE ARE NOT VACCINE-MEDIATED CHANGES.
AND WHAT WE WOULD HATE IS FOR PEOPLE TO ASSUME THIS IS A BIG OR LONG-LASTING CHANGE THAT THEY
SAW WITH JUST A VACCINE SIDE EFFECT WHEN REALLY THEY SHOULD BE GOING TO THE DOCTOR AND
GETTING THAT CHECKED OUT BECAUSE IT'S LIKELY TO BE SOMETHING ELSE.
SO, YEAH, I THINK THAT WE NOW HAVE ENOUGH EVIDENCE TO SAY IT'S A SMALL CHANGE, IT WILL GO BACK
TO NORMAL.
IF YOU NOTICE A BIG CHANGE OR ONE THAT DOESN'T GO BACK TO NORMAL, YOU REALLY NEED TO GET
THAT CHECKED OUT.
IT'S NOT THAT LIKELY TO BE A SIDE EFFECT OF THE VACCINE.
>> Nam: IN OUR LAST 30 SECONDS, SOME RESEARCHERS HAVE ARGUED THAT THERE'S A LACK
OF UNDERSTANDING ON HOW MALES AND FEMALES REACT TO VACCINES DIFFERENTLY.
WHAT'S YOUR TAKE ON THAT?
>> Victoria: I DON'T THINK THAT'S ACTUALLY TRUE.
THE TRIALS, PARTICULARLY FOR THESE VACCINES, WERE REALLY, REALLY CAREFUL TO MAKE SURE THAT
THERE WAS A GOOD BALANCE BETWEEN THE SEXES, AND ACTUALLY THE TRIALS ALSO MADE SURE THAT THERE
WAS A REALLY GOOD BALANCE OF ETHNIC GROUPS THAT REPRESENTED, IN PARTICULAR, THE AMERICAN
POPULATION.
AND THE TRIALS DID LOOK SEPARATELY AT HOW PEOPLE RESPONDED TO THE VACCINE
DEPENDING ON ALL THESE KINDS OF IMPORTANT DEMOGRAPHIC FACTORS AND HOW WELL THEY WERE
PROTECTED.
SO I WOULDN'T NECESSARILY SAY THAT THAT'S REALLY THE CASE.
BUT I DO DEFINITELY THINK THAT WE SHOULD CONSIDER SEX A BIT MORE IN THE FUTURE IN MEDICAL
RESEARCH.
>> Nam: DR. MALE, THANK YOU SO MUCH FOR SPENDING SOME TIME WITH US AND HELPING US UNDERSTAND
THESE COMPLEX TOPICS.
WE REALLY APPRECIATE IT.
THANK YOU SO MUCH.