New Study Demonstrates Better Covid-19 Outcomes in Women Who Ovulate

Published on August 8, 2020

Do healthy hormone levels and ovulation help women battle COVID-19? According to a recent study, the answer seems to be yes.

One of the most important principles of FEMM education and medical management is that ovulation is a sign of health. As explained in the FEMM White Paper, “a woman’s biomarkers indicate the vital signs of her entire health. Since ovulation is a sign of both health and fertility, understanding these changing hormonal fluctuations through biomarker observation allows a woman to understand and manage her long-term health.” Learning to chart her cycle using FEMM or a similar method can help a woman to identify potential underlying health problems and collaborate with her doctor to find solutions that improve, rather than suppress, the functioning of her ovulatory cycle. 

With this in mind, it should come as no surprise that new research is still revealing important connections between ovulation and improved health outcomes. As the world continues to reel from the COVID-19 pandemic, however, one new study is particularly noteworthy. The study, titled “Potential Influence of Menstrual Status and Sex Hormones on Female SARS-CoV-2 Infection,” explicitly links healthy hormone levels and ovulation to improved outcomes in women suffering from COVID-19. 

The researchers behind the study were motivated by a puzzling phenomenon: studies have shown that women are generally less vulnerable to COVID-19 than men, demonstrating lower morbidity and mortality, as well as a lower severe case rate. As early as February, data had begun to emerge suggesting that men were disproportionately affected by COVID-19. In fact, one study in China showed that the death rate for men with COVID was 2.8 percent, while it was only 1.7 percent for women. Theories abounded about the reasons for this, and as early as April, some doctors in the US were testing their hypothesis that female sex hormones could be the key. No one was sure what caused the disparity in outcomes, though. The researchers behind this most recent study readily admit that there is still a need for further research, but their work is a significant step toward answering the “why.”

Through their studies involving COVID-19 patients in China, the researchers discovered that the key factor in the disparity between male and female outcomes may not be just be sex, but hormone levels and ovulation. While non-menopausal women with COVID-19 fared better than men of the same age, menopausal women (i.e. women who no longer ovulate) had outcomes similar to men of their age. In particular, the non-menopausal women were less likely than their menopausal counterparts to be hospitalized, and when they were, they were generally discharged more quickly. This implies that “female hormones of pre-menopausal women may provide protection.” In other words, women who ovulate seem to have an advantage when it comes to fighting COVID-19.

The researchers concluded that this may be due to the high levels of E2, or estradiol, that are present in women who ovulate. Estradiol is a type of estrogen, which in turn plays a crucial role in the ovulatory cycle; if estrogen doesn’t reach a high enough level in a given cycle, ovulation fails to occur. While the researchers stopped short of drawing a definitive causal connection between E2 and improved COVID-19 outcomes, they did note a strong correlation and suggested that E2 likely offers protection through its regulation of cytokines (cell proteins that play an important part in the immune system’s functioning). 

While this is good news for ovulating women, it might seem discouraging to women who have reached menopause or who struggle with anovulatory cycles (i.e. cycles in which no ovulation occurs). In reality, however, this study is good news for everyone. As doctors learn about COVID-19, they can make treatment decisions tailored to the specific needs of their patients. Identifying ovulation and hormone levels as important factors in managing COVID-19 opens up new possibilities for treatment, even for women who don’t ovulate regularly and have low levels of estrogen. The researchers behind this study suggested that hormone therapy might benefit COVID-19 patients. In particular, it seems likely that estrogen replacement could improve outcomes for menopausal women, as well as women with anovulatory cycles and low levels of estrogen. 

Today, many women are taught that female hormones and ovulation are inconveniences that ought to be suppressed. In some societies, menstruation is considered to be shameful. Too often, complaints of severe symptoms that could indicate underlying conditions fall on deaf ears. Fortunately, many women have been able to break free of this mentality through hormonal health education programs like FEMM. As women learn to chart and understand their cycles, they are able to work with their doctors to significantly improve their health. The need for education on the importance of ovulation existed before COVID-19, and it will still exist once the pandemic ends. In the meantime, however, this study is a reminder that women’s reproductive health can never be separated from overall health and wellbeing. Let’s hope that this study inspires more women to learn about their bodies and gives doctors much-needed insight into the best treatments for COVID-19.

Article by: Siobhan Heekin-Canedy, August 8, 2020

 

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