Female reproductive health impacts of Long COVID and associated illnesses including ME/CFS, POTS, and connective tissue disorders: a literature review.

Observed Findings

• Women with ME/CFS, POTS, EDS, and endometriosis report elevated rates of dysmenorrhea, amenorrhea, and oligomenorrhea compared to general populations
• Infertility, endometriosis, vulvodynia, and pelvic pain disorders are significantly more prevalent in these patient populations
• Adverse pregnancy complications including preeclampsia, maternal mortality, and premature birth are documented in patients with these associated illnesses
• Symptom exacerbation occurs in relation to menstrual cycle phase, pregnancy, and menopause in Long COVID and related conditions
• Patients with these conditions undergo gynecological surgery at higher rates, suggesting greater reproductive morbidity

Inferred Conclusions

• Long COVID disproportionately impacts reproductive health in premenopausal women, with patterns similar to related illnesses like ME/CFS and POTS
• Sex hormones and the menstrual cycle likely play significant but poorly understood roles in symptom severity and disease progression
• Historical research inequities and lack of reproductive health screening have created critical knowledge gaps in understanding and managing these conditions
• Future research must directly study reproductive health impacts in Long COVID and investigate sex hormone contributions to pathophysiology

Remaining Questions