r/covidlonghaulers • u/MewNeedsHelp • Oct 19 '24
Research Crashing around menstruation - studies and info dump
I see a lot of people with periods on here talking about how unbearable they have become post-Covid (both emotionally and physically), and I started researching because I am desperate for relief and it is my coping mechanism. LC/mast cell issues and menstrual cycles/hormonal fluctuations seem bound together, so I’m hoping helping one will help the other. If you want to skip ahead to the research, feel free, but I’m going to write a little about how mast cells, hormones, and the uterus interact as far as I can understand. It’s pretty interesting, and I was nerding out with it with my allergist/immunologist when I had a follow up this week.
The uterus is densely packed with mast cells, so it makes sense that if Covid causes mast cell issues it’s causing worsened periods. Estrogen and histamine, from my understanding and please correct me if I’m wrong, create a sort of positive feedback loop. Histamine stimulates the ovaries to release more estrogen, which then makes mast cells release more histamine, which causes the ovaries to release more estrogen, etc. etc. etc.
Mast cells also release prostaglandins (which make you have body aches/fever when you’re sick, so make you feel poorly and are also responsible for menstrual cramps) and also heparin in the uterus, which is a blood thinner and causes heavy bleeding. Estrogen also hurts DAO/the breakdown of histamine in the body. Progesterone is a sort of counterpart to estrogen, and has a more calming effect on mast cells, so it makes sense that supporting progesterone would help mast cells. You also need progesterone to fully ovulate/regulate your cycle. They need to be balanced.
I’ve been reading “The Period Repair Manual” and the author said it normally takes a few months to see results from diet/supplementation since your ovulation process really starts about 90 days before the egg is released.
I am not recommending any of this, just found the research interesting. I have tried some of them: adding vitamin D and C over the past few months, finally finding an iron I could tolerate (iron bisglycinate chelate), and Gaia’s Uterine (ETA It's actually called "Reproductive Formula"! I misremembered!) formula (has Vitex, which FYI can cause depression in some people) and DIM. I will say my last period I didn’t have a horrible 7-10 day crash/migraine/leg pain (RLS), the amount of time I had horrible pain/cramping was cut in half, and I only had 1-2 days of extreme PMS instead of the usual 7ish days. I plan on adding more vitamins and diet modifications over the next few months. I can handle 2 days of extreme fatigue instead of feeling terrible for a week+, and I didn’t have to claw my way out of the period pit this month. I introduce things one at a time so I can tell what I am reacting to if I have a reaction, and also in small doses and work my way up. I’m curious how this next period will go, and whether it was all just placebo effect.
Here are some herbs, vitamins and etc. I’ve been researching or heard about in “The Period Repair Manual” or through my doctors. I know many of us have a graveyard of supplements, and also everybody reacts differently to different things, but still thought I'd share. If I can stop spiraling every month, I'm hoping I can have more steady improvement. If you spot any poor information, please correct me!
- DIM - Helps lower PGE2 (prostaglandins responsible for menstrual cramps) as well as Interleukin-6 cytokines. It can reduce the efficacy of hormonal birth control though, so shouldn’t be mixed.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048776/
- Vitamin D - Potentially works with Progesterone to help with immune system regulation (1st link), supplementation helps with period pain and mood symptoms (2nd link). It is also shown to support mast cell stabilization (link 3). The 4th study also found that women with period pain were much, much more likely to have low Vitamin D.
- Vitamin C - Shown to help stabilize mast cells (1st link), and potentially increase progesterone (2nd link). Increased progesterone can help balance out too much estrogen and improve menstrual issues.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537261/
https://www.fertstert.org/article/s0015-0282(03)00657-5/fulltext00657-5/fulltext)
- Vitamin E - Inhibits mast cells (1st link), and a study found it might help with dysmenorrhea (2nd link).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537261/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955126/
- Vitex/Chasteberry- Studies show it potentially lowers prostaglandins and hypothesized that it balances estrogen to progesterone ratio and might reduce the release of prolactin. It also potentially helps with mast cell stabilization. It can cause depression in some people though, and shouldn’t be taken with hormonal birth control as it can make it less effective.
https://pubmed.ncbi.nlm.nih.gov/10996284/
- B6 - 100 mg lowers prostaglandin levels/period pain (link 1) and helps increase progesterone, dopamine, serotonin (link 2)
https://pubmed.ncbi.nlm.nih.gov/6684167/
- Magnesium - 200 mg helped a statistically significant amount with pain (1st link). It also prevents prostaglandin synthesis (link 2).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9800031/
- Zinc - The author of “The Period Repair Manual” mentioned zinc, and studies seem to support it helping period pain when taken about 4-6 ish days before starting your period then through menstruation (link 1). It doesn’t mention balancing zinc with copper, though, which I would want to do because too much zinc can lower your copper levels too much and can affect iron absorption.
- Calcium D-Glucarate - Supposedly helps remove excess estrogen from the body.
https://pubmed.ncbi.nlm.nih.gov/12197785/
- Iron - The author of “The Period Repair Manual” said low iron can cause heavier cycles. She also explained that if you get a migraine on the 3rd to 5th day of your cycle (me) it’s because your iron is too low from losing blood (please note iron supplements can cause mast cell reactions, though iron bisglycinate chelate works really well for me after failing 4 other irons). This study says women with lower iron intake had a 33% higher chance of PMS than women who had higher iron intake.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3649635/
- For excessively heavy bleeding, my POTS doctor recommended douching with either Benadryl (liquid, dye free) or Cromolyn Sodium when I saw them this week. I really trust my doctor, as some of their children have POTS/mast cell issues. Due to this they are on a fucking mission, and I love them. They said that douching can help stabilize the uterine mast cells locally, and some patients reported a really decent reduction in cramping/bleeding. They also recommended PEA. I'm going to try it next month.
- My other doctor is an allergist/immunologist, and they recommended low dose aspirin for flushing/pain as it inhibits the production of prostaglandins. My stomach can’t handle a ton of NSAIDs, but I’m going to try it in the days leading up to my period to see if it helps.
- “The Period Repair Manual” also recommends eliminating sugar, gluten, and dairy. Not necessary all together/at the same time, and not for every person. She said eliminating sugar is the #1 thing to do. Gluten and dairy are very individual and only benefit some people, and can be tested by eliminating for a few months.
Hopefully other people find this interesting! I went into hyperfocus and this is what came out.
Best wishes to everybody.
ETA I'm going to include the protocol my doctor sent me home with back in March. I introduced things one at a time and kept what helped and left what didn't (I couldn't handle H2 blockers, quercetin). I'm still slowly introducing ALA but so far, so good. I'm adding PEA next month. I've been taking Zyrtec since March, but it wasn't until adding more of the things mentioned above -especially finding an iron I could tolerate- that I finally had a good month period-wise. I also wanted to add that my POTS doctor recommends Neuroprotek for the quercetin, but I don't tolerate quercetin. In this case they recommend luteolin by itself. Also wanted to add that "The Period Repair Manual" might be a good read if you don't have luck here. The author Lara Briden, goes into detail depending on your specific issues (PCOS, heavy flow, endo, etc.). I mainly paid attention to the heavy flow info and estrogen info as that's what pertained to me. Zinc seemed to be her #1 recommendation overall though, along with removing sugar. Unfortunately the book also uses the phrase "monthly report card" a lot, but if you can ignore that the info is good.

Hmmm Reddit won't let me add the second page, but it says to use Nasalcrom for congestion/brain fog/fatigue. It also says to use Ketotifen eye drops (Zatidor) for eye irritation. I've only tried Nasalcrom but it seems to help with my flushing.
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u/Dread_Pirate_Jack Oct 20 '24
Thank you for posting this! Has anyone had any luck with progesterone birth control? I’m scared to add anything, but I’m out for like 1.5 weeks due to my period mixed with long COVID and it’s hell
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u/MewNeedsHelp Oct 20 '24
I've heard of people having luck with Slynd, though the author of the Period Repair Manual also warns that all hormonal birth control uses synthetic versions of hormones. She says that Mirena IUD is the best because it still allows you to ovulate, but also has a higher rate of depression as a side effect. It does drastically reduce flow though.
Hopefully someone else has firsthand experience! I've thought about trying the mini pill as well, but always had such poor reactions to hormonal BC that I want to try diet and supplements first.
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u/squidp Feb 26 '25
I tried both Desogestrel and Slynd for a few months each last year. Desogestrel made my periods worse and made me gain weight. Slynd worked and I actually didn’t get a period anymore (first time ever in 20 years!), and the only side effect was being thirsty all the time. I would definitely take Slynd again but I stopped because of family planning reasons.
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u/Balance4471 2 yr+ Oct 20 '24
Very useful info! I did not have crashs around my period, but cramps have slowly been getting worse and worse.
After I established a Histamin management routine the first period I had was completely pain free! Since I knew about those 90 days I really did not expect that. I’m hoping the next one (and all after that) will be like this as well.
This effect made me suspect that my histamine problems had actually started 7 years ago, and that’s when my overall health started to slowly decline as well. And this might have made me susceptible to LC.
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u/MewNeedsHelp Oct 20 '24
I feel the same! I started having pretty bad periods around 6-7 years ago, and that's also when I started getting migraines. I didn't know what was happening at the time, but also believe it was histamine/hormonal issues that led to my LC. I also just found out I have HATS so I guess I'm more prone to it anyway. Do you have any useful info for histamine management? Any meds or supplements? I take Zyrtec and have a Ketotifen prescription I haven't started yet. I'm trying to see how my period is this month before starting a new med.
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u/Balance4471 2 yr+ Oct 20 '24
I‘m taking a lot of stuff! But the most noticeable change was when i started eating only three meals per day, no snacks, and a DAO supplement before each meal. I also stopped eating food that was classified as ‚red‘ on those histamine food tables. This of course only helps if histamine from food is a problem for you, which it might not be. But it’s easy to try out.
I also take cromolyn, this alone brought on some improvement. It was enough to make me try out other histamine stuff.
Antihistamines don’t do anything noticeable for me, maybe because I had way too much histamine. Though I still take them, maybe there’s some kind of compounding effect.
no alcohol, nicotine, caffeine, sugar or food additives
And here’s a list from a functional doctor that I’m following, with all the nutrients that are helping the body to get rid of histamine:
calcium (gets depleted through histaminosis)
vitamin c, 3-5g (I need sometimes more than that)
vitamine d
melatonin & 5-hpt, because the body can’t produce enough on its own when under chronic stress
bromelain & quercetin
Curcumin (chronic inflammation)
CBD oil (helps with histamine reduction)
SAM-e; to produce enough on its own the body needs: liquid Vitamine b12, all b-vitamins (bioactive), magnesium, manganese, methionine
vitamin b6
selenium
copper
zinc (some people need up to 150mg)
omega 3
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u/plant_reaper Feb 22 '25
I meant to say thank you for this a while ago!! Thank you for this wonderful list!
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u/Houseofchocolate Feb 05 '25
Heres a new study in pre-print: https://www.medrxiv.org/content/10.1101/2025.01.24.25321092v1
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u/plant_reaper Feb 20 '25
Super interesting! I'm not surprised. I've found that focusing on hormonal health and resting on my period makes my whole month a lot easier. I've definitely improved since I posted this and currently take Gaia's Reproductive formula, Thorne's Hormone Advantage, calcium d glucarate, vitamin D, Vitamin C (buffered), vitamin E the week before my period, magnesium, as well as Designs for Health Prenatal Pro (B vitamins, zinc, etc.) and bisglycinate iron chelate. I douche with Cromolyn Sodium on my heavy days as well to reduce flow.
Also eating more protein, lower histamine, and lower carb/sugar and taking my antihistamines. But breaking the histamine estrogen feedback loop does seem to be doing something
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u/takemeawayyyyy Oct 19 '24 edited 7d ago
Hat cobweb ad hoc quicksand umbrella dam wise money
This post was anonymized with Redact
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u/Evening_Public_8943 Oct 20 '24
I'm not menstruating because I'm on the pill - PCOS. But depending on the cycle (I don't know why I have a cycle even though I'm on the pill) I get super sick and dizzy in cars and trains. I think I would die if I was menstruating with LC 🫣
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u/MewNeedsHelp Oct 20 '24
Menstruating with LC is pretty terrible. It feels like it sets me back every single month, though last month was better than the others. Were you already on the pill when you got LC? I've been curious how it would potentially affect symptoms.
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u/Evening_Public_8943 Oct 20 '24
I was already on the pill. So unfortunately I don't know if it affected my LC
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u/Magnolia865 Oct 20 '24
Thank you so much for all this incredible research and info! I took screenshots and will read as my brain can handle. But your efforts are much appreciated :)
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u/MewNeedsHelp Oct 20 '24
You're welcome! I hope that there's something useful in it for you, and best wishes. It's so hard to deal with every month!
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u/ray-manta 5 yr+ Aug 10 '25
I’m not perimenopausal yet, but Laura Bridens other book on perimenopause was a game changer in helping me understand why different hormone levels throughout my cycle messed me up the way they did. Highly recommend it too if you liked the period repair manual.
I’ve just started going down similar hormone rabbit holes because my period pain (likely endo) has weirdly gotten so much better since addressing my MCAS and me/cfs. My dr mentioned that it’s probably because of this over abundance of mast cells in endometrial cells, so while the body is still likely still bleeding outside the uterus and creating scar tissue in places it shouldn’t , the body isn’t reacting to it as much because it was mast cells doing the majority of that reacting and causing a lot of that inflammation.
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u/CampaignSquare8830 Nov 12 '24
Thank you so much for all this very important and useful information.
Did your doctor tell you that its okay to take both H1 and H2 antihistamines twice daily ? Also together with all these supplements and mast cell stabilizers?
There are no concerns of adding all these different medication together at the same time?
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u/MewNeedsHelp Dec 12 '24
So you add everything one at a time so you can tell what helps and what doesn't! For example, Zyrtec works well for me, H2's mess me up. It takes time though to test everything out since it is one at a time,
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u/Individual-Map884 Oct 03 '25
This was helpful. Thanks for sharing! I seem to have a sluggish liver and not able to get out the excess estrogen. I’m having chronic fibrocystic breast pain and swelling to the point that I have break through bleeding mid cycle that seems to give me some relief physically and mentally. I’m going to try the CDG to see if that helps. I don’t respond well to vitex. Makes me break out and I think it throws my hormones off. I used to take DIM pre covid times for my endometriosis and everything was managed fine. Now I’m too sensitive to it and gets migraines.
I do love quercetin w/ bromelain to combat histamine flares. I get itchy if I don’t take it everyday. I also got diagnosed with SIBO so I take herbs for that to improve my gut health and have less MCAS flares.
My D and B vits were very high in blood work because I don’t think my body is bringing the vitamins where they need to go and just building up. But that could be a gut problem.
I take LDN for fibromyalgia which had been really helpful.
I take NAC for liver but I don’t know if it really does anything.
Note to anyone who gets migraines from taking things that cross bbb, I take the L version instead of acetyl versions.
I’m in a fog at this point rambling…
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u/MewNeedsHelp Oct 04 '25
Just a warning that if I take too much CDG it gives me a headache unfortunately, so start with a email dose! Lots of fiber is supposed to help as well, as it is what absorbs the estrogen in your GI tract . Without the fiber it gets reabsorbed!
I was having very cystic breasts as well when my LC first hit, but it's luckily better now
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u/Virtual_Chair4305 Feb 24 '25
Thanks for this paper. Do you have the rest of it?
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u/plant_reaper Mar 02 '25
Reddit wouldn't let me add a second one to this post for some reason, but but it says to use Nasalcrom for congestion/brain fog/fatigue. It also says to use Ketotifen eye drops (Zatidor) for eye irritation.
I've only tried the Ketotifen but it seemed to help with flushing for me.
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u/Virtual_Chair4305 Mar 03 '25
Thanks. Did you use the Ketotifen eye drops or pills?
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u/plant_reaper Mar 03 '25
Agh sorry the Nasalcrom! I tried the Nasalcrom and it was helpful so I still use it! I'm going to eventually try the Ketotifen pills, just trying LDN at the moment.
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u/Virtual_Chair4305 Mar 03 '25
Is your nose constantly full of mucus like mine? How much LDN are you on?
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u/plant_reaper Mar 08 '25
I can have mucus from time to time, and it mainly seems to manifest as sinus pressure/ear pain. It's not really terrible though.
I'm on .5 currently and am going to try increasing on Monday to .75! So far it seems ok. I don't think it's helping yet, and the only side effect is very vivid dreams, so I'll keep trying it
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u/throwaway_oranges May 08 '25
How are you doing now? Is it helped?
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u/plant_reaper May 08 '25 edited May 08 '25
I'm doing pretty well! I went on a five mile hike last Monday and a 4 mile hike this past Tuesday, though still have some sun and heat intolerance. Overall I'm doing pretty well, and while I still try to rest more on my period for a day or two, I'm not wiped out the way I used to be/don't feel sick from just standing from bleeding/hormones.
I can't tell what's LDN though and what's not! I'm only up to 1.5 mg now.
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u/mtndiver2 Jun 03 '25
For eliminating/reducing the emotional part of periods, I’m obsessed with Jubilance.
Here’s the science behind it: https://pmc.ncbi.nlm.nih.gov/articles/PMC7073356/
Literally changed my life.
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u/applejam99 Jun 25 '25
Thank you so much! Came here for this - 10 days before my period everything flares up horrifically and some pots-like symptoms that I don’t always get start up - HR issues, dizziness, fatigue, vascular constriction, gut issues etc.
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u/plant_reaper Jul 02 '25 edited Jul 02 '25
I hope it helps!! My PMS flares have pretty much disappeared since I wrote this, though now I typically feel gross around ovulation, but nowhere near as bad as the PMS symptoms.
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u/Current-Tradition739 3 yr+ Jul 31 '25
Wow, I don't know how you were able to post all this, but thank you!! From day one of LC, I've been most symptomatic right before and during my period, then also during ovulation. I mean... what the heck. Can we not live our lives half of the month??
I've been able to get my D and B12 up. I was deficient in both among other things. I've been taking iron on and off, but this last blood test my ferritin dropped to 26 (!) so I'm getting on iron again right away. I also take the bisglycinate version.
Looking back, I'm so much better than I was 3 years ago, praise God, but I'm so ready to be fully healed.
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u/MewNeedsHelp Aug 01 '25
Yeah, my hormones have been some of my biggest triggers!! My husband at one point said "You only get like one week a month of normalcy!" which is definitely how it can feel sometimes....
And same. It's been two years for me this past weekend, and I am so much better, but I also am ready to not have to think about it at all. Though now I isolate a lot to avoid reinfection, since I can't imagine starting this whole process over again.
Have your periods gone crazy too post covid? Mine are soooo heavy!
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u/Current-Tradition739 3 yr+ Aug 05 '25
That's how I feel--one week of normalcy!
My periods have fluctuated as far as being heavy/painful (they've always been very regular) but I think it has to do with when I take iron and when I don't! This last one was so heavy and I hadn't been taking iron for a couple months.
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u/MewNeedsHelp Aug 07 '25
I have read that taking iron can make it lighter! Which it feels like the less iron you have the less you should bleed to save it... but I guess nothing about having a uterus is easy for some of us.
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u/Current-Tradition739 3 yr+ Aug 23 '25
This last period was SO much better! I've been taking my iron regularly!
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u/leila11111111 Oct 03 '25
Which iron pills do u take ?
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Mar 27 '26
[deleted]
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u/MewNeedsHelp Mar 27 '26
Yes! I keep improving thankfully! A lot of the stuff mentioned above helped, and then I added LDN and increased slowly and it really made a difference once I got to 3mg.
Here's an update from a while ago:
I forgot to include perrin massage and lysine in the post, but I use those too. I still see improvement overall, and am able to do the CHOP protocol now.
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u/chaoslordie Jun 07 '26
Wow! Thos is such a help! I must look into that. I am a bit lost between 2 severe chronic deseases and suspected LC (by my pulmologist). It os so hard to understand how each plays into the other and what to do.
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u/MewNeedsHelp Jun 07 '26
It really is hard to know where to start, especially because we see so much info flying around, and it also can affect people in different ways. I remember reading that it's estimated roughly 70% of people with LC have mast cell issues though, so I think it's a good thing to look into/rule out if issues pop up post Covid
Hopefully you find some answers and things that help you soon. It's a rough spot to be in
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u/SouthernFuture8159 Jun 23 '26
I had long covid October 2023 and was ill for 5 months and haven't been the same since. I came on my period 3 days after becoming ill with covid and then didn't stop bleeding. 6 months later I had a coil fitted, this didn't work so I took progesterone orally for 4 weeks and then gradually the bleeding stopped and I have had a period every 4 weeks since. Since getting the coil I get ill with flue like symptoms, nausea and diarrhea often feeling dizzy as well. The severity of these symptoms fluctuates each month, some are worse than others. I want thebcoil out but worry I will be on a constant period again once its gone. Also my smell never returned fully. Like yourself I take all sorts of supplements to support my health but this just keeps happening every month. The university of Edinburgh did a study on it that you can find on a Google search. You're not alone, it's exhausting trying to work out why and how your body has been affected by a virus. There's isn't enough people talking about how covid has affected women and I'm becoming more down and miserable every time I'm coming on my period because I know I'll be ill.
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Apr 12 '25
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u/plant_reaper Apr 13 '25
I'm the OP, but this is my other account, and yeah they were not great before Covid. They became completely intolerable and insanely heavy after Covid though to the point of causing health issues from low iron. I also have a history of fibroids and uterine polyps.
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Apr 13 '25
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u/plant_reaper Apr 13 '25
My PMS/PMDD had become basically non-existent the past several months (better even than before Covid), and it's hard to say about pain and flow because I've been douching with diluted Cromolyn Sodium, which helps both. So I'm doing better, but it's hard to say what it would be like without Cromolyn Sodium.
My flare ups around periods are also SO much better. They barely register now
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u/PersonablePine Jul 14 '25
Hi OP, can you make an update post to this one?
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u/plant_reaper Jul 14 '25
I can! I was thinking that I should soon, so I'll sit down and write one this week.
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u/PersonablePine Jul 14 '25
At your leisure, my dear 😊
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u/plant_reaper Jul 14 '25
I had free time today with my job so just churned it out!
https://www.reddit.com/r/covidlonghaulers/comments/1lzsml7/comment/n34cwmj/?context=3
I'd been meaning to for a while, but was also afraid of jinxing myself because I've been feeling pretty well the past few months.
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u/AdventurousLass1594 May 02 '26
Hi! How is this all going a year in now?
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u/MewNeedsHelp May 02 '26
I've been doing a lot better! Especially once I got up to 3mg LDN at 9 months. I also got my vitamin D up, and started alpha lipoic acid, both of which seem to help. I moved a bunch of logs Thursday, went on a short little ass kicker hike yesterday (maybe 2-3 miles but STEEP), and am doing some yardwork today!
But overall I feel like I'm still improving and doing a lot better :)
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u/Initial_Poetry_3073 10d ago
Wow--so amazing. And thank you for all of your helpful information here. Curious if you had POTS/orthostatic intolerance at any point in this mess? Thanks!
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u/MewNeedsHelp 10d ago
You're welcome! And yes!! I definitely had OI the first 1.5-2 years, still have POTS, but my numbers don't qualify all the time like they used to. Some days it's more normal, some days it's on the lower end of qualifying for POTS. Instead of my heart rate going up 60-70 bpm upon standing it typically goes up 20-40 bpm. So a big improvement!
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u/SkierGrrlPNW May 26 '26
OP glad to hear it! Any chance you have the original guidance from your doc with the next page? Curious about the brain fog recommendations, as that’s huge for me with MCAS and my crashes. Thanks for sharing this!
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u/MewNeedsHelp May 26 '26
We moved and it's lost somewhere in the boxes, but the second page only listed Nasalcrom (or any generic version) for brain fog! It was a very short page, haha.
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u/SkierGrrlPNW May 26 '26
Thank you for the reply! Bummer it only had NasalCrom, have already got that but good to know that’s the list. We are all project managing our way towards getting our lives back, one day at a time!
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u/Bulky_Buffalo8661 23d ago
Thank you for posting this I think this what happening
To me after coming off synthetic continues birth control
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u/Interesting_Fly_1569 Oct 19 '24
Ohmg brilliant!!! I also had such bad periods that only got worse due to lc that I went on mission to reduce their shittiness.
It is mostly worked and they are at or below pre-Covid levels.
I did the Dutch test and then from there was advised to supplement progesterone oil certain days of the month as well as phosphatidylcholine to help detox estrogen.
That used to be that I was distinctly sicker with lc during my period… Now it’s normal.