Everything you need to know about COVID-19 & Menopause

By Julia W. – RN, BSN

Menopause is already a challenging time for women as we navigate the physical, mental, and emotional changes. Add in a pandemic, and it can surely increase some of the more intense symptoms of menopause. Here, we answer burning questions about menopause and coronavirus and share tips on how to take care of your health during this time.

What We Are Learning About COVID-19 for Women in Menopause

We have been battling COVID-19 for several months now and are learning new characteristics about this disease daily. Recently, studies have pointed to obvious disparities between sexes. Some studies have found that men are twice as likely as women to contract COVID-19. In Italy, the results were even more staggering in that men in their 50’s were four times more likely to be infected by the disease than women of the same age. This blatant disparity between sexes has led researchers to question whether apparent differences between the sexes, like estrogen, play a role in fighting COVID-19. 

We know that estrogen has an immunoprotective role in the body. Women tend to have a more robust response to infections and vaccinations. Powerful female immune systems can sometimes even go rogue and cause women to experience autoimmune diseases more frequently than men. 

In search of an answer to the gap between the sexes, some clinicians have tried injecting estrogen into men to boost their immune systems. However, there are many factors that can contribute to this disproportionate difference between the sexes, including age, health status, race or ethnicity, class, and other social factors (like occupation). Indeed, one of the key factors is that women are generally in better health compared to men. One study found that men in China had more comorbidities than women, and thus were more likely to be hospitalized and have negative outcomes if infected with COVID-19. 

So, what does this mean for women in menopause who have lower estrogen levels, and may be at risk for some health conditions related to low estrogen?  

Does Menopause Increase Your Risk For COVID-19?

Menopause does not directly affect a woman’s risk for COVID-19. There are multiple factors that contribute to your susceptibility to having a difficult time fighting this infection. However, people with chronic health conditions and comorbidities are more likely to suffer, and postmenopausal women are at greater risk for chronic health conditions like heart disease and weight gain. People with both of these health conditions are likely to have difficulty fighting COVID-19.  

Lower estrogen levels are also associated with a weaker immune system, which could compromise your immune response. Some studies have suggested that estrogen hormone replacement therapy (HRT) may help boost the immune system. Still, the current data cannot confirm the efficacy of starting HRT to improve your immune response. 

COVID-19 Safety Measures in Public Spaces: What If I Have a Hot Flash?!

Before COVID-19, most of us never gave a second thought to a sneeze or cough in the grocery store check-out lane. But in light of the current pandemic, people understandably have a heightened awareness of other people’s health sharing a similar space. But if you have symptoms related to another condition, such as allergies, asthma, or even menopause, it can make you feel quite self-conscious and possibly nervous about going out in public. 

Public safety measures are in place to keep you and everyone else safe. However, menopause symptoms can make following these safety measures difficult and downright anxiety-provoking. Save from wearing a shirt that says, “I’m not sick, just menopausal,” consider this information when you are next out in public and worried about your menopause symptoms.

Temperature and Hot flashes. Many venues require a temperature check before you can enter. Women who have hot flashes often worry that they will be denied entrance (and subsequently humiliated) because their temperature may be elevated during a hot flash. Rest assured, hot flashes usually do not change a temperature reading on a thermometer. Although it doesn’t feel like it, your core temperature remains relatively stable during a hot flash. Hot flashes are thought to be caused by an inappropriate response of your hypothalamus to subtle changes in body temperature. And while sweating can be annoying, it actually cools your skin, so temperature scanners should not pick up the fire you are feeling beneath your skin. 

Masks, Hot Flashes, and Anxiety. Many businesses and cities require masks to prevent the spread of COVID-19. Women commonly report that masks cause them to have hot flashes and even make them feel panicky. Worrying about your symptoms being mistaken for early signs of the virus, coupled with a general fear for public spaces during a pandemic, women can feel a lot of anxiety that is worsened by not being able to breathe normally. However, masks (and social distancing) are the best ways to prevent the spread of COVID-19 at this point, so it is essential that you wear a mask. If you find masks make you have hot flashes or contribute to anxiety, try the following when you have to go out in public:

• Keep your neck and upper chest free of clothes and accessories such as tight-fitting collars, necklines, necklaces, and scarves.
• Lighten your load by not carrying a heavy bag or purse
• Plan your outings so that you maximize your productivity but minimize your time while wearing a mask. 
• Take advantage of services that keep you out of stores and in your car or at home. Some places off curbside pick-up for groceries and other goods.
• Practice steady, diaphragmatic breathing or repeat mantras that help you stay calm and focused while wearing your mask
• Consider adding essential oils such as lavender or peppermint below your nose or on your chin. Aromatherapy can be calming and even uplifting. 

Caring For Your Mental Health During COVID-19

The loss of our normal routines, coupled with the uncertainty and fear surrounding this pandemic, can wreak havoc on everyone’s mental health. Because menopause can cause anxiety and depression, your mental health may be even more compromised. Taking care of your mental wellbeing is always important, but it is especially critical right now. Consider these strategies to help keep you healthy and happy.

• Find a routine. Our pre-COVID routines have been out the window for several months now. If you haven’t established a new routine, do so, as having a routine can make you feel more secure and relieve anxiety about unpredictable days. 
• Be kind to yourself. So often, we put our families and careers above our own needs. Yet, in order to care for others long-term, we have to learn to care for ourselves. Do something kind to yourself each day to lift your spirits, such as practicing mindfulness, doing yoga, or doing something you love just for yourself.
• See if you are a candidate for HRT. While some theories suggest estrogen could play a role in protecting people from COVID-19, the studies are inconclusive at this point. Nonetheless, HRT can be quite effective in managing menopause symptoms and curbing your risk for chronic health conditions related to low estrogen that may also increase your risk of having an adverse outcome from COVID-19. If you are struggling with anxiety, mood swings, hot flashes, or weight gain, talk with your doctor to see if HRT is a good option for you. 
• Talk to someone. Meeting with a therapist (which can be done remotely) can be a great way to take care of your mind. Techniques such as talk therapy and cognitive behavioral therapy can help you identify negative thought patterns, teach you to respond to negative stimuli in a healthier way, and help you develop coping mechanisms. 
• Stay connected. Fortunately, we live in an age where we can easily connect with almost everyone. Schedule regular chats with family and friends who lift your spirits. Sometimes family and friends may not understand what you’re feeling in menopause, so staying connected with others on a similar journey can also be helpful. Know that Caria and its community are here for you during these tough times.

How have you been coping during the pandemic? Share your experience or advice with the community below.