Continued...
Third paragraph, since some of us, whom I shall not name or call out *cough*Flog*cough* are unable to click on links...
There are multiple plausible biological mechanisms to explain a relationship between an acute immune challenge like a vaccine (
12), its corresponding and well-known systemic effects on hemostasis and inflammation (
13), and menstrual repair mechanisms of the uterus (
14–
17). The uterine reproductive system is flexible and adaptable in the face of stressors to weather short-term challenges in a way that leaves long-term fertility intact (
18,
19). We know that running a marathon may influence hormone concentrations in the short term while not rendering that person infertile (
20), that short-term calorie restriction that results in a loss of menstrual cycling can be overcome by resuming normal feeding (
21), that inflammation influences ovarian hormones (
22–
24), and that psychosocial stressors can correspond to cycle irregularity and yet resilience can buffer one from these harms (
25–
27). Less severe, short-term stressors can and do influence menstrual cycling and menstruation, and this has been established over 40 years of cycle research (
19,
20,
28–
30). This work has also established that while sustained early stressors can influence adult hormone concentrations, short-term stressors resolve and do not produce long-term effects (
31). The immune response invoked by a vaccine is quite different from the sustained immune assault of COVID-19 itself: Studies and anecdotal reports are already demonstrating that menstrual function may be disrupted long term, particularly in those with long COVID (
32–
35).
further down the study, since some of us, whom I shall not name or call out *cough*Flog*cough* are unable to click on links...
Reproductive conditions
We additionally examined the relationship of specific reproductive conditions often associated with altered menstrual bleeding by comparing respondents with diagnosed conditions to respondents with no reported reproductive conditions (
Fig. 4). A higher proportion of respondents with endometriosis (51.1%), menorrhagia (44.3%), fibroids (49.1%), polycystic ovarian syndrome (PCOS) (46.2%), and adenomyosis (54.9%) reported experiencing a heavier menstrual flow after vaccine than the respondents without diagnosed reproductive conditions (40.9%). Odds ratios and chi-square results for these groups are in table S7
further down the study, since some of us, whom I shall not name or call out *cough*Flog*cough* are unable to click on links...
Despite this,
menstruation is seldom considered a variable during vaccine trials aside from determining last menstrual period as part of established protections against volunteers being or getting pregnant. The vast majority of research that has been conducted regarding reproductive and menstrual function centers around whether live and attenuated vaccines are safe to give to someone who is pregnant (
66–
69) or whether it affects fertility (
48,
70,
71). The research that has been conducted on menstrual cycles specifically is often not able to establish a causal link, as the data are obtained through retrospective surveys or data mining (
72,
73) and randomized controlled trials often do not allow a mechanism for reporting these changes (
74).
Menstruation is an inflammatory and hemorrhagic event that must be resolved quickly to restore uterine function and prevent infection and continued hemorrhage (
14,
76).
Disruption of the normal coagulation pathway of the endometrium may delay the repair mechanisms that allow menses to end quickly. A few of our findings suggest that vaccination is less likely to be affecting periods via ovarian hormone pathways, and more likely along these inflammatory pathways.
Flog, can you sum this up yourself or do you need Tim and his handy dandy Crayolas and notepad to draw a picture for you?
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