Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case report

Menstrual irregularities and abnormal uterine bleeding have been increasingly reported following severe acute respiratory syndrome coronavirus 2 infection, likely due to viral-induced endocrine disruption and immune dysregulation. A woman in her late 30s, with previously regular menses, developed pe...

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Main Authors: Adrianna Clapp, Dani Zapp, Thomas DeLuca, Anjali Morris, Shin jie Yong, Ridwan Ahmad, Bala Munipalli
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251364093
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author Adrianna Clapp
Dani Zapp
Thomas DeLuca
Anjali Morris
Shin jie Yong
Ridwan Ahmad
Bala Munipalli
author_facet Adrianna Clapp
Dani Zapp
Thomas DeLuca
Anjali Morris
Shin jie Yong
Ridwan Ahmad
Bala Munipalli
author_sort Adrianna Clapp
collection DOAJ
description Menstrual irregularities and abnormal uterine bleeding have been increasingly reported following severe acute respiratory syndrome coronavirus 2 infection, likely due to viral-induced endocrine disruption and immune dysregulation. A woman in her late 30s, with previously regular menses, developed persistent abnormal uterine bleeding after recovering from coronavirus disease 2019. Lab work-up over the next 2 years demonstrated high follicle-stimulating hormone, low anti-Müllerian hormone, low estrogen, and borderline antinuclear antibody titers. A pelvic ultrasound showed low antral follicle count, and she had challenges with fertility preservation. The patient was suspected of having an exaggerated immune reaction to severe acute respiratory syndrome coronavirus 2 infection with her strong family history of autoimmune disease and borderline antinuclear antibody, which may have led to an autoimmune-induced premature ovarian insufficiency. This case highlights the need to recognize post-viral menstrual irregularities and endocrine dysfunction as a potential consequence of coronavirus disease 2019. Clinicians should consider postinfectious endocrine disturbances in patients with new-onset abnormal uterine bleeding or infertility and evaluate for immune-mediated mechanisms when appropriate. Further research is needed to elucidate the long-term impact of coronavirus disease 2019 on reproductive health.
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spelling doaj-art-4267e687acdd4779b6df0ca700e122ab2025-08-20T03:58:15ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-07-011310.1177/2050313X251364093Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case reportAdrianna Clapp0Dani Zapp1Thomas DeLuca2Anjali Morris3Shin jie Yong4Ridwan Ahmad5Bala Munipalli6Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USADepartment of Family Medicine, Mayo Clinic, Jacksonville, FL, USADepartment of Family Medicine, Mayo Clinic, Jacksonville, FL, USAUniversity of Florida, Gainesville, FL, USASchool of Medical and Life Sciences, Sunway University, Selangor, MalaysiaDepartment of Medicine, Mayo Clinic, Jacksonville, FL, USADepartment of Medicine, Mayo Clinic, Jacksonville, FL, USAMenstrual irregularities and abnormal uterine bleeding have been increasingly reported following severe acute respiratory syndrome coronavirus 2 infection, likely due to viral-induced endocrine disruption and immune dysregulation. A woman in her late 30s, with previously regular menses, developed persistent abnormal uterine bleeding after recovering from coronavirus disease 2019. Lab work-up over the next 2 years demonstrated high follicle-stimulating hormone, low anti-Müllerian hormone, low estrogen, and borderline antinuclear antibody titers. A pelvic ultrasound showed low antral follicle count, and she had challenges with fertility preservation. The patient was suspected of having an exaggerated immune reaction to severe acute respiratory syndrome coronavirus 2 infection with her strong family history of autoimmune disease and borderline antinuclear antibody, which may have led to an autoimmune-induced premature ovarian insufficiency. This case highlights the need to recognize post-viral menstrual irregularities and endocrine dysfunction as a potential consequence of coronavirus disease 2019. Clinicians should consider postinfectious endocrine disturbances in patients with new-onset abnormal uterine bleeding or infertility and evaluate for immune-mediated mechanisms when appropriate. Further research is needed to elucidate the long-term impact of coronavirus disease 2019 on reproductive health.https://doi.org/10.1177/2050313X251364093
spellingShingle Adrianna Clapp
Dani Zapp
Thomas DeLuca
Anjali Morris
Shin jie Yong
Ridwan Ahmad
Bala Munipalli
Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case report
SAGE Open Medical Case Reports
title Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case report
title_full Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case report
title_fullStr Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case report
title_full_unstemmed Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case report
title_short Abnormal uterine bleeding and fertility challenges secondary to long COVID: A case report
title_sort abnormal uterine bleeding and fertility challenges secondary to long covid a case report
url https://doi.org/10.1177/2050313X251364093
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