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Immunity, COVID-19 and your menstrual cycle

Updated: May 7, 2020

Our immune system is one of the most complex systems in our body, consists of various number of cells in charge of different reactions constantly happening in order to protect us from outside and internal ongoing misbalancing threats.

Menstrual cycle immune interval

That brings us to the immune system activity pattern in women during reproductive age. Do you know the feeling of “I’m about to get the flu...” or that feverish sensation just before getting the menstrual flow? Well, you are absolutely on it! There is a pattern. The cyclic nature expressed in hormonal levels and their effect has an impact on the different systems in our body including the immune system.

Understanding the general idea behind the biomechanism of action is looking at the menstrual cycle divided in two, menstruation up to ovulation- low hormonal phase, and after ovulation until the beginning of the next period- high hormonal phase.

There is a biological rational in the differences of the immune system function throughout the menstrual cycle. Let’s take a look at two main types of lymphocytes, which are white blood cells that are also one of the body’s main types of immune cells. First, T helper 1 cells, that provides help to other cells in the immune response by recognizing foreign antigens such as bacteria and viruses that would penetrate the cell, replicate their genetic material within it, multiply, destroy the cell and cause infection. Second are T helper 2 cells which are important for immune responses against pathogens that do not directly infect cells’ more like the reaction towards invading parasites thar would cause a systemic elevation in the immune response causing elevation in cytokines and inflammation that would have systemic impact.

During the first phase, the low hormonal phase of the menstrual cycle, there is an elevated response of the T helper 1 cells. In that phase the body is preparing for a possible pregnancy which means maintaining as healthy as possible state especially alert for those bacterial and viral infections that are running around outside.

So, here’s a good point, during menstruation we are relatively more immune for bacterial and viral (COVID-19) infection, one more reason to love menstruation.

The hormonal surge and shift around ovulation and after, the high hormonal phase as we call it, is characterized by elevated progesterone levels that impacts on certain cytokines. Elevation in cytokines cause inflammation response that can drive fever which is an immune response to fighting invaders that might cause systemic infection or even systemic breakdown. This biological mechanism is to protect a whole-body concern phenomenon called- pregnancy.

Cycle Immunity awareness

Understanding the mechanism makes us realize we are more susceptible to upper respiratory tract infections (COVID-19), viral and bacterial infections in the late luteal phase, towards the end of the high hormonal phase. That’s when our immune response to those type of infections is downregulated. On the other hand, we are more immune to other type of infections that can cause a systemic immune reaction.

Awareness is a super powerful starting point in how to handle the facts. We are able to support ourselves in various ways during the changing phases of the cycle. Providing ourselves with appropriate sleeping hours, maintaining physical activity that’s adjusted to our cycle’s phase, such as parasympathetic promoting activity (deep breathing, mindfulness, yin yoga) during the late luteal phase. Balanced diet containing fresh vegetables, fruits and refraining from processed foods, that’s true through life in general!

Biohacking your body

There are many ways to track body changes that reflect proper or disturbed function of our body systems. I find that systematic tracking and charting indicators and signs of the feminine reproductive system, is a highly effective approach. Since tracking true sleep temperature (traditional BBT) and identifying a temperature shift, points out that ovulation has occurred, it is a significantly useful parameter for drawing the important line of the beginning of the high hormonal phase. This information has, as previously explained immense impact on our immunity and can help us adopt approaches that support our individual and health and wellbeing, as well as others.


Shirley Pavlik RN, MPH certified academic women’s health and public health nurse. Certified NFP instructor. Member of NFPTA UK. Founder of the Wander Women Clinic – providing comprehensive fertility counselling for women and couples taking charge of their fertility, for nearly two decades. Expertise in hormone free contraception and feminine barrier fitting (diaphragms and cervical caps). Professional consultant for Tempdrop Ltd.

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