Can HRT protect against Covid-19?

New analysis by The Menopause Doctor suggests that Covid-19 and HRT might be more closely linked than widely thought.
The analysis of health records from nearly 70,000 people found that women taking HRT are 50% less likely to die of Covid-19 infections than women over the age of 50 who aren’t taking HRT. These findings are shining a crucial spotlight on women’s health, especially around middle age, and the importance of hormones on our health.
International research of Covid-19 shows that women are less likely to be fatally affected by the virus than men. While we don’t know for sure why this is, it’s likely to be due to the infection-fighting powers of estrogen.
To find out more, we spoke to Dr Louise Newson, a leading Menopause specialist GP with a degree in immunology, as well as the founder of the Balance app and The Menopause charity.

Estrogen, HRT and fighting infection

Much of Louise’s interest in medical research has focussed on the infection-fighting power of estrogen. Estrogen helps to support our immune systems in a number of ways. There are estrogen receptors on all of our infection-fighting cells, including the different types of white blood cells. Healthy amounts of good quality estrogen increases the number of immune cells as well as improving their function.
It appears estrogen can help to fight Covid-19, too. An early study of Covid from Wuhan found that women with low estrogen levels had a more severe disease. What’s more, the protective effect that estrogen has on our cardiovascular health is also thought to play a role in the response to Covid.
Having low levels of estrogen can be a problem for the strength of our immune system. HRT is a safe and effective way to make sure our bodies have enough of this helpful hormone.

Cytokine storms and Covid

There’s been a lot of chat about ‘cytokine storms’ in relation to the immune response of Covid-19. Cytokines are immune system proteins that surge when the body needs an extra boost to fight infection. Sometimes, however, this is too strong a reaction that causes cell and organ damage. What’s more, it’s not easy to switch off once active.
It’s thought that the occurence of cytokine storms may be the cause of some of the organ and tissue damage, especially in the lungs, that’s being seen in Long Covid patients. Estrogen regulates cytokines, and can even block the production of some chemicals found in severe Covid-19 infections. This means these proteins don’t damage healthy cells. This may also be why less women are likely to die from Covid than men.
Estrogen stimulates cells to be more efficient and less likely to become inflamed. Inflamed cells go on to increase the risk of conditions such as heart disease, obesity and diabetes. In this way, estrogen is essential to regulating immune responses to make sure they’re proportionate and effective.

Long Covid and hormones

While women appear to have a greater chance of surviving Covid, many middle-aged and older women are developing Long Covid. Long Covid patients are defined as those who have contracted the virus but continue to experience symptoms, such as fatigue, for over 12 weeks.
The group affected most by Long Covid appears to be women in their early fifties. This is around the same time as the average onset of menopause. Covid-19 enters the body through a specific receptor found on the ovaries. Infections, therefore, may likely affect our ovaries and their ability to produce hormones.
An online survey of 1,294 women with Long Covid found that 74% reported a change in their periods since having Covid-19. The survey also revealed that these women’s Covid symptoms were worse before or during their periods. This is the time when estrogen levels are at their lowest.

What to do about Long Covid

Many of the symptoms of Long Covid are similar to those of the perimenopause and menopause. They may be attributed to low levels of estrogen and also testosterone. Testosterone in women can often improve symptoms of low stamina, fatigue, low mood and anxiety. It’s also very safe to take.
Replacing these hormones to improve symptoms and future health should be considered a priority for female sufferers of Long Covid, says Dr. Newson.
All women who attend a Long Covid clinic should be asked about the possibility of being perimenopausal or menopausal and offered HRT to help alleviate their perimenopausal and menopausal symptoms. This could potentially improve their symptoms related to Long Covid too.
The benefits of HRT outweigh the risks for the majority of women. Yet it’s still only the minority of perimenopausal and menopausal women that take HRT, despite overwhelming evidence to support its safety and effectiveness. According to Dr. Newson, this avoidance of HRT is putting women’s future health at risk.
Replacing estrogen safely through HRT can help make sure we keep all of our immune cells in check. This means they can effectively fight infection and keep healthy tissue safe.
For more information, visit Dr Louise Newson’s website, download the balance app or read her report Covid, the menopause and HRT.

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The Truth About HRT Liz EarleLiz’s bestselling e-book uncovers the truth about HRT. The aim of this guide is to give all women affected by menopause symptoms, as well as their medical advisors, the most up-to-date, relevant and helpful information on HRT to inform choices that significantly improve long-term health and wellbeing.
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