Perimenopause and Long Covid: When Two Conditions Collide
Long Covid and perimenopause share fatigue, brain fog, and sleep disruption. Learn how to manage both, advocate for yourself medically, and protect your wellbeing.
What We Know About Hormones and Long Covid
Emerging research suggests that sex hormones may play a role in Long Covid, with some studies noting that women of perimenopausal age are disproportionately represented among Long Covid patients. Estrogen has broad anti-inflammatory and immune-modulating effects, and its decline during perimenopause may reduce the body's capacity to recover from the inflammatory burden of Covid infection. Some clinicians are exploring whether hormonal support might ease Long Covid symptoms in perimenopausal women, though this remains an active area of research rather than established guidance. It is a conversation worth raising with your doctor.
Managing Post-Exertional Malaise
Post-exertional malaise, where physical or cognitive effort triggers a disproportionate and prolonged worsening of symptoms, is a feature of Long Covid that requires careful management. The standard perimenopause advice to exercise regularly must be adjusted when post-exertional malaise is present. Pacing within your current energy envelope, rather than pushing to previous fitness levels, reduces the risk of crashes. This is not a permanent state for everyone, but in the acute phase of Long Covid it is the most evidence-aligned approach available. Rest is a legitimate treatment, not a sign of giving up.
Sleep, Palpitations, and Hormonal Volatility
Night sweats from perimenopause disrupt the sleep that Long Covid patients need most for recovery. Heart palpitations are common in both conditions and can be alarming even when they are benign. If you experience palpitations, it is worth discussing with a doctor whether they need investigation or whether they are consistent with the autonomic nervous system dysregulation seen in Long Covid and the hormonal changes of perimenopause. Keeping the bedroom cool, using breathable bedding, and maintaining consistent sleep routines supports recovery from both conditions.
Getting the Right Medical Support
Long Covid clinics and GP surgeries vary considerably in their knowledge of perimenopause, and perimenopause specialists may not be familiar with Long Covid. You may need to bring information to both settings. Ask your GP to review your hormonal status if you have not already had this discussion. If you are enrolled in a Long Covid rehabilitation programme, let those clinicians know about your perimenopausal symptoms, since they may affect your capacity to engage with rehabilitation activities. Having a coherent narrative about how the two conditions interact gives your care team the best chance of supporting you well.
Tracking Patterns to Guide Your Recovery
Both Long Covid and perimenopause are conditions where day-to-day variability is high and symptoms can shift without obvious explanation. Tracking your symptoms consistently over weeks and months reveals patterns that are invisible in the short term. You might notice that certain symptoms worsen at particular phases of your cycle, or that they improve in response to specific adjustments. PeriPlan lets you log symptoms and track patterns over time, giving you something concrete to discuss at medical appointments rather than trying to reconstruct weeks of experience from memory.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.