You may have seen articles about a possible association between getting the Covid vaccine and experiencing a longer menstrual cycle. To be clear, what they were referring to was a longer number of days from the beginning of one cycle until the beginning of the next cycle, not an increased number of days of menstrual flow. When women started reporting some irregularity, 1.7 million dollars was distributed by the National Institute of Health to five institutions to study the situation. Women enrolled in the study were in either a vaccinated or an unvaccinated group and all were asked to keep track of their menstrual cycles.

It was found that the vaccinated women had a “nearly one day” increase in their cycle. It is normal for cycle length to vary from month to month. And one day is well within the normal range of variability according to Dr. Alison Edelman MD, M.P.H. of the Oregon Health Sciences University.

Regardless of whether the one day increase was statistically significant, what really interested me was the possible influence of bio-psycho-social factors on this “outbreak” of longer cycles.
In her fascinating book, Sleeping Beauties, Irish neurologist Dr. Suzanne Sullivan makes a great case that what happens to the body is often a result of our belief systems and social environment. Her interest in “bio-psycho-social” medicine lead her to investigate bazaar and unexplainable mass outbreaks of coma in Afghan refugee girls, seizures in girls at a Connecticut middle school, and ENT symptoms in US Embassy staff in Cuba. Dr. Sullivan interviewed., observed, and did neurological exams of the people in these groups, and found no abnormal lab test, reflexes, electrical studies, or brain scans. Her diagnosis was FND, or functional neurological disease.

Functional disease was originally called hysteria, from the Greek word for uterus, hyster, because unexplained symptoms were believed to be more common in women than men. Which is actually not true. Later the term became psychosomatic or psychogenic disorder, and was applied to gastro-intestinal diseases like irritable bowel syndrome in which diarrhea or constipation occur but there are no signs of bowel inflammation or damage. When groups of people in close proximity or within the same time frame experienced similar unexplainable symptoms, it was labeled, “mass hysteria”.

Dr. Sullivan made a compelling case that belief systems, secondary gain, stressors and other social influences can result in serious physical disease. In the case of comatose Afghan girls, the common social and psychological link was that their families had all been denied asylum Sweden where they had been living and faced deportation, clearly a stressor. She emphasized that while they had no abnormal neurological tests, their comatose states were real—no amount of pinching could arouse them and they had to be tube fed and turned. Her diagnosis was functional neurological disease due to bio-psycho-social factors. In her book, Dr. Sullivan provided a detailed and compelling explanation of the specific factors that could have accounted for the Connecticut outbreak of seizures and the ENT symptoms in the US Embassy staff. That functional disease can sometimes appear to be “contagious” is not well understood, and possibly occurs more frequently than we realize. Emergency departments have recently reported an increase in the number of girls presenting with the uncontrollable movements known as tics. Some professionals believe that it may be linked to popular TikTok videos of girls with tics.

Back to cycles. I wondered whether we are all a bit stressed by the important need to be immunized with a vaccine we didn’t know a lot about at first, and our natural tendencies to be on high alert had sent us searching for possible adverse effects or signs, like longer cycles. Psychologists call this the process of “looping”. The concept of “predictive processing” also comes into play here, which is the mind’s tendency to direct the body to react in the same way to an old stimuli when it is presented again. We may have gotten sick after a previous flu shot or vaccination, and our bodies have fallen prey to the expectation of the mind. And as more women reported longer cycles, more women took a look to see if they had them too.

Even if the vaccine is found to truly elongate cycles, it is interesting to consider whether this change was solely a biological effect or one in which thoughts, emotions, expectations and on-line information influenced women’s hormones and cycle length. Bio-psycho-social theory would say that it was all of the above. And Dr. Sullivan ends her book by urging health practitioners to look for these dynamics in all patients.