Covid-19 vaccination and postmenopausal bleeding

In the Spring of 2021, reports started accumulating of menstrual changes and unexpected vaginal bleeding after covid-19 vaccination.1 Fortunately, a wealth of data from menstrual cycle tracking apps allowed researchers to quickly show that vaccination can temporarily increase cycle length and menstrual flow, with cycles returning to normal soon after.23 Although postmenopausal bleeding is generally not cause for concern, in approximately 9% of cases, bleeding is a sign of endometrial cancer.4 For individuals who are accustomed to no longer having regular periods, both the bleeding itself and subsequent investigations to rule out cancer are a cause of substantial distress. As such, investigating whether covid-19 vaccination raises the risk of postmenopausal bleeding and, if so, why this occurs and what outcomes are expected, should be a priority.A nationwide cohort study of the female population of Sweden, recently published in the linked paper (doi:10.1136/bmj-2023-074778) by Ljung and colleagues, takes the first step…
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