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Mar 12, 2020

Are Menopausal Women More Susceptible to New Coronavirus (Covid-19)?

Are Menopausal Women More Susceptible to New Coronavirus (Covid-19)?

Are Menopausal Women More Susceptible to the New Coronavirus?

“Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.” - Marie Curie

The other day, one of my patients asked me if she was more susceptible to the new strain of coronavirus infection due to menopause. It was an excellent question and caused me to do some research. From what I found, the answer might surprise you.

Here is what I told my patient regarding the risk of coronavirus for menopausal women:

  1. Lowered levels of hormones, specifically estrogen, can have an impact on the immune system.

Patients in menopause or postmenopause have dramatically lowered levels of female hormones compared to premenopause.  One of these hormones in particular, estrogen, is well-known to affect the immune system in women and is an important factor in the production of cells that help to fight off infection. 

Several immune system cells critical to fighting viral infection are typically decreased or less effective in postmenopausal women. These include special immune cells that circulate to scout for signs of viral infection and other immune cells that respond to signals sent by these scout cells to join the fight. 

As a result, postmenopausal women may have a diminished immune system response to invasion of the respiratory system by viruses such as the new coronavirus.  In other words, menopause may increase susceptibility to coronavirus.

  1. The data seem to suggest that those in midlife are more susceptible to COVID-19.

There isn’t much public data yet regarding COVID-19 prevalence in the US across age/gender, as the number of cases is still relatively small compared to other countries. However, reports from China, where thousands have been infected, seem to confirm this general susceptibility among those in midlife. As we can see from the chart below, citizens between 40-69 years old comprise the majority of COVID-19 cases.

Age also plays a large role in the severity of COVID-19 cases. Prior to age 50, the risk of death from coronavirus infection prior to age 50 is relatively negligible (less than 0.4% of COVID-19 cases result in a fatality). However after age 50, the risk of death from COVID-19 roughly doubles every 10 years, reaching ~15% of cases by age 80.

  1. Pre-existing conditions are a major influence on COVID-19 susceptibility.

Independent of age and hormone levels, the data coming from China also seem to suggest that citizens with certain pre-existing conditions are at a higher risk of complications from COVID-19. As seen in the table below, those with respiratory disease, hypertension, diabetes, or cancer have a death rate above 5%. For those with cardiovascular disease, that rate exceeds 10%.

So what is someone’s best course of action to reduce the risk of contracting coronavirus?

At this point, I underscore for my menopausal patients that age and underlying health are the most important risk factors for susceptibility to the new coronavirus infection. While we can’t change our age, we can take steps to improve our health!

I also carefully review the precautions we should all be taking to avoid getting infected in the first place:

  • avoid close contact with sick persons
  • wash hands frequently for at least 20 seconds with soap and water
  • use alcohol based hand-sanitizer with at least 60% alcohol (if soap is not available)
  • avoid touching the face (especially the mouth and nose)
  • clean and disinfect frequently touched objects and surfaces,
  • sneeze and cough into tissues and discard them
  • avoid areas with a ton of people packed into small spaces

See here for more advice from the CDC’s recent COVID-19 fact sheet

I urge patients to follow the CDC guidelines outlined above for minimizing your exposure. With a little common sense and practical steps we can get past this latest winter virus. And our MDs are here to answer any questions that you might have about midlife health and new coronavirus.