Association of COVID19-affected Mental Health with Menstrual Abnormalities among University Students: A cross sectional study from Pakistan

Abstract

Introduction: Mental health is crucial for wellbeing. COVID-19 pandemic has caused mental health problems. In this study it was hypothesized that COVID19 related mental health disturbances may have impacted the menstrual health. Objective of this study was to evaluate the impact of COVID-19 affected mental health on the menstrual health of university students. Methods: A cross sectional study was conducted at University of Sindh, Jamshoro between July to August 2021 during fourth wave. A pre-tested questionnaire was administered to collect the data. Healthy unmarried female students were included in the study. Mental health parameters were assessed using DAS Scale. Results: For a total 400 study participants the mean age was 20.82±1.69. The prevalence of mild to severe depression, mild to severe anxiety, and mild to moderate stress was 46.3%, 62% and 29.3% respectively. In moderately depressed females there was an increased prevalence of oligomenorrhea [ꭓ2=34.5 p<0.0001], heavy menstrual blood flow [ꭓ2=21.8 p<0.001], increased duration of menstrual bleeding [ꭓ2=21.56 p<0.001], and heavy menstrual dysmenorrhea [ꭓ2=18.78 p<0.002]. In moderately anxious females there was an increased prevalence of oligomenorrhea [ꭓ2=15.5 p<0.07], heavy menstrual blood flow [ꭓ2=12.4 p<0.03], and increased duration of menstrual bleeding [ꭓ2=21.56 p<0.001]. In moderately stressed females there was increased prevalence of polymenorrhagia [ꭓ2=22.3 p<0.001], increased duration of menstrual bleeding [ꭓ2=24.23 p<0.0001], heavy menstrual dysmenorrhea [ꭓ2=21.28 p<0.01] and secondary amenorrhea [ꭓ2=4.28 p<0.01]. Conclusion: COVID19-affected Mental Health affected menstrual health. Healthcare system of Pakistan should address this issue while planning to mitigate the impacts of COVID-19 on human health.

Stress exposure due to the COVID-19 pandemic on menstrual abnormalities: A systematic review

“…Medina-Perucha et al 15 found 7.2% of their respondents experienced an increase in bleeding. This finding was in line with a study by Samo et al 13 which found that 15% of the respondents experienced heavy bleeding during the COVID-19 pandemic, and also in line with the research by Phelan et al 11 who also mentioned that 28% of the respondents had menstruation for more than eight days. Higher percentage was found on a study by Maher et al 12 which stated that 50% of their respondents felt that their menstrual volume during the pandemic had also increased.…”

“…Research conducted by Samo et al also found that 16% of the respondents experienced amenorrhea during the pandemic. [13][14][15][16][17][18][19][20] Higher percentage were found in a study by Garcia de Leon et al 21 , which found that 23.7% of their respondents, specifically 13.1% of their under 40s respondent having fewer periods than before.…”

“…Payne et al 10 also revealed that the increase in stress and distress due to COVID has a relationship with more significant menstrual pain disorders. Samo et al 13 also found that respondents to their study experienced dysmenorrhea. Higher percentage were found in these following latest studies: Garcia de Leon et al 21 found that 44.3% of their respondents indicated more symptomatic on their periods, specifically 52.7% of their under 40s respondents.…”

“…This was in line with a study by Maher et al 12 which 5.1% of their respondents experienced a reduction in menstrual days, and 5% experienced a reduction in menstrual volume. Samo et al 13 also revealed a decrease in menstrual volume in 16.75% of their respondents. Phelan et al 11 on their studies also revealed that 29% of their respondents experienced menstruation in under two days.…”

COVID-19 Pandemi Döneminin Adet Döngüsü ve Premenstrüel Sendrom Üzerindeki Etkisine Genel Bir Bakış

“…In a study conducted in Mumbai, India, the results showed that more than half (78%) of the 155 respondents observed alterations in their menstrual periods (32). In another study applied in Pakistan, COVID-19 has impacted 59.75% of study participants' mental health (33). Moreover, in a study that was among students of the Faculty of Health Sciences during COVID-19, out of 500 students, 73% had severe PMS (34).…”