Impact of COVID-19 Vaccination on Menstrual Cycle: A Cross-Sectional Study From Karachi, Pakistan

Abstract

BackgroundThe coronavirus disease 2019 (COVID-19) disease triggered a worldwide health catastrophe. To deal with this deadly situation multiple vaccines were developed and a mass immunization program started globally. However, vaccine hesitancy was seen, especially among women of reproductive age, having concerns that the vaccine might affect their menstrual cycle. This study investigated the link between COVID-19 vaccination and menstrual abnormalities. It is essential for us to understand the effects of vaccines on menstruation as menstrual distress can have effects on everyday life, and mental and reproductive health. MethodsA cross-sectional study was performed using self-administered online forms to collect data from all over Karachi. The sample included 384 females aged 18 years and above. The data were collected from November 2021 to February 2022. ResultsMajority of the participants were aged 21 years and had a normal body mass index (BMI). Most were moderately stressed (n=245) with 146 reporting menstrual changes post-vaccination. The difference between the post-vaccine menstruation affected (n=146) and the unaffected cohort (n=238) was significant. Other factors which likely contributed to the post-vaccine menstrual changes included Perceived Stress Scale (PSS) score, strenuous physical activity, and the pre-vaccine menstrual flow. ConclusionsAmong the women vaccinated for COVID-19, strenuous physical activity and high perceived stress levels affected the menstrual cycle. There is no denying that existing data are inadequate, which is one of the grounds for vaccination apprehension, particularly among menstruating women. To minimize this hesitation, the spread of disinformation about the vaccine's influence on the menstrual cycle must be avoided. In future research and clinical trials, menstruation-related side effects should also be investigated when developing vaccines.

Menstrual-Related Disturbances Following SARS-CoV-2 Vaccination: A Spanish Retrospective Observational Study in Formerly Menstruating Women

“…Focusing on the menstrual bleeding disturbances, those related with the length and flow stand out. This observation is consistent with that found in previous studies reporting longer-lasting menstruation [14,20], and/or heavier flow [14,21,25,33,34] than usual in vaccinated women. Unexpectedly, increased bleeding has also been observed in women using hormonal contraception [14,21,25,33], which may indicate that certain immunological processes may be also involved.…”

Assessing Menstrual Changes Among Young Indian Females Post-SARS-CoV-2 Vaccination

“…Another retrospective online study involving females aged 18 to 41 years also reported that 20.8% of participants experienced delayed menstruation and 21.4% experienced early menstruation, findings that mirror our own study [19]. Similarly, a study among Pakistani women aged 18 and above reported that one-tenth of the participants missed their menstrual cycle post-SARS-CoV-2 vaccination, further supporting our findings [21]. Our study also aligns with the findings of the Arizona COVID-19 cohort (CoVHORT), which also documented irregularities in the menstrual cycle in 43% of the participants [22].…”

Effects of Covid-19 Vaccines on the Menstrual Cycle: A Cross-Sectional Study.

“…Consistent with the previous research ndings, the results of this study also presented evidence that changes to the women's menstrual cycle after exposure to the Covid-19 vaccination are short lived. 9,28,29,30 The results of the chi-square test analysis indicated that there were fewer incidences of menstrual disturbances after the second dose cycle compared to the menstrual abnormalities after the rst dose cycle. The implication is that the extent of immunological stimulation of the menstrual cycle hormones tends to decrease after the second dose cycle.…”