Impact of Stress on Menstrual Cyclicity During the Coronavirus Disease 2019 Pandemic: A Survey Study

Abstract

Background: The Covid-19 pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the Covid-19 pandemic and its related stressors have impacted women's menstrual cyclicity. Materials and Methods: An online survey instrument designed to capture self-reported information on menstrual cycle changes and perceived stress levels was distributed between July and August 2020. A total of 210 women between the ages of 18-45 years met stringent inclusion and exclusion criteria and completed the survey. Results: Of the 210 respondents, more than half (54%) reported changes in their menstrual cycles. These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses ( p < 0.001) and heavier bleeding during menses ( p = 0.028) compared with those with moderate Covid PSS scores. Conclusions: By uncovering a trend in increased menstrual cycle irregularities during the early months of the Covid-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.

Menstrual Symptoms After COVID-19 Vaccine: A Cross-Sectional Investigation in the MENA Region

“… 20 , 21 One source of stress that has taken the world by storm was the COVID-19 pandemic, such that several studies showed an increase in menstrual cycle abnormalities during the pandemic compared to before. 17 , 18 , 22 , 23 In our study, nearly one-third (35.3%) of the participants experienced menstrual changes during the COVID-19 pandemic before vaccination. However, 66.3% of women experienced abnormal periods after vaccination.…”

The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature

“…Therefore, it is universally accepted that extremely stressful experiences induce menstrual cycle changes. Many of the studies included in this review reinforce the idea that high-stress levels were more likely to markup menstrual changes [ 35 , 36 , 40 , 41 ]. Long-term stress might also be a contributor.…”

Menstrual changes following COVID-19 infection: A cross-sectional study from Jordan and Iraq

“…In a previous study conducted in the United States, it was found that COVID-19-related stressors may also be a contributing factor in menstrual cycle changes. In that study, females showed a high perceived stress scale, at the same time they reported significant changes in their menstrual bleeding during the COVID-19 pandemic [ 32 ]. The majority of the participating females in our study, were vaccinated against COVID-19 (~91%), and 35% of them were also vaccinated against the seasonal flu ( Table 3 ).…”

“…The five most common post COVID-19 effects are headache, fatigue, attention disorder, hair loss and dyspnea [7]. In addition, other studies indicated that one of the long term symptoms of COVID-19 is disturbances in the menstrual cycle of females [8][9][10].…”