Menstrual cycle changes and mental health states of women hospitalized due to COVID-19

Abstract

Purpose Many studies have evaluated the impact of the COVID-19 pandemic on women’s mental health and menstrual changes. However, most of these studies only included nonhospitalized COVID-19 patients, while information on hospitalized women is very limited. Thus, this study aimed to examine the mental health status and menstrual changes in hospitalized female COVID-19 patients. Methods A survey was administered to female COVID-19 patients in the isolation ward of a national referral hospital in Indonesia between January and August 2021, and the women were followed up 3 months after discharge. The survey evaluated menstrual patterns and mental health using the Self Reporting Questionnaire-29 (SRQ-29). Results The study enrolled 158 female patients. There was an increase in patients who had a cycle length of > 32 or < 24 days, and significant increases in menstrual irregularity and heavy menstrual bleeding were noted. Overall, 37.3% of the patients reported a change in menstrual pattern after infection with COVID-19. Based on SRQ-29 scores, 32.3% of the women had neurotic symptoms, 12.7% had psychotic symptoms, and 38.0% had symptoms of posttraumatic stress disorder. Patients with symptoms of mental health disorders were twice as likely to report a menstrual change (OR 2.17, 95% CI 1.12–4.22; p = 0.021). Conclusion Menstrual changes and increased symptoms of mental health disorders occur in hospitalized female COVID-19 patients. The length of isolation was the key factor affecting overall menstrual changes and mental health in hospitalized female COVID-19 patients.

Menstrual Changes after COVID-19 Infection and COVID-19 Vaccination

“…Some women complained of shortened or delayed menstrual cycles, while some complained of heavier or lighter bleeding. The altered menstruation pattern following COVID-19 infection or vaccination is a very current issue, and different results are reported from different countries and races [ 5 , 8 , 9 ].…”

“…In the Arizona CoVHORT study, the incidence of menstrual changes after COVID-19 infection was 16%, and in another study, it was 37.3% among hospitalized patients. In another study, the incidence of menstrual changes following infection was 47.2% [ 5 , 8 , 9 ].…”

“…In our study, the change in the menstrual pattern after COVID-19 infection occurred in the form of a delayed cycle in 17.4% of the participants, shortened cycle in 14%, heavier bleeding in 7.4%, lighter bleeding in 5.8%, shorter period in 2.5%, and longer period in 4.1%. In the literature, following infection, a delayed cycle was reported by 19.6% of the patients, a shortened cycle was reported by 15.2%, heavier bleeding was reported by 33%, a longer period was reported by 11.4%, and a shorter period was reported by 6.3% [ 5 ]. The incidence and the nature of the changes in our study are in concordance with the literature.…”

“…In addition, ACE-2 receptors are widely expressed in the ovaries and endometrium, suggesting that SARS-CoV-2 infection may cause menstrual irregularities by directly affecting the ovaries and endometrium. Menstrual changes have also been reported following COVID-19 vaccination, which may be attributed to immunological processes [ 5 – 7 ].…”

The Effect of COVID-19 on the Menstrual Cycle of Female Medical Staff: A Cross-sectional Survey in China

“…Nevertheless, to date, the majority of COVID-19 studies [20,21] concerning the menstrual cycle have focused on patients infected by the virus, while there has been little research on menstrual health for medical staff working on the frontline of the ght against the epidemic. However, Huang and Zhao [22] found that healthcare workers were more at risk of mental health problems.…”