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

Muhaidat, Nadia; Alshrouf, Mohammad Ali; Azzam, Muayad I.; Karam, Abdulrahman M; Al-Nazer, Majed W; Al-Ani, Abdallah

doi:10.2147/ijwh.s352167

Cited by 118 publications

(196 citation statements)

References 33 publications

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“…Previous studies have shown increased cycle length, 20 as well as menstrual cycle irregularities in relation to COVID-19 vaccination. [21][22][23][24] The current work is consistent with results from Edelman et al that showed a less than one day increase in length during cycles when vaccination occurred. 20 We extended this work to evaluate vaccine timing and menstrual cycle length and found follicular dosing of all vaccines associated with longer cycles, while a second dose of an mRNA vaccine in the luteal phase was associated with slightly shorter cycles.…”

Section: Discussionsupporting

confidence: 92%

“…3 Improved understanding of these associations, such as whether one exists and the magnitude and persistence of potential changes, will assist clinicians in counselling women concerning vaccination. 19 While research on the COVID-19 vaccine and menstrual characteristics is limited, existing studies have reported temporarily increased menstrual cycle length, 20 increased menstrual bleeding, 21 longer duration of menses, 22 and menstrual irregularities, 23,24 as well as breakthrough bleeding in individuals who previously menstruated. 25 Generally, these changes were considered short term, but detailed follow-up data beyond the first cycle after vaccination were not presented.…”

Section: Introductionmentioning

confidence: 99%

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Covid-19 vaccination and menstrual cycle length in the Apple Women’s Health Study

Gibson¹,

Li²,

Fruh³

et al. 2022

Preprint

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Background: COVID-19 vaccination may be associated with change in menstrual cycle length following vaccination. Methods: We conducted a longitudinal analysis within a subgroup of 14,915 participants in the Apple Womens Health Study (AWHS) who enrolled between November 2019 and December 2021 and met the following eligibility criteria: were living in the U.S., met minimum age requirements for consent, were English speaking, actively tracked their menstrual cycles, and responded to the COVID-19 Vaccine Update survey. In the main analysis, we included tracked cycles recorded when premenopausal participants were not pregnant, lactating, or using hormonal contraceptives. We used conditional linear regression and multivariable linear mixed-effects models with random intercepts to estimate the covariate-adjusted difference in mean cycle length, measured in days, between pre-vaccination cycles, cycles in which a vaccine was administered, and post-vaccination cycles within vaccinated participants, and between vaccinated and unvaccinated participants. We further compared associations between vaccination and menstrual cycle length by the timing of vaccine dose within a menstrual cycle (i.e., in follicular or luteal phase). We present Bonferroni-adjusted 95% confidence intervals to account for multiple comparisons. Results: A total of 128,094 cycles (median = 10 cycles per participant; interquartile range: 4-22) from 9,652 participants (8,486 vaccinated; 1,166 unvaccinated) were included. The average within-individual standard deviation in cycle length was 4.2 days. Fifty-five percent of vaccinated participants received Pfizer-BioNTechs mRNA vaccine, 37% received Modernas mRNA vaccine, and 7% received the Johnson & Johnson/Janssen vaccine (J&J). We found no evidence of a difference between mean menstrual cycle length in the unvaccinated and vaccinated participants prior to vaccination (0.24 days, 95% CI: -0.34, 0.82). Among vaccinated participants, COVID-19 vaccination was associated with a small increase in mean cycle length (MCL) for cycles in which participants received the first dose (0.50 days, 95% CI: 0.22, 0.78) and cycles in which participants received the second dose (0.39 days, 95% CI: 0.11, 0.67) of mRNA vaccines compared with pre-vaccination cycles. Cycles in which the single dose of J&J was administered were, on average, 1.26 days longer (95% CI: 0.45, 2.07) than pre-vaccination cycles. Post-vaccination cycles returned to average pre-vaccination length. Estimates for pre vs post cycle lengths were 0.14 days (95% CI: -0.13, 0.40) in the first cycle following vaccination, 0.13 days (95% CI: -0.14, 0.40) in the second, -0.17 days (95% CI: -0.43, 0.10) in the third, and -0.25 days (95% CI: -0.52, 0.01) in the fourth cycle post-vaccination. Follicular phase vaccination was associated with an increase in MCL in cycles in which participants received the first dose (0.97 days, 95% CI: 0.53, 1.42) or the second dose (1.43 days, 95% CI: 1.06, 1.80) of mRNA vaccines or the J&J dose (2.27 days, 95% CI: 1.04, 3.50), compared with pre-vaccination cycles. Conclusions:COVID-19 vaccination was associated with an immediate short-term increase in menstrual cycle length overall, which appeared to be driven by doses received in the follicular phase. However, the magnitude of this increase was small and diminished in each cycle following vaccination. No association with cycle length persisted over time. The magnitude of change associated with vaccination was well within the natural variability in the study population. Menstrual cycle change following COVID-19 vaccination appears small and temporary and should not discourage individuals from becoming vaccinated.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Covid-19 vaccination and menstrual cycle length in the Apple Women’s Health Study

Gibson¹,

Li²,

Fruh³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Our results are consistent with a recent preliminary study of 39,129 participants in the United States, where 42% reported more severe bleeding after vaccination [2]. The frequency of irregular menstruation in the literature ranges from 5% to 35.6%, depending on the profession, age and area of residence [20].…”

Section: Introductionsupporting

confidence: 92%

“…One of the sources of stress that shocked the world was the COVID-19 pandemic, so several studies have shown an increase in menstrual disorders during the pandemic compared to the previous period [2,8,20]. In our study, 13.8% of participants experienced menstrual changes during the COVID-19 pandemic before vaccination.…”

Section: Introductionmentioning

confidence: 54%

Symptoms and Duration of the Menstrual Cycle and Vaccination against Coronavirus Disease (COVID-19)

Akperbekova¹

2022

Ukr. ž. med. bìol. sportu

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The purpose of the study was to determine the association of COVID-19 vaccination with changes in cycle or duration of menstruation during menstrual cycles while receiving vaccine doses. Materials and methods. The study included 200 women aged from 20 to 38 who had at least three cycles after pregnancy or after using hormonal contraception. The women were vaccinated with Pfizer-BioNTech (Pfizer) and CoronaVac (Sinovac) (Sinovac Biotech) vaccines. The distribution of women by age is as follows: 20–24, 25–29, 30–34, 35–38 years. Additional characteristics included parity (nulliparous versus parous), body mass index, which was classified as underweight or normal weight, overweight or obese; education and relationship status (sustainable relationship or not). Results and discussion. Of 200 women included in the study, 110 (55.0%) patients were vaccinated, 90 (45.0%) were unvaccinated. Average age of vaccinated was 31.6 ± 2.88 years, unvaccinated – 29.3 ± 3.05 years (t = 0.55, p = 0.584). Among 110 vaccinated women, 73.6% had regular menstrual cycles before the introduction of the vaccine during the last year, among 90 unvaccinated women, 74.4% of women had regular menstrual cycles. Menstrual irregularities among those who were vaccinated and those who did not undergo COVID-19 were 11.8% and 14.5%, respectively. Symptoms appeared within a week in 27.6%. In 62.1% of cases, symptoms appeared after the first dose, in 37.9% of cases – after the second dose. There was a significant difference between menstrual irregularities during the COVID-19 pandemic and menstrual irregularities after vaccination (p < 0.001). The study showed that 26.4% of our sample complained of menstrual irregularities after vaccination against COVID-19, especially after the first dose (16.4%). The type of vaccine did not affect the frequency of menstrual disorders in these women. After vaccination, women reported significantly longer average duration of menstruation and duration of the menstrual cycle compared to their condition before vaccination. These symptoms decreased a month after vaccination. Although 27.6% had a clinically noticeable change in cycle duration by 7-8 days, this change rapidly weakened during two post-vaccination cycles. We found no significant changes in the duration of menstruation between vaccination doses. Conclusion. Among women who received vaccines against COVID-19, 26.4% of cases had menstrual irregularities. When counseling women who have received a COVID-19 vaccine, it is advisable to inform them of the possible occurrence of temporary and self-limiting menstrual irregularities in the following months

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“…The observation of myocarditis in young males associated with the mRNA-platform COVID-19 vaccines has demonstrated that risks of harm may not be equal between different sexes or ages [ 3 ]. Furthermore, menstrual disorders after vaccination have been reported from thousands of women throughout the world [ 4 – 7 ] and a review was initiated by the European Medicines Agency in February 2022 [ 8 ], drawing attention to the importance of sex-specific and patient-reported outcomes in clinical trial designs.…”

Section: Introductionmentioning

confidence: 99%

The International Society of Pharmacovigilance Vaccines Special Interest Group: Challenges and Opportunities

Chandler¹

2022

Drug Saf

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

Cited by 118 publications

References 33 publications

Covid-19 vaccination and menstrual cycle length in the Apple Women’s Health Study

Covid-19 vaccination and menstrual cycle length in the Apple Women’s Health Study

Symptoms and Duration of the Menstrual Cycle and Vaccination against Coronavirus Disease (COVID-19)

The International Society of Pharmacovigilance Vaccines Special Interest Group: Challenges and Opportunities

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