The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities

Sharp, Gemma C; Fraser, Abigail; Sawyer, Gemma; Kountourides, Gabriella; Easey, Kayleigh; Ford, Gemma K.; Olszewska, Zuzanna; Howe, Laura D; Lawlor, Debbie A.; Alvergne, Alexandra; Maybin, Jacqueline A.

doi:10.31219/osf.io/fxygt

Cited by 27 publications

(41 citation statements)

References 30 publications

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“…Highly educated females believed that COVID-19 infection has lower tendency to cause disturbances in the menstrual cycle. This could be explained that highly educated have more updated knowledge about COVID-19 and its effects [ 36 ], and only few reports from the literature reported the association between COVID-19 infection and menstrual cycle disturbances [ 8 , 37 , 38 ]. Moreover, the non-married females and those who are currently smoking they believe that COVID-19 had higher tendency to cause changes on the menstrual cycle.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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Purpose COVID-19 infection is normally followed by several post-COVID effects. This study aimed to investigate to evaluate menstrual changes in females following COVID-19 infection, and to evaluate female perception about the effect of COVID-19 on their menstrual cycles. Methods During this cross-sectional survey-based study, a convenience sample of 483 women from Jordan and from Iraq, who had infected with COVID-19 were invited to fill-out the study questionnaire. Results The study was conducted on the females, with a median age 31 years old. Results showed that 47.2% of them (n = 228) suffered from a change in the number of days between two consecutive periods, as well as from a change in the amount of blood loss. Also, more than 50% of them believed that COVID-19 infection may cause changes in the amount of blood loss during the cycle (n = 375, 56.9%), and changes in the number of days between the two consecutive periods (n = 362, 54.2%). Regression analysis showed that participants with higher educational level (bachelor or higher) (Beta = -0.114, P = 0.011), and those living in Iraq (Beta = -0.166, P<0.001) believed that COVID-19 has lower tendency to cause menstrual changes. In addition, non-married females (Beta = 0.109, P = 0.017), and those who are current smokers (Beta = 0.091, P = 0.048) believed that COVID-19 has higher tendency to cause menstrual changes. Conclusion his study revealed that COVID-19 infection could affect the menstrual cycle for the females. Further prospective studies should be done to confirm these findings and evaluate how long these menstrual irregularities lasted.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…There has been increasing public concern that COVID-19 vaccines cause disruption of menstrual cycles [1–3], leading to problematic menstrual symptoms, vaccine hesitancy [4] and fears about the impact of vaccination on fertility [5–7]. There are currently limited data [8] for investigating the relationship between the COVID-19 vaccines and menstrual cycles [1,9,10]. This is despite rising awareness among clinicians that the menstrual cycle should be used as a vital sign of female health [11,12], that sex is a biological variable which should be considered in immunological studies [13] and that there have been reports of heavy, infrequent or irregular menstrual bleeding following vaccination [1,8–10].…”

Section: Introductionmentioning

confidence: 99%

“…There are currently limited data [8] for investigating the relationship between the COVID-19 vaccines and menstrual cycles [1,9,10]. This is despite rising awareness among clinicians that the menstrual cycle should be used as a vital sign of female health [11,12], that sex is a biological variable which should be considered in immunological studies [13] and that there have been reports of heavy, infrequent or irregular menstrual bleeding following vaccination [1,8–10]. Quantitative evidence for any such relationship between COVID-19 vaccination and menstrual cycle disturbance, as well as the factors mediating this relationship, are crucial for evaluating how female health has been impacted by the pandemic.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccination and menstrual cycle changes: A United Kingdom (UK) retrospective case-control study

Alvergne

Kountourides²,

Argentieri

et al. 2021

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Background. There has been increasing public concern that COVID-19 vaccines cause menstrual cycle disturbances, yet there is currently limited data to evaluate the impact of vaccination on menstrual health. Our objectives were (1) to evaluate the prevalence of menstrual changes following vaccination against COVID-19, (2) to test potential risk factors for any such changes, and (3) to identify patterns of symptoms in participants' written accounts. Methods. We performed a secondary analysis of a retrospective online survey titled The Covid-19 Pandemic and Women's Reproductive Health, conducted in March 2021 in the UK before widespread media attention regarding potential impacts of SARS-CoV-2 vaccination on menstruation. Participants were recruited via a Facebook ad campaign in the UK and eligibility criteria for survey completion were age greater than 18 years, having ever menstruated and currently living in the UK. In total, 26,710 people gave consent and completed the survey. For this analysis we selected 4,989 participants who were pre-menopausal and vaccinated. These participants were aged 28 to 43, predominantly from England (81%), of white background (95%) and not using hormonal contraception (58%). Findings. Among pre-menopausal vaccinated individuals (n=4,989), 80% did not report any menstrual cycle changes up to 4 months after their first COVID-19 vaccine injection. Current use of combined oral contraceptives was associated with lower odds of reporting any changes by 48% (OR = 0.52, 95CI = [0.34 to 0.78], P<0.001). Odds of reporting any menstrual changes were increased by 44% for current smokers (OR = 1.44, 95CI = [1.07 to 1.94], P<0.01) and by more than 50% for individuals with a positive COVID status [Long Covid (OR = 1.61, 95CI = [1.28 to 2.02], P<0.001), acute COVID (OR = 1.54, 95CI = [1.27 to 1.86], P<0.001)]. The effects remain after adjusting for self-reported magnitude of menstrual cycle changes over the year preceding the survey. Written accounts report diverse symptoms; the most common words include 'cramps', 'late', 'early', 'spotting', 'heavy' and 'irregular', with a low level of clustering among them. Conclusions. Following vaccination for COVID-19, menstrual disturbance occurred in 20% of individuals in a UK sample. Out of 33 variables investigated, smoking and a previous history of SARS-CoV-2 infection were found to be risk factors while using oestradiol-containing contraceptives was found to be a protective factor. Diverse experiences were reported, from menstrual bleeding cessation to heavy menstrual bleeding.

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“…SARS-CoV-2 infection could affect the hypothalamic-pituitary-ovarian-endometrial axis, resulting in menstrual cycle changes. Hypothalamic hypogonadism may occur in severe COVID-19, which can cause temporary amenorrhea and infrequent menstruation [16]. ACE-2 receptors are widely expressed in the ovaries and endometrium [17,18].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities

Cited by 27 publications

References 30 publications

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

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

COVID-19 vaccination and menstrual cycle changes: A United Kingdom (UK) retrospective case-control study

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

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