ABSTRACT
Background: The menstrual cycle in women is the main indicator of their reproductive health which is affected by the ongoing coronavirus disease 2019 (COVID-19) pandemic. This review aims to summarize the effects of the COVID-19 infection and the global pandemic on the menstrual health of women. Methods: The literature search was conducted in PubMed, Cochrane library, and Google Scholar using keywords "COVID-19," "Menstrual Cycle," "Menstrual Cycle Irregularities," "Amenorrhea," "Polymenorrhea," and "Dysmenorrhea." The articles were selected according to the following inclusion criteria: (i) cross-sectional studies, (ii) cohort studies, (iii) surveys, and (iv) other observational studies observing the effects of SARS-CoV-2 infection or COVID-19 pandemic on menstrual health of women. Exclusion criteria included: case reports, gray literature, and website articles regarding menstrual health. Results: A total of 30,510 articles were shortlisted after a comprehensive search. Sixteen articles were included out of which 13 studies investigated the effects of the COVID-19 pandemic on the menstrual cycle while 3 evaluated the possible effects of COVID-19 infection on the menstrual health of women. Menstrual disorders or irregularities were a more common finding during the pandemic as compared to before (p = 0.008). Women affected by pandemic-related stress were more prone to changes in the duration of their menses (p = 0.0008), reported heavier bleeding (p = 0.028), and increased incidence of painful periods (p < 0.0001). COVID-19 infected women also reported changes in their menstrual cycle including irregular menstruation, increased symptoms of premenstrual syndrome, and infrequent menstruation. Conclusions: Women suffering from COVID-19 infection or pandemic-associated stress and anxiety were more likely to experience irregular menstruation, dysmenorrhea, amenorrhea, and other menstrual abnormalities compared to those who were less exposed.
ABSTRACT
Post-COVID-19 vaccination changes to the menstrual cycle have been reported, particularly through social media, but little evidence exists.1,2 Fewer than 200 individuals have self-reported menstrual disturbances through the Vaccine Adverse Event Reporting System. The authors of this retrospective analysis used prospectively collected menstrual cycle data from the FDA-cleared digital fertility awareness application “Natural Cycles” to assess associations between changes in the menstrual cycle or menses length and the COVID-19 vaccine. When stressors occur during the first half of the menstrual cycle (the follicular phase, when a dominant follicle is recruited and matures), cycle length can change.3 The immune response generated by mRNA vaccines could function as a stressor and temporarily affect the H-P-O axis, depending on the timing of vaccination. Because of the 21-day dosing schedule for the Pfizer mRNA vaccine and 28-day dosing schedule for the Moderna mRNA vaccine, receiving two doses in a single cycle necessitates that the first dose occurs during the early follicular phase for a normal cycling individual.