Impact of COVID-19 and Its Vaccine on Menstrual Cycle Among Medical Staff in Sulaimani Maternity Teaching Hospital
Abstract
Despite extensive research on the effects of the COVID-19 pandemic and its vaccine, detailed reports specifically addressing their impact on the menstrual cycle and the female reproductive system have been lacking. The present study aimed to assess the impact of the COVID-19 virus and its vaccines on the menstrual cycle pattern among Sulaimani Maternity Teaching Hospital medical staff. This cross-sectional study was conducted among female healthcare workers at Sulaimani Maternity Teaching Hospital who contracted COVID-19 or received the COVID-19 vaccine. Demographic data were collected through direct interviews, while clinical information was obtained through medical history reviews, clinical examinations, and relevant investigations. A total of 143 participants were recruited out of an initial 195 candidates, all meeting the study’s inclusion criteria. Data analyses were performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 21. The participants’ ages ranged from 20 to 35 years, with over half (60.8%) being married. Among the study participants, 93% had contracted COVID-19, and 72% had received the COVID-19 vaccine. Among the women who had contracted COVID-19, 30.1% reported experiencing menstrual irregularities, with the most common being oligomenorrhea (54.83%). Following vaccination, 8.4% of participants experienced menstrual changes, primarily intermenstrual spotting (58.33%) and oligomenorrhea (25%). However, no significant associations were found between the severity of COVID-19 infection, vaccination status, and menstrual irregularities, with P of 0.773 and 0.676, respectively. Furthermore, thyroid dysfunction was observed in 70% of the women who experienced prolonged menstrual irregularities, suggesting a potential endocrine-related factor contributing to these changes. COVID-19 infection and vaccination were associated with transient menstrual irregularities in some women. These changes were generally short-lived and not significantly linked to the severity of infection or vaccine type.
2. Zhou B, Yuan Y, Wang S, Zhang Z, Yang M, Deng X, et al. Risk profiles of severe illness in children with COVID-19: a meta-analysis of individual patients. Pediatric Research 2021;90:347-52.
3. Abufares HI, Oyoun Alsoud L, Alqudah MAY, Shara M, Soares NC, Alzoubi KH, et al. COVID-19 Vaccines, Effectiveness, and Immune Responses. Int J Mol Sci 2022;23.
4. Callaway E. The race for coronavirus vaccines: a graphical guide. Nature 2020;580:576-7.
5. Handy AB, Greenfield SF, Yonkers KA, Payne LA. Psychiatric Symptoms Across the Menstrual Cycle in Adult Women: A Comprehensive Review. Harv Rev Psychiatry 2022;30:100-17.
6. Itriyeva K. The normal menstrual cycle. Curr Probl Pediatr Adolesc Health Care 2022;52:101183.
7. Dubol M, Epperson CN, Sacher J, Pletzer B, Derntl B, Lanzenberger R, et al. Neuroimaging the menstrual cycle: A multimodal systematic review. Front Neuroendocrinol 2021;60:100878.
8. Greco C, Cacciani M, Corleto R, Simoni M, Spaggiari G, Santi D. Alterations in the Menstrual Cycle as a Peculiar Sign of Type 1 Diabetes Mellitus: A Meta-analytic Approach. Can J Diabetes 2024;48:133-40.e2.
9. Saei Ghare Naz M, Farahmand M, Dashti S, Ramezani Tehrani F. Factors Affecting Menstrual Cycle Developmental Trajectory in Adolescents: A Narrative Review. Int J Endocrinol Metab2022;20:e120438.
10. Lebar V, Laganà AS, Chiantera V, Kunič T, Lukanović D. The Effect of COVID-19 on the Menstrual Cycle: A Systematic Review. J Clin Med 2022;11.
11. Sharp GC, Fraser A, Sawyer G, Kountourides G, Easey KE, Ford G, et al. The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities. Int J Epidemiol 2022;51:691-700.
12. Jing Y, Run-Qian L, Hao-Ran W, Hao-Ran C, Ya-Bin L, Yang G, et al. Potential influence of COVID-19/ACE2 on the female reproductive system. Mol Hum Reprod 2020;26:367-73.
13. Takmaz T, Gundogmus I, Okten SB, Gunduz A. The impact of COVID-19-related mental health issues on menstrual cycle characteristics of female healthcare providers. J Obstet Gynaecol Res 2021;47:3241-9.
14. Li K, Chen G, Hou H, Liao Q, Chen J, Bai H, et al. Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age. Reprod Biomed Online 2021;42:260-7.
15. Ozimek N, Velez K, Anvari H, Butler L, Goldman KN, Woitowich NC. Impact of Stress on Menstrual Cyclicity During the Coronavirus Disease 2019 Pandemic: A Survey Study. J Womens Health 2022;31:84-90.
16. Amer AA, Amer SA, Alrufaidi KM, Abd-Elatif EE, Alafandi BZ, Yousif DA, et al. Menstrual changes after COVID-19 vaccination and/or SARS-CoV-2 infection and their demographic, mood, and lifestyle determinants in Arab women of childbearing age, 2021. Front Reprod Health 2022 ;4:927211.
17. Lee KMN, Junkins EJ, Luo C, Fatima UA, Cox ML, Clancy KBH. Investigating trends in those who experience menstrual bleeding changes after SARS-CoV-2 vaccination. Sci Adv 2022;8:eabm7201.
18. Prado RCR, Silveira R, Asano RY. SARS-CoV-2 (COVID-19) pandemic and a possible impact in the future of menstrual cycle research. Health Sci Rep 2021;4:e276.
19. Lin DY, Gu Y, Wheeler B, Young H, Holloway S, Sunny SK, et al. Effectiveness of COVID-19 Vaccines over a 9-Month Period in North Carolina. N Engl J Med 2022;386:933-41.
20. Minakshi R, Rahman S, Ayaggari A, Dutta D, Shankar A. Understanding the Trauma of Menstrual Irregularity After COVID Vaccination: A Bird's-Eye View of Female Immunology. Front Immunol 2022;13:906091.
21. Baena-García L, Aparicio VA, Molina-López A, Aranda P, Cámara-Roca L, Ocón-Hernández O. Premenstrual and menstrual changes reported after COVID-19 vaccination: The EVA project. Womens Health (Lond) 2022;18:17455057221112237.
22. Edelman A, Boniface ER, Benhar E, Han L, Matteson KA, Favaro C, et al. Association Between Menstrual Cycle Length and Coronavirus Disease 2019 (COVID-19) Vaccination: A U.S. Cohort. Obstet Gynecol 2022;139:481-9.
23. Doğan E, Uncu B, Duman R. Comparison of menstrual cycle irregularities among young women based on coronavirus disease 2019 infection status: a cross-sectional study. Rev Assoc Med Bras (1992) 2024;70:e20230801.
24. Rodríguez Quejada L, Toro Wills MF, Martínez-Ávila MC, Patiño-Aldana AF. Menstrual cycle disturbances after COVID-19 vaccination. Womens Health (Lond) 2022;18:17455057221109375.
25. Muhaidat N, Alshrouf MA, Azzam MI, Karam AM, Al-Nazer MW, Al-Ani A. Menstrual Symptoms After COVID-19 Vaccine: A Cross-Sectional Investigation in the MENA Region. Int J Womens Health 2022;14:395-404.
26. Wang S, Mortazavi J, Hart JE, Hankins JA, Katuska LM, Farland LV, et al. A prospective study of the association between SARS-CoV-2 infection and COVID-19 vaccination with changes in usual menstrual cycle characteristics. AJOG 2022;227:739.1-11.
27. Warner P, Whitaker LHR, Parker RA, Weir CJ, Douglas A, Hansen CH, et al. Low dose dexamethasone as treatment for women with heavy menstrual bleeding: A response-adaptive randomised placebo-controlled dose-finding parallel group trial (DexFEM). EBioMedicine 2021;69:103434.
28. Ding T, Wang T, Zhang J, Cui P, Chen Z, Zhou S, et al. Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study. Front Med (Lausanne) 2021;8:635255.
29. Alvergne A, Woon EV, Male V. Effect of COVID-19 vaccination on the timing and flow of menstrual periods in two cohorts. Front Reprod Health 2022:4:952976.
30. Alvergne A, Kountourides G, Argentieri MA, Agyen L, Rogers N, Knight D, et al. A retrospective case-control study on menstrual cycle changes following COVID-19 vaccination and disease. iScience 2023;26:106401.
| Files | ||
| Issue | Vol 63 No 2 (2025) | |
| Section | Original Articles | |
| Keywords | ||
| COVID-19 infection Menstrual cycle COVID-19 vaccination Amenorrhea | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
