Introduction: The Coronavirus disease 2019 (COVID-19) vaccine has been approved by the United States Food and Drug Administration as safe and effective against the virus. In addition to the vaccine known adverse effects, a lot of women worldwide have experienced abnormal uterine bleeding (AUB) after receiving the COVID-19 vaccine. This study aimed to figure out the relationship between AUB and the COVID-19 vaccine and to compare the effects of different vaccine types on AUB. Methods: An e-questionnaire-based cross-sectional study conducted between December 2021 to February 2022. The targeted population of the study was all COVID-19 vaccinated female in Saudi Arabia. A total of 1912 respondents participated in the survey, only 1533 were eligible for inclusion in the study. The collected data were analyzed using descriptive statistical methods via Statistical Packages for Social Sciences version 26. Result: Out of 1533 participants, 998 (64.4%) reported AUB in relation to the COVID-19 vaccine. The mean age of the participants was 31.2±8.4 years, and more than half of them (59.4%) were married. Majority had received the Pfizer-BioNTech vaccine in their three shots (77.1%), (78%), and (92.1%), respectively. The incidence of AUB was (82.7%) mainly in form of menorrhagia (38.3%) in the first shot and (88.8%) after the second dose also in the form of menorrhagia (39.1%). Only 3.8% of women had the third dose, the incidence of AUB was 65.8%, mainly in the form of oligomenorrhea (21.1%). Regarding different types of the vaccine in three doses, the Chi-square test (p=0.239), (p=0.200) and Fischer exact test (p=0.265) were statistically significant showing no difference in AUB with different COVID-19 vaccines. Conclusion: The majority of participants had AUB as a result of receiving the COVID-19 vaccine. Furthermore, there was no difference in the incidence of AUB between the Pfizer-BioNTech vaccination and the AstraZeneca Oxford vaccine for the two vaccine types investigated in the study.
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