COVID-19-Associated Mental Health Impact on Menstrual Function Aspects: Dysmenorrhea and Premenstrual Syndrome, and Genitourinary Tract Health: A Cross Sectional Study among Jordanian Medical Students

Abstract

The physiology of reproduction is affected by psychological distress through neuroendocrine pathways. Historically, COVID-19 is one of the most stressful events with devastating consequences. This research aims to investigate the relationship between dysmenorrhea, PMS, and reproductive tract health on one hand, and COVID-19-related anxiety, depression, and stress on the other among medical students in Jordan. Medical students were invited through teaching platforms and social media to complete an online survey. SPSS software was used to analyze data. A total of 385 medical students participated in this research. Hence, 49.9% of the study population reported severe dysmenorrhea during COVID-19 compared to 36.9% before COVID-19 (p = 0.000). Dysmenorrhea was significantly associated with disruptions of sport and daily activities during COVID-19 (p = 0.015 and p = 0.002, respectively). The prevalence of PMS components, e.g., mastalgia, fatigue, headache, palpitation, and emotional and sleep disturbances, was raised during COVID-19 compared with before (p < 0.05). Symptoms of genitourinary tract infections, such as lower abdominal pain, vaginal discharge, genitalia rash/ulcers and itching, and urgency, were significantly increased after COVID-19 (p < 0.05). Positive Pearson correlations between COVID-19-associated mental health disorders and dysmenorrhea severity, PMS, and genital tract health abnormalities were observed (p < 0.05). The multiple linear regression model revealed that dysmenorrhea severity, PMS symptoms like palpitation, and genitourinary symptoms like lower abdominal pain and urgency were associated with worsening of depression, while dysuria was associated with a protective effect against depression. Moreover, it was observed that dysmenorrhea severity, PMS symptoms, such as headache and palpitation, and urinary urgency were associated with aggravation of anxiety. However, food craving and dysuria were protective against anxiety. Finally, dysmenorrhea severity, PMS symptoms of headache and palpitation, lower abdominal pain, and urgency were related to worsening of stress, whereas the premenstrual symptom of breast pain was a protective factor against stress. This work showed that COVID-19 pandemic-related psychological distress and menstrual, premenstrual, and genitourinary symptoms are closely related. Further future work is required to evaluate the long lasting-effects of the pandemic on mental health and the physiology of reproduction.

The effect of COVID-19 vaccination on the menstrual pattern and mental health of the medical students: A mixed-methods study from a low and middle-income country

“…In our study, the majority of the participants (66.4%) had no history of prior COVID-19 infection, which is similar to the study of Aolymet et al who reported that 65.2% of their sample population also had no such history [20].…”

Effects of SARS‐CoV‐2 infection and COVID‐19 pandemic on menstrual health of women: A systematic review

“…COVID‐19‐associated anxiety was linked to an increase in the severity of dysmenorrhea in women ( p = 0.025) whereas depression caused by COVID‐19 was also linked with worsening dysmenorrhea ( p = 0.008). The incidence and severity of dysmenorrhea increased during the pandemic as 49.9% of the women involved in the study experienced it as compared to 36.9% before the pandemic 21 . This is supported by evidence from another study which shows that out of 125 participants, 22.4% experienced increased menstrual pain during the pandemic as compared to before, and 25.6% of women reported worsening menstrual cycles 22 .…”

COVID-19 Pandemi Döneminin Adet Döngüsü ve Premenstrüel Sendrom Üzerindeki Etkisine Genel Bir Bakış

“…Despite this, 46% of women experienced a change in their menstrual cycle since the pandemic began, compared to 25% before the pandemic (25). In a further experiment conducted in Jorden, 49.9% of 385 female medical students reported severe PMS during COVID-19 compared to before, which was 36.9% (26).…”