Investigating trends in those who experience menstrual bleeding changes after SARS-CoV-2 vaccination

Lee, Katharine M. N.; Junkins, Eleanor J; Fatima, Urooba A; Cox, Maria L; Clancy, Kathryn B. H.

doi:10.1101/2021.10.11.21264863

Cited by 21 publications

(21 citation statements)

References 84 publications

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“…The findings also suggest that exogenous oestrogen may reduce post-vaccination menstrual disturbances through anti-inflammatory or anti-viral effects. This is consistent with the recent suggestion that an “inflammatory” rather than an “ovulatory” route might explain menstrual disturbances following COVID-19 vaccination given the high prevalence of breakthrough bleeding among users of long-acting reversible contraceptives (LARC) [8]. A protective effect of oestrogen [33] and oestradiol [34] has been suggested in relation to the severity of COVID-19, and randomized control trials on unbiased samples would be needed to establish causality between oestrogen and the reduced risk of menstrual disturbances following COVID-19 vaccination.…”

Section: Discussionsupporting

confidence: 91%

“…While the survey is also sensitive to recall bias, it is limited as compared to more recent surveys [8] as the issue of menstrual disturbances was not reported by the British Broadcasting Corporation until May 13, 2021 [31], as compared to a flurry of attention in US media throughout April [1–3]. Reassuringly, reporting bias would be expected to affect all sections of the sample similarly, and thus it would not explain specific associations such as with contraceptive type.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…Recent data from a gender-diverse sample receiving COVID-19 vaccination in the US suggests that changes in the form of heavy and breakthrough bleeding affect many people. However, there has been no quantitative assessment of the risk factors for menstrual disturbances following COVID-19 vaccination prior to widespread media attention ([8], Box 1).…”

Section: Introductionmentioning

confidence: 99%

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

Alvergne

Kountourides²,

Argentieri

et al. 2021

Preprint

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Alvergne

Kountourides²,

Argentieri

et al. 2021

Preprint

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The effect of SARS-CoV-2 BNT162b2 vaccine on the symptoms of women with endometriosis

Gilan

Laster-Haim

Rottenstreich

et al. 2022

Arch Gynecol Obstet

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Purpose As the use of the messenger RNA (mRNA) BNT162b2 (Pfizer-BioNTech) Coronavirus disease 2019 vaccine has grown, reports on menstrual changes have arisen. We aimed to examine menstrual bleeding patterns and endometriosis-associated symptoms after receiving the mRNA BNT162b2 SARS-CoV-2 vaccine in women with endometriosis, as compared to the control group. Methods This is a questionnaire-based cross-sectional study including a total of 174 women. The study group included 86 women with a confirmed diagnosis of endometriosis and the control group included 88 women with no diagnosis or suspected diagnosis of endometriosis. Each woman completed a questionnaire on menstrual bleeding patterns and endometriosis-associated symptoms before and after receiving two doses of the BNT162b2 vaccine. Primary outcomes were changes in amount or length of menstrual bleeding, rates of intermenstrual bleeding and worsening in dysmenorrhea in the endometriosis patient group, as compared to the control group. Secondary outcomes included changes in all endometriosis-associated symptoms. Results In our cohort, women with endometriosis were more likely to experience changes in bleeding patterns (women with endometriosis: 39.5%, control group: 31.0%, p = 0.02), and a significant worsening in endometriosis-associated symptoms with an almost 4.3-fold worsening in dysmenorrhea [95% CI 1.9–9.9, p < 0.01] and 5.5-fold odds for any worsening in symptoms in endometriosis patients, as compared to the control group [95% CI 2.7–11.1, p < 0.01]. Conclusion In our cohort, endometriosis was shown to be a significant risk factor for worsening of menstrual symptoms, after receiving the SARS-CoV-2 BNT162b2 mRNA vaccine. Further research is needed to confirm these findings.

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The effects of the Covid-19 vaccine on menstrual disorders in women of reproductive age

Yoosefian,

Esmaeili,

Pakdin-Parizi

et al. 2023

J Public Health (Berl.)

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Investigating trends in those who experience menstrual bleeding changes after SARS-CoV-2 vaccination

Cited by 21 publications

References 84 publications

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

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

The effect of SARS-CoV-2 BNT162b2 vaccine on the symptoms of women with endometriosis

The effects of the Covid-19 vaccine on menstrual disorders in women of reproductive age

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