Menstrual irregularities and vaginal bleeding after COVID-19 vaccination reported to v-safe active surveillance, USA in December, 2020–January, 2022: an observational cohort study

Wong, Karen K.; Heilig, Charles M.; Hause, Anne M.; Myers, Tanya R.; Olson, Christine K.; Gee, Julianne; Marquez, Paige; Strid, Penelope; Shay, David K.

doi:10.1016/s2589-7500(22)00125-x

Cited by 34 publications

(24 citation statements)

References 31 publications

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“…The COVID-19 pandemic caused the prevalence of depression, stress, and anxiety among women in general. Many studies reported shorter or longer menstrual cycles and irregular menstrual volume because of psychological pressure in pandemics (18)(19)(20)(21) and COVID-19 vaccination (22,23)…”

Section: Resultsmentioning

confidence: 99%

The effect of COVID-19 infection on anti mullerian hormone

MADENLİ>

GÜRKAN²,

Tosun

2022

Anatolian Current Medical Journal

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Aim: The possible impact of COVID-19 infection on female reproductive system is a controversial issue. The aim of this study was to investigate the effect of COVID-19 infection on anti mullerian hormone (AMH) as a predictor of ovarian response to ovarian stimulation. Material and Method: This prospective study was conducted at a university-affiliated tertiary medical center between June 2021–February 2022. The study population included 79 reproductive-aged women (22-34 years) with COVID-19 infection. Blood samples were collected for AMH levels before COVID-19 infection and after three months of COVID-19 disease. Results: The mean age of the study group was 28.11±3.49 years. Estradiol and Luteinizing Hormone (LH) was found to be lower after three months of COVID-19 disease (p

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Section: Resultsmentioning

confidence: 99%

The effect of COVID-19 infection on anti mullerian hormone

MADENLİ>

GÜRKAN²,

Tosun

2022

Anatolian Current Medical Journal

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“…The concern for an association between SARS-CoV-2 vaccination and menstrual or bleeding disturbances in women has been triggered by the large number of spontaneous case reports related to such conditions 12310. Also, several studies on self-reported menstruation cycles changes after SARS-CoV-2 vaccination have been published 4567892728. The European Medicines Agency has recommended that heavy menstrual bleeding should be acknowledged as a side effect of both SARS-CoV-2 mRNA vaccines 12.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Several studies on self-reported menstruation cycles after SARS-CoV-2 vaccination, from survey data and a menstrual cycle tracking app, indicate changes in menstruation cycles. [4][5][6][7][8][9] A link between SARS-CoV-2 vaccination and menstrual disturbance has also doi: 10.1136/bmj-2023-074778 | BMJ 2023;381:e074778 | the bmj been widely discussed on social media. 10 However, menstrual cycles vary naturally and minor menstrual disturbances are generally not considered to be of clinical importance.…”

Section: Introductionmentioning

confidence: 99%

Association between SARS-CoV-2 vaccination and healthcare contacts for menstrual disturbance and bleeding in women before and after menopause: nationwide, register based cohort study

Ljung

Sundström

et al. 2023

BMJ

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Objectives To evaluate the risks of any menstrual disturbance and bleeding following SARS-CoV-2 vaccination in women who are premenopausal or postmenopausal. Design A nationwide, register based cohort study. Setting All inpatient and specialised outpatient care in Sweden from 27 December 2020 to 28 February 2022. A subset covering primary care for 40% of the Swedish female population was also included. Participants 2 946 448 Swedish women aged 12-74 years were included. Pregnant women, women living in nursing homes, and women with history of any menstruation or bleeding disorders, breast cancer, cancer of female genital organs, or who underwent a hysterectomy between 1 January 2015 and 26 December 2020 were excluded. Interventions SARS-CoV-2 vaccination, by vaccine product (BNT162b2, mRNA-1273, or ChAdOx1 nCoV-19 (AZD1222)) and dose (unvaccinated and first, second, and third dose) over two time windows (one to seven days, considered the control period, and 8-90 days). Main outcome measures Healthcare contact (admission to hospital or visit) for menstrual disturbance or bleeding before or after menopause (diagnosed with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes N91, N92, N93, N95). Results 2 580 007 (87.6%) of 2 946 448 women received at least one SARS-CoV-2 vaccination and 1 652 472 (64.0%) 2 580 007 of vaccinated women received three doses before the end of follow-up. The highest risks for bleeding in women who were postmenopausal were observed after the third dose, in the one to seven days risk window (hazard ratio 1.28 (95% confidence interval 1.01 to 1.62)) and in the 8-90 days risk window (1.25 (1.04 to 1.50)). The impact of adjustment for covariates was modest. Risk of postmenopausal bleeding suggested a 23-33% increased risk after 8-90 days with BNT162b2 and mRNA-1273 after the third dose, but the association with ChAdOx1 nCoV-19 was less clear. For menstrual disturbance or bleeding in women who were premenopausal, adjustment for covariates almost completely removed the weak associations noted in the crude analyses. Conclusions Weak and inconsistent associations were observed between SARS-CoV-2 vaccination and healthcare contacts for bleeding in women who are postmenopausal, and even less evidence was recorded of an association for menstrual disturbance or bleeding in women who were premenopausal. These findings do not provide substantial support for a causal association between SARS-CoV-2 vaccination and healthcare contacts related to menstrual or bleeding disorders.

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“…It is unclear whether being pregnant may escalate the severity of a concurrent SARS-CoV-2 infection, but some research has shown that a SARS-CoV-2 infection is associated with severe maternal death and morbidity from obstetric complications, such as hypertension, postpartum hemorrhage, or other infection [ 12 ]. There is not yet any research published that has found an association between SARS-CoV-2 infection and vaginal bleeding; however, an observational cohort study in the USA found 63,815 females had irregular menses or vaginal bleeding after receiving the COVID-19 vaccine [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Threatened Miscarriage in a COVID-19 Patient

Momin¹,

Nguyen²,

Stead³

et al. 2022

Cureus

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The authors present the case of a 30-year-old female who was pregnant and contracted COVID-19. She presented with vaginal bleeding and eventually went on to miscarry. Here, we discuss the risk factor of COVID-19 for threatened miscarriage and spontaneous abortion as well as pregnancy being a risk factor for increased COVID-19 disease severity. The patient received casirivimab and imdevimab per emergency department protocol due to this increased risk.

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Menstrual irregularities and vaginal bleeding after COVID-19 vaccination reported to v-safe active surveillance, USA in December, 2020–January, 2022: an observational cohort study

Cited by 34 publications

References 31 publications

The effect of COVID-19 infection on anti mullerian hormone

The effect of COVID-19 infection on anti mullerian hormone

Association between SARS-CoV-2 vaccination and healthcare contacts for menstrual disturbance and bleeding in women before and after menopause: nationwide, register based cohort study

Threatened Miscarriage in a COVID-19 Patient

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