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. 2023 Mar;119(3):392-400.
doi: 10.1016/j.fertnstert.2022.12.023. Epub 2022 Dec 17.

COVID-19 vaccination and changes in the menstrual cycle among vaccinated persons

Leslie V Farland  1 , Sana M Khan  2 , Alexandra Shilen  2 , Kelly M Heslin  2 , Providence Ishimwe  2 , Alicia M Allen  3 , Melissa M Herbst-Kralovetz  4 , Nichole D Mahnert  5 , Kristen Pogreba-Brown  2 , Kacey C Ernst  2 , Elizabeth T Jacobs  6
Affiliations

COVID-19 vaccination and changes in the menstrual cycle among vaccinated persons

Leslie V Farland et al. Fertil Steril. 2023 Mar.

Abstract
in English, Spanish

Objective: To describe the characteristics of people who experience changes to their menstrual cycle after COVID-19 vaccination.

Design: Longitudinal study.

Patient(s): We recruited a volunteer sample with and without a history of SARS-CoV-2 infection who enrolled in the Arizona COVID-19 Cohort (CoVHORT) study and participated in a reproductive sub-cohort who were pre-menopausal, not pregnant, and had received a COVID-19 vaccine in 2021 (n = 545).

Exposure(s): Demographic and reproductive characteristics were collected via self-reports.

Main outcome measure(s): Information on self-reported changes in the menstrual cycle after COVID-19 vaccination was collected from May 2021 to December 2021. We looked at demographic and reproductive characteristics as predictors of menstrual cycle change.

Result(s): The majority of our vaccinated sample received the Pfizer-BioNTech vaccine (58%), and were 26-35 years old (51%), non-Hispanic (84%), and White (88%). Approximately 25% of vaccinated participants reported a change in their menstrual cycle after vaccination; the majority reported changes after their second dose (56%) as compared with their first (18%) and third (14%) doses. The most commonly reported changes were irregular menstruation (43%), increased premenstrual symptoms (34%), increased menstrual pain or cramps (30%), and abnormally heavy or prolonged bleeding (31%). High self-reported perceived stress levels compared with low perceived stress (OR, 2.22; 95% CI 1.12-4.37) and greater body mass index (OR, 1.04; 95% CI 1.00-1.07) were associated with greater odds of experiencing the menstrual cycle changes after the vaccination. Participants having a history of SARS-CoV-2 infection were less likely to report changes in their menstrual cycle after vaccination compared with the participants with no history of SARS-CoV-2 infection (OR, 0.58; 95% CI 0.32-1.04).

Conclusion(s): Among vaccinated participants, approximately 25% of them reported predominantly temporary changes in the menstrual cycle, however, we are unable to determine whether these changes are due to normal cycle variability. The COVID-19 vaccines are safe and effective for everyone, including pregnant people and people trying to conceive; hence, these findings should not discourage vaccination.

Vacunación COVID-19 y cambios en el ciclo menstrual entre personas vacunadas.

Objetivo: Describir las características de la gente que experimenta cambios en su ciclo menstrual después de la vacunación COVID-19.

Diseño: Estudio longitudinal.

Paciente (s): Reclutamos una muestra voluntaria con y sin historia de infección de SARS-CoV-2 que se inscribió en el estudio de Cohorte COVID-19 de Arizona y participó en un sub-cohorte reproductivo que eran pre-menopáusicas, no embarazadas y habían recibido una vacuna COVID-19 en 2021 (n=545).

Intervención (es): Características demográficas y reproductivas fueron recolectadas via autoevaluación.

Principal (es) Medida (s) de Resultado (s): Información en la autoevaluación de cambios en el ciclo menstrual después de vacunación COVID-19 fue recolectada desde Mayo 2021 a Diciembre 2021. Buscamos características demográficas y reproductivas como predictores de cambios en el ciclo menstrual.

Resultado (s): La mayoría de nuestra muestra vacunada recibió la vacuna Pfizer-BioNTech (58%), y tenían 26-35 años (51%), no hispanas (84%), y blancas (88%). Aproximadamente 25% de las participantes vacunadas informaron un cambio en su ciclo menstrual después de la vacunación; la mayoría informó cambios después de la segunda dosis (56%) en comparación con la primera (18%) y la tercera (14%) dosis. Los cambios más comunes informados fueron menstruaciones irregulares (43%), aumento de síntomas premenstruales (34%), aumento de dolor menstrual o calambres (30%), y sangrado anormal abundante y prolongado (31%). Altos niveles de estrés se percibieron en las autoevaluaciones comparados con bajos niveles de estrés percibidos (OR, 2.22; 95% CI 1.12-4.37) y un mayor índice de masa corporal (OR, 1.04; 95% CI 1.00-1.07) fue asociado a mayor probabilidad de experimentar cambios en el ciclo menstrual después de la vacunación. Las participantes que tenían una historia de infección SARS-CoV-2 fueron menos propensas a informar cambios en su ciclo menstrual después de la vacunación comparadas con las participantes sin historia de infección SARS-CoV-2 (OR, 0.58; 95% CI 0.32-1.04).

Conclusión (es): Entre las participantes vacunadas, aproximadamente el 25% informó predominantemente cambios temporales en el ciclo menstrual, sin embargo, somos incapaces de determinar si estos cambios se deben a la variabilidad normal del ciclo. Las vacunas COVID-19 son seguras y efectivas para todos, incluyendo gente embarazada y gente tratando de concebir; por tanto, estos hallazgos no deben desalentar la vacunación.

Keywords: COVID-19 vaccination; SARS-CoV-2; menstrual cycle; menstrual regularity.

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Figures

Figure 1
Figure 1
Flow diagram of study participants.
See this image and copyright information in PMC

References

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