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Review
. 2025 Jun 16;8(6):e70882.
doi: 10.1002/hsr2.70882. eCollection 2025 Jun.

Impact of COVID-19 Vaccination on Menstrual Irregularities, Bleeding Patterns, and Cycle Duration: A Systematic Review and Meta-Analysis

Ganesh Bushi  1   2 , Abhay M Gaidhane  3 , Nasir Vadia  4 , Soumya V Menon  5 , Kattela Chennakesavulu  6 , Rajashree Panigrahi  7 , Muhammed Shabil  8 , Diptismita Jena  9   10 , Harish Kumar  11 , Anju Rani  12   13 , Sanjit Sah  14   15   16 , Shivam Rohilla  17 , Mahendra Pratap Singh  18 , Khang Wen Goh  19   20
Affiliations
Review

Impact of COVID-19 Vaccination on Menstrual Irregularities, Bleeding Patterns, and Cycle Duration: A Systematic Review and Meta-Analysis

Ganesh Bushi et al. Health Sci Rep. .

Abstract

Background: COVID-19 vaccination has raised concerns regarding its potential effects on women's reproductive health, particularly menstrual irregularities. This systematic review and meta-analysis aimed to assess the impact of COVID-19 vaccination on menstrual disturbances, bleeding patterns, and cycle duration among women of reproductive age.

Methods: A systematic search of PubMed, Embase, and Web of Science was conducted up to April 11, 2025. The study protocol was registered with the PROSPERO (CRD42024500832). Studies reporting menstrual changes postvaccination in women aged 13-50 were included. Data extraction and quality assessment were performed independently by two reviewers. Meta-analyses using random-effects models were conducted in R (version 4.3), with heterogeneity assessed using the I² statistic.

Results: Out of 586 records, 43 studies comprising 747,763 women met the inclusion criteria. The pooled RR for menstrual disturbances in vaccinated versus unvaccinated women was 1.03 (95% CI: 0.67-1.57; p = 0.88), indicating no significant association. Excluding one outlier increased the RR to 1.14 (95% CI: 0.97-1.34; p = 0.08). The overall pooled prevalence of menstrual disturbances postvaccination was 34% (95% CI: 26%-43%). Among vaccinated women, lighter bleeding was reported in 12.6%, heavier bleeding in 15.1%, irregular menstruation in 19.0%, and regular cycles in 56.6%. Shortened cycles occurred in 8.5%, longer cycles in 9.3%, amenorrhea (≥ 24 days) in 9.2%, and infrequent cycles (> 38 days) in 11.0%. All analyses showed high heterogeneity (I² = 98%-100%). Sensitivity analyses confirmed the robustness of findings, though Egger's test indicated potential publication bias (p = 0.0384).

Conclusion: COVID-19 vaccination was not significantly associated with an increased risk of menstrual disturbances. Although minor changes such as altered bleeding patterns and cycle length were observed in some women, the overall impact on menstrual health was minimal.

Keywords: COVID‐19 vaccines; adverse effects; menstrual cycle; menstruation disturbances; reproductive health; vaccination; women's health.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram represents the screening and selection process.
Figure 2
Figure 2
Forest plot depicting the association between menstrual disturbances and COVID‐19 vaccination.
Figure 3
Figure 3
Forest plot illustrating the pooled prevalence of irregular menstruation post‐COVID‐19 vaccination.
Figure 4
Figure 4
Forest plot depicting the irregular lighter bleeding during menstruation post‐COVID‐19 vaccinations.
Figure 5
Figure 5
Forest plot showing irregular, heavier bleeding during menstruation post‐ COVID‐19 vaccinations.
Figure 6
Figure 6
Forest plot representing the prevalence of regular menstrual cycles following COVID‐19 vaccinations.
Figure 7
Figure 7
Forest plot representing the prevalence of irregular menstrual cycles following COVID‐19 vaccinations.
Figure 8
Figure 8
Forest plot showing the prevalence of shorter menstrual cycles following COVID‐19 vaccination.
Figure 9
Figure 9
Forest plot represents the prevalence of longer menstrual cycles following COVID‐19 vaccination.
Figure 10
Figure 10
Forest plot represents the prevalence of amenorrhea of < 24 days and menstrual cycles > 38 days following COVID‐19 vaccination.
Figure 11
Figure 11
Forest plot represents the prevalence of infrequent menstrual cycles > 38 days following COVID‐19 vaccination.
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