Evaluation of changes in the menstrual cycle of Turkish women following vaccination with COVID-19 vaccines: a retrospective study

Abstract

Objective: To evaluate the effect of COVID-19 vaccines on menstrual cycle characteristics in Turkish women of reproductive age. Method: This retrospective study included 219 Turkish women who received minimum two doses of COVID-19 vaccine between June/2021-August/2022. Demographic characteristics, vaccination status, and menstrual cycle parameters of the women with regular menstrual cycles were collected through a survey between August/2022-November/2022. Women’s menstrual cycle characteristics were evaluated by comparing data before and after vaccination. Study population was divided into 3 groups according to COVID-19 vaccine type: Group BB (Biontech + Biontech), Group CB (CoronaVac + Biontech), and Group CC (CoronaVac + CoronaVac). Results: The median age of 219 women included in the study was 32. There were 102, 57, and 60 women in Groups BB, CB, and CC, respectively. There were no significant changes in the menstrual cycle and the menstrual bleeding duration post-vaccination. Following two rounds of vaccination, 22 (10.0%) and 5 (2.3%) women reported light and heavy menstrual bleedings, respectively. New intermenstrual bleeding and dysmenorrhea developed during post-vaccination period in 8 and 23 women, respectively. Conclusion: The study’s findings indicated that COVID-19 vaccines may cause changes in menstrual cycle characteristics, e.g., amount of bleeding, intermenstrual bleeding, and dysmenorrhea, suggesting the need for close monitoring of women’s menstrual health during vaccination campaigns. Large-scale studies are needed to better understand the potential potential effects of COVID-19 vaccines on women’s health.

Keywords

• COVID-19
• vaccination
• menstrual cycle
• irregular menstruation

References

1. Fernandes Q, Inchakalody VP, Merhi M, Mestiri S, Taib N, Moustafa Abo El-Ella D, et al. Emerging COVID-19 variants and their impact on SARS-CoV-2 diagnosis, therapeutics and vaccines. Ann Med. 2022;54(1):524-40. https://doi.org/10.1080/07853890.2022.2031274
2. Grana C, Ghosn L, Evrenoglou T, Jarde A, Minozzi S, Bergman H, et al. Efficacy and safety of COVID-19 vaccines. Cochrane Database Syst Rev. 2022;12(12):CD015477. https://doi.org/10.1002/14651858.CD015477
3. Rashedi R, Samieefar N, Masoumi N, Mohseni S, Rezaei N. COVID-19 vaccines mix- and-match: The concept, the efficacy and the doubts. J Med Virol. 2022;94(4):1294-9. https://doi.org/10.1002/jmv.27463
4. ElBagoury M, Tolba MM, Nasser HA, Jabbar A, Elagouz AM, Aktham Y, et al. The find of COVID-19 vaccine: Challenges and opportunities. J Infect Public Health. 2021;14(3):389-416. https://doi.org/10.1016/j.jiph.2020.12.025
5. Ndwandwe D, Wiysonge CS. COVID-19 vaccines. Curr Opin Immunol. 2021;71:111-269. https://doi.org/10.1016/j.coi.2021.07.003
6. Rodríguez Quejada L, Toro Wills MF, Martínez-Ávila MC, Patiño-Aldana AF. Menstrual cycle disturbances after COVID-19 vaccination. Womens Health. 2022;18:17455057221109375. https://doi.org/10.1177/17455057221109375
7. Edelman A, Boniface ER, Benhar E, Han L, Matteson KA, Favaro C, et al. Association Between Menstrual Cycle Length and Coronavirus Disease 2019 (COVID-19) Vaccination: A U.S. Cohort. Obstet Gynecol. 2022;139(4):481-9.. https://doi.org/10.1097/AOG.0000000000004695
8. Wang S, Mortazavi J, Hart JE, Hankins JA, Katuska LM, Farland LV, et al. A prospective study of the association between SARS-CoV-2 infection and COVID-19 vaccination with changes in usual menstrual cycle characteristics. Am J Obstet Gynecol. 2022;227(5):739. e1-. e11. https://doi.org/10.1016/j.ajog.2022.07.003

9. Darney BG, Boniface ER, Van Lamsweerde A, Han L, Matteson KA, Cameron S, et al. Impact of coronavirus disease 2019 (COVID-19) vaccination on menstrual bleeding quantity: An observational cohort study. BJOG. 2023;130(7):803-12. https://doi.org/10.1111/1471-0528.17471
10. Farland LV, Khan SM, Shilen A, Heslin KM, Ishimwe P, Allen AM, et al. COVID-19 vaccination and changes in the menstrual cycle among vaccinated persons. Fertil Steril. 2023;119(3):392-400. https://doi.org/10.1016/j.fertnstert.2022.12.023
11. Barabas K, Makkai B, Farkas N, Horvath HR, Nagy Z, Varadi K, et al. Influence of COVID-19 pandemic and vaccination on the menstrual cycle: A retrospective study in Hungary. Front Endocrinol (Lausanne). 2022;13:974788. https://doi.org/10.3389/fendo.2022.974788
12. Hariton E, Morris JR, Ho K, Chen C, Cui E, Cedars MI. The effect of the coronavirus disease 2019 vaccine and infection on menstrual cycle length: an analysis of 12 months of continuous menstrual cycle data from 5,314 participants. Fertil Steril. 2023;120(2):387-8. https://doi.org/10.1016/j.fertnstert.2023.05.158
13. Li K, Chen G, Hou H, Liao Q, Chen J, Bai H, et al. Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age. Reprod Biomed Online. 2021;42(1):260-7. https://doi.org/10.1016/j.rbmo.2020.09.020
14. Sharp GC, Fraser A, Sawyer G, Kountourides G, Easey KE, Ford G, et al. The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities. Int J Epidemiol. 2022;51(3):691-700. https://doi.org/10.1093/ije/dyab239
15. Brumfiel G. Why reports of menstrual changes after COVID vaccine are tough to study. Npr August. 2021. 16. Kajiwara S, Akiyama N, Baba H, Ohta M. Association between COVID-19 vaccines and the menstrual cycle in young Japanese women. J Infect Chemother. 2023;29(5):513-8. https://doi.org/10.1016/j.jiac.2023.01.003
16. Kajiwara S, Akiyama N, Baba H, Ohta M. Association between COVID-19 vaccines 304 and the menstrual cycle in young Japanese women. J Infect Chemother. 305 2023;29(5):513-8. https://doi.org/10.1016/j.jiac.2023.01.003
17. Pormohammad A, Zarei M, Ghorbani S, Mohammadi M, Razizadeh MH, Turner DL, et al. Efficacy and Safety of COVID-19 Vaccines: A Systematic Review and Meta- Analysis of Randomized Clinical Trials. Vaccines (Basel). 2021;9(5). https://doi.org/10.3390/vaccines9050467
18. Hasdemir PS, Senol Akar S, Goker A, Kosova F, Ucar D, Ozalp Ates FS, et al. The effect of COVID-19 vaccinations on menstrual cycle and serum anti-Mullerian hormone levels in reproductive age women. Hum Fertil (Camb). 2023;26(1):153-61. https://doi.org/10.1080/14647273.2023.2181710
19. Yılmaz NT. OPTIMAL SIZE OF TURKIYE’S GROWING CITY: TEKİRDAĞ. Journal of Research in Economics. 2023;7(2):162-70. https://doi.org/10.29228/JORE.30
20. Munro MG, Critchley HOD, Fraser IS, Committee FMD. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393-408. https://doi.org/10.1002/ijgo.12666
21. Tandon A, Kumar N, Aggarwal S, Anjana Y, Sachdeva MP, Gupta V, et al. Assessing Menstrual Changes Among Young Indian Females Post-SARS-CoV-2 Vaccination. Cureus. 2023;15(12):e50025. https://doi.org/10.7759/cureus.50025