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Large-scale COVID-19 studies and clinical trials should collect data on menstrual changes, according to new research which evaluated current evidence. The findings, to be published in the International Journal of Epidemiology and led by University of Bristol researchers, say there is an important public health imperative for accurate scientific investigation of menstrual changes in relation to the COVID-19 pandemic.
Researchers from the universities of Bristol, Edinburgh and Oxford sought to evaluate the existing anecdotal and scientific literature on menstrual cycle feature changes in the COVID-19 pandemic and provide suggestions for future research. They conducted a comprehensive review of current literature and found just 12 studies that had reported on menstrual changes in relation to the pandemic in general and/or COVID-19 specifically. None of the COVID-19 vaccine trials has collected data on menstrual changes.
Anecdotes shared online and data from the MHRA’s Yellow Card scheme for adverse drug reactions, suggested that many women and people who menstruate have experienced disruptions to their menstrual cycles since the start of the pandemic, either due to pandemic-related factors like stress and behavior changes and/or due to COVID-19 illness itself or COVID-19 treatments and vaccines.
However, the researchers say from what is known about how the menstrual cycle works and how it can be disrupted by factors like stress, weight changes, infection, and inflammation (e.g. following vaccination), they strongly suspect that any pandemic-related changes will be short term with no serious or lasting effect on health and fertility.
Further research into the effects of COVID-19 and other health related exposures on women’s menstrual health is urgently needed and any COVID recovery plan needs to consider women’s health.
Dr. Gemma Sharp, Senior Lecturer in Molecular Epidemiology in the MRC Integrative Epidemiology Unit and lead author of the study at the University of Bristol, said: “More recent anecdotal reports of menstrual changes after vaccination for COVID-19 have fuelled vaccine hesitancy or refusal. Some women are understandably worried and they deserve to know more about why these menstrual changes have happened. Without robust menstrual data collection and analysis, menstrual problems will continue to be occult and undermanaged in society.
“Determining the scale of menstrual problems, their cause and the impact on those who menstruate and wider society will allow identification of new preventative and therapeutic strategies. Findings can inform policies to mitigate against gender inequalities in health and society, allowing us to build back better post-COVID.”
University of Bristol