Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age

Reprod Biomed Online. 2021 Jan;42(1):260-267. doi: 10.1016/j.rbmo.2020.09.020. Epub 2020 Sep 29.


Research question: Does SARS-CoV-2 infection have an effect on ovarian reserve, sex hormones and menstruation of women of child-bearing age?

Design: This is a retrospective, cross-sectional study in which clinical and laboratory data from 237 women of child-bearing age diagnosed with COVID-19 were retrospectively reviewed. Menstrual data from 177 patients were analysed. Blood samples from the early follicular phase were tested for sex hormones and anti-Müllerian hormone (AMH).

Results: Among 237 patients with confirmed COVID-19, severely ill patients had more comorbidities than mildly ill patients (34% versus 8%), particularly for patients with diabetes, hepatic disease and malignant tumours. Of 177 patients with menstrual records, 45 (25%) patients presented with menstrual volume changes, and 50 (28%) patients had menstrual cycle changes, mainly a decreased volume (20%) and a prolonged cycle (19%). The average sex hormone and AMH concentrations of women of child-bearing age with COVID-19 were not different from those of age-matched controls.

Conclusions: Average sex hormone concentrations and ovarian reserve did not change significantly in COVID-19 women of child-bearing age. Nearly one-fifth of patients exhibited a menstrual volume decrease or cycle prolongation. The menstruation changes of these patients might be the consequence of transient sex hormone changes caused by suppression of ovarian function that quickly resume after recovery.

Keywords: COVID-19; Menstrual change; Ovarian function; SARS-CoV-2.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • COVID-19* / blood
  • COVID-19* / epidemiology
  • COVID-19* / pathology
  • COVID-19* / physiopathology
  • China / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Gonadal Steroid Hormones / analysis
  • Gonadal Steroid Hormones / blood*
  • Humans
  • Menstrual Cycle / physiology
  • Menstruation / physiology*
  • Middle Aged
  • Ovarian Reserve / physiology
  • Ovary / physiology
  • Reproduction / physiology*
  • Retrospective Studies
  • SARS-CoV-2 / physiology
  • Severity of Illness Index
  • Young Adult


  • Gonadal Steroid Hormones