Effects of SARS-CoV-2 infection and COVID-19 pandemic on menstrual health of women: A systematic review

Syeda Tayyaba Rehan; Laiba Imran; Hussain Mansoor; Qudsia Sayyeda; Hassan Ul Hussain; Mustafa Sajjad Cheema; Muhammad Junaid Tahir; Muhammad Sohaib Asghar; Mohammed Mahmmoud Fadelallah Eljack; Md Saiful Islam

doi:10.1002/hsr2.881

Effects of SARS-CoV-2 infection and COVID-19 pandemic on menstrual health of women: A systematic review

Health Sci Rep. 2022 Oct 8;5(6):e881. doi: 10.1002/hsr2.881. eCollection 2022 Nov.

Affiliations

¹ Department of Medicine Dow University of Health Sciences Karachi Pakistan.
² Department of Medicine Red Crescent of Tampa Bay Tampa Florida USA.
³ Department of Medicine CMH Lahore Medical College Lahore Pakistan.
⁴ Department of Medicine Lahore General Hospital Lahore Pakistan.
⁵ Department of Internal Medicine Dow University of Health Sciences-Ojha Campus Karachi Pakistan.
⁶ Division of Nephrology and Hypertension Mayo Clinic Rochester Minnesota USA.
⁷ Department of Community Medicine, Faculty of Medicine and Health Sciences University of Bakht Alruda Ad Duwaym White Nile state Sudan.
⁸ Department of Public Health and Informatics Jahangirnagar University Savar Dhaka Bangladesh.
⁹ Centre for Advanced Research Excellence in Public Health Savar Dhaka Bangladesh.

Abstract

Background: The menstrual cycle in women is the main indicator of their reproductive health which is affected by the ongoing coronavirus disease 2019 (COVID-19) pandemic. This review aims to summarize the effects of the COVID-19 infection and the global pandemic on the menstrual health of women.

Methods: The literature search was conducted in PubMed, Cochrane library, and Google Scholar using keywords "COVID-19," "Menstrual Cycle," "Menstrual Cycle Irregularities," "Amenorrhea," "Polymenorrhea," and "Dysmenorrhea." The articles were selected according to the following inclusion criteria: (i) cross-sectional studies, (ii) cohort studies, (iii) surveys, and (iv) other observational studies observing the effects of SARS-CoV-2 infection or COVID-19 pandemic on menstrual health of women. Exclusion criteria included: case reports, gray literature, and website articles regarding menstrual health.

Results: A total of 30,510 articles were shortlisted after a comprehensive search. Sixteen articles were included out of which 13 studies investigated the effects of the COVID-19 pandemic on the menstrual cycle while 3 evaluated the possible effects of COVID-19 infection on the menstrual health of women. Menstrual disorders or irregularities were a more common finding during the pandemic as compared to before (p = 0.008). Women affected by pandemic-related stress were more prone to changes in the duration of their menses (p = 0.0008), reported heavier bleeding (p = 0.028), and increased incidence of painful periods (p < 0.0001). COVID-19 infected women also reported changes in their menstrual cycle including irregular menstruation, increased symptoms of premenstrual syndrome, and infrequent menstruation.

Conclusions: Women suffering from COVID-19 infection or pandemic-associated stress and anxiety were more likely to experience irregular menstruation, dysmenorrhea, amenorrhea, and other menstrual abnormalities compared to those who were less exposed.

Keywords: COVID‐19; females; menses; psychological impact; quality of life; stress.