Citation Information :
Sharma P, Jindal S, Kahlon N, Sarkar A, Pandey AK, Sharma JC, Kollabathula P, Jaggarwal S. Transient Alterations in Menstrual Pattern Following COVID-19 Vaccination: An Exploratory Survey in Indian Women. J South Asian Feder Obs Gynae 2023; 15 (5):564-568.
Background: Menstrual cycle is an important indicator of a woman's health, and innocuous alterations in menstrual pattern can affect women profoundly. With the increase in the vaccination drive across the Indian subcontinent, women have reported irregularities in menstrual pattern after coronavirus disease-2019 (COVID-19) vaccination. Through this study, we aimed to assess the pattern and severity of menstrual irregularities observed in Indian women post COVID-19 vaccination and determine its association with vaccine type and dosage.
Materials and methods: It was a prospective cohort study conducted over a period of 1 year. Women visiting gynecology outpatient department who voluntarily consented to participate in the survey and who had received at least one dose of Government-of-India-approved COVID-19 vaccine at least 3 months prior were eligible for recruitment in the study. All symptomatic or asymptomatic COVID-19-infected individuals with confirmed reverse transcriptase polymerase chain reaction (RT-PCR) positive report within the past 14 days were excluded from the study. A structured survey questionnaire was used to obtain data pertaining to alterations in menstrual pattern, duration, and severity of menstrual dysfunction. During the first 6 months, eligible participants were recruited. All recruited patients were prospectively followed up for the next 6 months to assess the persistence and severity of their menstrual irregularity.
Results: A total of 355 women participated. Majority of the study population were less than 30 years of age. Among the recruited women, 82% had previously regular menstrual cycles and 6.5% had a polycystic ovarian morphology. Almost 91.8% women had received at least two doses of the COVID vaccine. Of them, 87.9% women had received Covishield (Astra Zeneca/Serum Institute of India) and 11.5% had received Covaxin (Bharat Biotech). Five women had a history of recent (within 3 months of vaccination) use of hormonal contraception. Of the 33 women afflicted with disordered menstrual pattern, 57.6% were less than 30 years of age. Early onset of menstrual flow (30.3%) followed by reduced flow in 24.2% and heavy flow in 21.2% was the most common complaint recorded. Around 72.7% experienced symptoms within the first month of vaccination. Only two cases required medical attention. Of the 33 women who reported experience symptoms of menstrual alteration after COVID-19 vaccine, all have recovered at 6-months follow-up.
Conclusion: Transient menstrual abnormalities have been reported to succeed vaccination with Covishield (Astra Zeneca/Serum Institute of India) and Covaxin (Bharact Biotech). Most alterations were mild and self-limiting. Further large-scale multicentric trials are needed to confirm the findings of this exploratory survey.
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