Effects of Different Types of COVID-19 Vaccines on Menstrual Cycles of Females of Reproductive Age Group (15-49): A Multinational Cross-Sectional Study

Nuha N Filfilan; Suhaib Bukhari; Maryam Rizwan; Nirmeen M Bukhari; Nisreen K Aref; Farzana R Arain; Ibrahim K Alabbadi

doi:10.7759/cureus.39640

Effects of Different Types of COVID-19 Vaccines on Menstrual Cycles of Females of Reproductive Age Group (15-49): A Multinational Cross-Sectional Study

Cureus. 2023 May 29;15(5):e39640. doi: 10.7759/cureus.39640. eCollection 2023 May.

Authors

Nuha N Filfilan¹, Suhaib Bukhari², Maryam Rizwan³, Nirmeen M Bukhari⁴, Nisreen K Aref⁵, Farzana R Arain⁵, Ibrahim K Alabbadi⁶

Affiliations

¹ Public Health and Preventive Medicine, Taif University, Taif, SAU.
² Obstetrics and Gynaecology, University of Jeddah, Jeddah, SAU.
³ Obstetrics and Gynaecology, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK.
⁴ Obstetrics and Gynaecology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
⁵ Obstetrics and Gynaecology, Taif University, Taif, SAU.
⁶ Health Services and Hospital Administration, Taif University, Taif, SAU.

Abstract

Background Globally, there are more than 474 million cases and around 6 million deaths due to COVID-19. The case fatality rate was 0.5-2.8% while for 80-89 years old, it was 3.7-14.8%. Given the seriousness of this infection, prevention becomes critical. Hence, the introduction of vaccines led to a significant reduction (> 75% protection) in COVID-19 cases. On the other hand, patients seeking help for serious pulmonary, cardiovascular, neurological, and gynecological complaints have also been recorded. Clinical studies on the effects of vaccination focused mostly on life-or-death results rather than reproductive outcomes such as menstruation, fertility, or even pregnancy outcomes. This survey was conducted to get more evidence on the association between menstrual cycle irregularities and some globally most prevalent COVID-19 vaccines. Methods An online cross-sectional survey was conducted by a team from Taif University, Kingdom of Saudi Arabia, from January to June 2022 on females within the reproductive age group (15-49 years) using a semi-structured questionnaire. Data were analyzed using SPSS Statistics version 22.0 and presented as frequency and percentage. The chi-square test was applied for the association and a p-value of <0.05 was considered significant. Results A total of 2381 responses were included. The mean age of respondents was 25±7.7 years. Around 1604 (67%) participants observed post-vaccination menstrual changes, and the findings were significant (p< 0.001). A strong association (p=.008) was found between the type of vaccine and changes in the menstrual cycle in participants (AstraZeneca 11 (36%)) after one dose. A strong association (p=.004) was also seen between the type of vaccine (Pfizer 543 (83%)) and menstrual changes after the booster dose. Cycles became irregular 180 (36%) or prolonged 144 (29%) in females inoculated with Pfizer after two doses of vaccination (p=0.012). Conclusion Post-vaccination menstrual irregularities were reported by females of reproductive age, especially the new vaccines. Prospective studies for similar insights are needed. Finding the co-occurring impacts of vaccination and COVID-19 infections in the wake of the emerging new long-haul COVID-19 phenomena is crucial for reproductive health.

Keywords: covid-19 vaccines; menstrual irregularities; reproductive age; types of covid-19 vaccines; vaccine side-effects.

Grants and funding

Help with manuscript preparation and statistical analyses was received from colleagues.