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November 09, 2022
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Pandemic-related stress linked to changes in menstruation

Fact checked byRichard Smith
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Perceived high stress related to the COVID-19 pandemic was associated with self-reported changes in menstruation, according to data published in Obstetrics & Gynecology.

“The menstrual cycle is an indicator of women’s overall well-being,” Martina Anto-Ocrah, PhD, MPH, assistant professor of medicine at the University of Pittsburgh Center for Research on Health Care, told Healio. “Disruption to the menstrual cycle and fluctuating hormones can impact fertility, mental health, cardiovascular disease and other outcomes. Ultimately, these factors can also play into relationship dynamics, potentially compounding strain on relationships.”

Data derived from Anto-Ocrah M, et al. Obstet Gynecol. 2022;doi:10.1097/AOG.0000000000005010.
Data derived from Anto-Ocrah M, et al. Obstet Gynecol. 2022;doi:10.1097/AOG.0000000000005010.

Anto-Ocrah and colleagues administered an online survey from May 4 to 7, 2021, to a geographically and racially representative sample of U.S. women aged 18 to 45 years who were using nonhormonal birth control. The survey collected self-reported information on cycle length, duration and flow and frequency of spotting between cycles.

The researchers also administered the COVID-19 Pandemic-related Perceived Stress Scale (PSS-10-C). Scores of 25 or higher were interpreted as indicating high stress and scores lower than 25 as low stress.

In total, 354 women completed the PSS-10-C and the menstruation survey. Of these, 191 women reported changes in their cycles since the start of the pandemic, and 37 (10.5%) had high COVID-19-related stress scores.

Since the beginning of the pandemic, women with high PSS-10-C scores more often reported shorter or longer cycles (P = .008), shorter or longer periods (P < .001), heavier flow (P = .035) and more frequent spotting between cycles (P = .006) compared with women who reported low stress related to the pandemic.

Fully adjusted models revealed that high stress levels during the pandemic were associated with greater odds of any change in cycle length (adjusted OR = 2.32; 95% CI, 1.12-4.85), period duration (aOR = 2.38; 95% CI, 1.14-4.98) and spotting between cycles (aOR = 2.32; 95% CI, 1.03-5.22) compared with low stress levels. Associations between perceived stress level and heavier menstrual flow were not statistically significant.

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Martina Anto-Ocrah

Anto-Ocrah noted that “vaccination status had no bearing on the findings, which was incredibly fascinating,” and that approximately 12% of respondents reported changes in all the menstrual cycle parameters.

In light of the findings, Anto-Ocrah said women should report any unusual changes in their cycles to their providers. Future research should investigate the impact of COVID-19-related stress on women’s health in the context of long-term fertility, menopause and mental health, she said.