Menstrual symptoms variation among Lebanese women before and after the COVID-19 pandemic

Bloody stressed! A systematic review of the associations between adulthood psychological stress and menstrual cycle irregularity

Regular menstruation is a key indicator of general health and irregular menstrual parameters have been associated with elevated risk of adverse health outcomes. While psychological stress is believed to contribute to abnormal menstruation, little is known of the effects of discrete psychological stressors, including the COVID-19 pandemic, on menstrual function. A systematic database search was performed and studies investigating the relation between psychological stress and menstrual cycle irregularity in otherwise healthy adults were included. Two independent investigators completed abstract and full-text screening, data extraction, and risk of bias assessment. In the 41 included studies, a variety of stressors were assessed, namely COVID-19 pandemic stress, academic stress, and occupational stress. Our review found most studies report an association between psychological stress and menstrual dysfunction, with the most common disruptions being irregular menstruation and abnormal menstrual flow. Our findings also underlined notable discrepancies in the operational definitions used in the study of menstrual disorders. These observations emphasize the importance of psychological stress as a modifiable risk factor associated with irregular menstruation.

Assessment of COVID-19 impact on menstrual symptom variation among women in the United Arab Emirates

COVID-19 pandemic has resulted in short-term and long-term health, economic, and social repercussions since its outbreak in December 2019. More research is required to determine how the pandemic impacts various segments of the population. Preliminary research suggests that COVID-19 impacts menstrual cycles in different ways. The primary objective of this study was to assess alterations in menstrual cycles among women in the United Arab Emirates (UAE) following the pandemic. A cross-sectional online study was conducted between October 2022 and January 2023, enrolled 439 UAE women using the snowball technique. The Menstrual Symptom Questionnaire and Depression Anxiety Stress Scale were used to evaluate menstrual symptoms and assess depression and stress levels, respectively. The findings showed a significant increase in menstrual symptoms with both higher mean of pads usage per day and use of pain medication during menses after COVID-19 with a p-value <0.001. Moreover, women reported higher levels of psychological distress after COVID-19 (Beta = 1.47). The findings show that COVID-19 affected the menstrual symptoms in women, reflected by higher pads usage per day, bleeding days, and frequency of pain medication intake during menses. Furthermore, higher stress levels were reported in the post-COVID-19 period.

Impact of traditional Chinese Baduanjin exercise on menstrual health among international female students studying in China: a randomized controlled trial

Background

Menstrual symptoms were the common complaints of international female students during the acculturation period, and the symptoms negatively affected the daily life and school performance of those women. The present study aimed to evaluate the effectiveness of the traditional Chinese Baduanjin exercise on reducing menstrual symptoms for international female students studying in China during the acculturation period.

Methods

We conducted a randomized controlled trial among 62 international female students who suffered menstrual symptoms during the first 6 months after arriving in China. The study was carried out at three campuses of the two largest universities in the capital of a province in south-central China from March to October 2021. After screening, participants were randomly assigned to a control or intervention group. The intervention group engaged in 24 weeks of Baduanjin exercise for at least 30 min per day. The menstrual symptoms, sociocultural adaptation, perceived stress, and sleep quality were evaluated at baseline, the 12th week, and the 24th week. The chi-square test or Fisher's exact test, paired sample t-test, and multivariate analysis of variance (MANOVA)were adopted to analyze the data using SPSS 25.0.

Results

Totally, 62 participants were enrolled in this study from 30 countries. Their mean age was 27.87 ± 5.58 years. None of the participants reported an adverse event. The results of the MANOVA test showed that the traditional Chinese Baduanjin exercise reduced the total score of MSQ among international female students (intervention: 47.83 ± 8.71 vs. control: 65.12 ± 16.86; F = 19.49, P < 0.01). In addition, the results of the MANOVA indicated statistically significant decreases in scores for the two subscales of MSQ: premenstrual symptoms (intervention: 17.07 ± 3.33 vs. control: 28.42 ± 7.56; F = 44.70, P < 0.01)and menstrual pain (16.03 ± 4.53 vs. 19.58 ± 5.14; F = 6.50, P < 0.05). Moreover, the results showed that traditional Chinese Baduanjin exercise reduced the scores of the sociocultural adaptation level, the perceived stress level, and sleep quality and improved the blood progesterone hormone and blood estrogen hormone.

Conclusion

Regular Baduanjin exercise is a safe, acceptable, and effective form of exercise to promote international female students' menstrual health, reduce stress levels, and improve sleep quality.

Trial registration

www.chictr.org.cn, Chinese Clinical Trial Registry: ChiCTR2300072376.