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du Preez HN, Lin J, Maguire GEM, Aldous C, Kruger HG. COVID-19 vaccine adverse events: Evaluating the pathophysiology with an emphasis on sulfur metabolism and endotheliopathy. Eur J Clin Invest 2024:e14296. [PMID: 39118373 DOI: 10.1111/eci.14296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024]
Abstract
In this narrative review, we assess the pathophysiology of severe adverse events that presented after vaccination with DNA and mRNA vaccines against COVID-19. The focus is on the perspective of an undersulfated and degraded glycocalyx, considering its impact on immunomodulation, inflammatory responses, coagulation and oxidative stress. The paper explores various factors that lead to glutathione and inorganic sulfate depletion and their subsequent effect on glycocalyx sulfation and other metabolites, including hormones. Components of COVID-19 vaccines, such as DNA and mRNA material, spike protein antigen and lipid nanoparticles, are involved in possible cytotoxic effects. The common thread connecting these adverse events is endotheliopathy or glycocalyx degradation, caused by depleted glutathione and inorganic sulfate levels, shear stress from circulating nanoparticles, aggregation and formation of protein coronas; leading to imbalanced immune responses and chronic release of pro-inflammatory cytokines, ultimately resulting in oxidative stress and systemic inflammatory response syndrome. By understanding the underlying pathophysiology of severe adverse events, better treatment options can be explored.
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Affiliation(s)
- Heidi N du Preez
- Catalysis and Peptide Research Unit, University of KwaZulu-Natal, Durban, South Africa
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Johnson Lin
- School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Glenn E M Maguire
- Catalysis and Peptide Research Unit, University of KwaZulu-Natal, Durban, South Africa
- School of Chemistry and Physics, University of KwaZulu-Natal, Durban, South Africa
| | - Colleen Aldous
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Hendrik G Kruger
- Catalysis and Peptide Research Unit, University of KwaZulu-Natal, Durban, South Africa
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Homam Safiah M, Kalalib Al Ashabi K, Khalayli N, Hodaifa Y, Kudsi M. The prevalence of menstrual changes in COVID-19 vaccinated women: A cross-sectional study. Prev Med Rep 2024; 44:102804. [PMID: 39040951 PMCID: PMC11261097 DOI: 10.1016/j.pmedr.2024.102804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/24/2024] Open
Abstract
Background This study aimed to examine the prevalence of menstrual cycle changes (MCs) and their patterns among healthy Syrian women following the administration of the first and second doses of a vaccine. Methods A cross-sectional online survey following campaigns for COVID-19 vaccines was conducted in 2022 from June 26 to August 3. Data collected included the participants' demographic characteristics, vaccination status, and multiple-choice questions for MCs changes after the first and second doses. Results Of 236, 89.8 % completed all shots of the vaccine. After the first dose, 36.9 % reported MCs, and 35 % after the second dose. Most women did not experience changes in menstrual cycle frequency-81.8 % after the first dose and 83.4 % after the second dose. Similarly, most women did not observe changes in cycle length, or menstrual flow quantity-5.5 % after the first dose and 8 % after the second dose reported spotting. Dysmenorrhea was reported by 15.7 % and 14.1 % of women after the first and second doses, respectively. Conclusion MCs are a potential symptom that a healthy woman at childbearing age could have after a different type of COVID-19 vaccine. MCs patterns do not significantly differ following vaccine doses.
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Affiliation(s)
- Mhd Homam Safiah
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | | | - Naram Khalayli
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Yara Hodaifa
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Maysoun Kudsi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
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Pragathi S, Narayanamoorthy S, Dhivya S, Saraswathy R, Pamucar D, Simic V, Kang D. A complex fuzzy decision model for analysing the post-pandemic immuno-sustainability. Acta Trop 2024; 256:107261. [PMID: 38772435 DOI: 10.1016/j.actatropica.2024.107261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/23/2024]
Abstract
The post-effects of the COronaVIrus Disease (COVID-19) vary depending on socioeconomic and biological factors. Similarly, the effects of vaccination on people's immunity vary across several factors. After the pandemic, real-life post-vaccination anomalies significantly impact women's health, access to medical treatments and medications, mental well-being, and daily physical activities. However, there has been scant investigation into the physical, psychological, social, and economic ramifications of vaccine effects on women in the post-pandemic era. Therefore, conducting a comprehensive risk assessment is crucial to safeguard women from the post-vaccination effects.To address this issue, the research encompasses complex bipolar spherical fuzzy ℵ-soft set, which has two-sided periodic ambiguous data due to its parametric properties as an adaptable ℵ-soft set and distinguishing criteria as a complex bipolar spherical fuzzy set. In addition, some fundamental operations and properties are presented in a complex bipolar spherical fuzzy ℵ-soft environment. Furthermore, the robust assessment of a real-world application demonstrate the efficacy of the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach to optimise the decision result. Finally, the provided decision-making approach is compared with existing techniques to illustrate their remarkable credibility and integrity.
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Affiliation(s)
| | | | - Selvaraj Dhivya
- Department of Biochemistry, Post Graduate Institute of Child Health, Sector-30, Noida, Gautam Buddha Nagar-201303, India
| | - Ranganathan Saraswathy
- Department of Radiology, Karpagam Medical College and Hospital, Coimbatore 641032, Tamil Nadu, India
| | - Dragan Pamucar
- Department of Operations Research and Statistics, Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia; College of Engineering, Yuan Ze University, Taoyuan City, Taiwan; Department of Mechanics and Mathematics, Western Caspian University, Baku, Azerbaijan
| | - Vladimir Simic
- University of Belgrade, Faculty of Transport and Traffic Engineering, Vojvode Stepe 305, Belgrade 11010, Serbia; Department of Computer Science and Engineering, College of Informatics, Korea University, Seoul 02841, Republic of Korea
| | - Daekook Kang
- Department of Industrial and Management Engineering, Inje University 197 Inje-ro, Gimhae-si 50834, Gyeongsangnam-do, Republic of Korea.
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Payne LA, Wise LA, Wesselink AK, Wang S, Missmer SA, Edelman A. Association between COVID-19 vaccination and menstruation: a state of the science review. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:212-225. [PMID: 38857991 PMCID: PMC11246222 DOI: 10.1136/bmjsrh-2024-202274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/25/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Menstrual health is a key patient-reported outcome beyond its importance as a general indicator of health and fertility. However, menstrual function was not measured in the clinical trials of COVID-19 vaccines. The purpose of this review was to synthesise the existing literature on the relationship between COVID-19 vaccination and menstrual health outcomes. METHODS A PubMed search to 31 October 2023 identified a total of 53 publications: 11 prospective cohort studies, 11 retrospective cohort studies or registry-based cohort studies, and 31 cross-sectional or retrospective case-control studies. RESULTS Identified studies were generally at moderate-to-high risk of bias due to retrospective design, interviewer bias, and failure to include a non-vaccinated control group. Nonetheless, the bulk of the literature demonstrates that COVID-19 vaccine is associated with temporary changes in menstrual characteristics (cycle length and flow) and menstrual pain. Follicular phase (at the time of vaccination) is associated with greater increases in cycle length. Evidence suggests temporary post-vaccine menstrual changes in adolescents, abnormal vaginal bleeding in postmenopausal individuals, and a potential protective effect of using hormonal contraception. CONCLUSIONS In this review we found evidence supporting an association between the COVID-19 vaccine and menstrual health outcomes. Given the importance of menstrual function to overall health, we recommend that all future vaccine trials include menstruation as a study outcome. Future vaccine studies should include rigorous assessment of the menstrual cycle as an outcome variable to limit sources of bias, identify biological mechanisms, and elucidate the impact of stress.
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Affiliation(s)
- Laura A Payne
- McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren A Wise
- Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Siwen Wang
- Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Stacey A Missmer
- Harvard Medical School, Boston, Massachusetts, USA
- Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
- Michigan State University, East Lansing, Michigan, USA
| | - Alison Edelman
- Oregon Health & Science University, Portland, Oregon, USA
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Küçükerdem HS, Özdemir TD. Evaluation of menstrual irregularities following COVID-19 infection or vaccination: The impact of COVID anxiety and associated risk factors. Medicine (Baltimore) 2024; 103:e38771. [PMID: 38941384 DOI: 10.1097/md.0000000000038771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
There has been significant interest in the changes in menstrual cycles following coronavirus disease 2019 (COVID-19) infection or vaccination. This study aimed to investigate the evidence for such changes and their potential risk factors. We used a descriptive study design and gathered data by sharing an online survey questionnaire on social media platforms. The questionnaire included questions regarding sociodemographic factors, menstrual cycle changes, and COVID-19 anxiety. The study population comprised women aged 18 to 49 years from Izmir. All data analyses were performed using Statistical Package for the Social Sciences 21.0. The risk factors influencing menstrual irregularities were determined after the COVID binary logistic regression analysis, including univariate and multivariate models. Among the 465 participants, those with an associate's degree had a significantly higher risk of menstrual irregularities than those with a high school diploma (P = .012). Anxiety scores emerged as a significant risk factor for menstrual cycle irregularities (P = .026). However, neither COVID-19 infection nor vaccination resulted in significant changes in the menstrual cycle characteristics (P > .05). Other sociodemographic variables, such as age, body mass index, and smoking, were not significantly associated with menstrual cycle changes(P > .05). The study findings suggest that educational level and anxiety may play a role in menstrual irregularities, whereas COVID-19 infection or vaccination itself may not directly affect menstrual cycle.
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Affiliation(s)
- Halime Seda Küçükerdem
- Department of Family Medicine, Health Science University, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Tuğçe Doğa Özdemir
- Department of Radiology, Health Science University, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
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Bar-Joseph H, Raz Y, Eldar-Boock A, Michaan N, Angel Y, Saiag E, Nemerovsky L, Ben-Ami I, Shalgi R, Grisaru D. The direct effect of SARS-CoV-2 virus vaccination on human ovarian granulosa cells explains menstrual irregularities. NPJ Vaccines 2024; 9:117. [PMID: 38926432 PMCID: PMC11208497 DOI: 10.1038/s41541-024-00911-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Following administration of the SARS-CoV-2 vaccine, many women worldwide reported short-term menstrual irregularities. Although menstrual bleeding, "the fifth vital sign", is experienced by more than 300 million people on any given day worldwide, these changes were only partially studied. Irregular periods are important well beyond fertility and the discomfort they impose; they are associated with the risk of cardiovascular morbidity, chronic diseases, and premature mortality. Pre-clinical examination of the vaccine polymeric envelope indicates its accumulation in the ovaries. The somatic endocrine cells of the ovarian follicle - the granulosa cells (GCs)-participate in the strict hypothalamic-pituitary-ovarian (HPO) feedback loop that governs the menstrual cycle via endocrine and paracrine regulators, as AMH and Inhibins. We aimed to unravel the direct effect of the COVID-19 vaccine on GCs and link their post-vaccine activity to changes in menstrual patterns. Human primary GCs exposed in-vitro to the Pfizer COVID-19 vaccine BNT162b2, demonstrated no change in their viability but altered mRNA transcripts, specifically of the regulatory key factors: InhibinB was upregulated, whereas AMH was downregulated. We further examined pre- and post-vaccination blood samples from individual women and found a 2-3 folds change in the post-vaccination FSH/InhibinB protein level ratio, compared to their pre-vaccination values. This altered expression of InhibinB could significantly impact the HPO axis in vaccinated women and may ultimately influence the endometrium cyclicity, manifested clinically by the commonly reported changes in menstrual bleeding patterns.
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Affiliation(s)
- Hadas Bar-Joseph
- TMCR Unit, The Veterinary Service Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Yael Raz
- Department of Gynecologic Oncology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel. Affiliated to the Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Anat Eldar-Boock
- TMCR Unit, The Veterinary Service Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Nadav Michaan
- Department of Gynecologic Oncology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel. Affiliated to the Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Yoel Angel
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, The Faculty of Medical & Health Sciences and the Coller School of Management, Tel Aviv University, Tel Aviv, Israel
| | | | - Luba Nemerovsky
- Department of Cell and Developmental Biology, The Faculty of Medical & Health Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Ido Ben-Ami
- Department of Obstetrics and Gynecology, IVF and Infertility Unit, Sha'are Zedek Medical Center, The Hebrew University Medical School of Jerusalem, Jerusalem, 9103102, Israel
| | - Ruth Shalgi
- Department of Cell and Developmental Biology, The Faculty of Medical & Health Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Dan Grisaru
- Department of Gynecologic Oncology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel. Affiliated to the Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
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Rahimi Mansour F, Keyvanfar A, Najafiarab H, Hooshmand Chayijan S, Farzaneh F, Mortezaei G. Menstrual Cycle Disturbances after COVID-19 Vaccination: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2024; 18:201-206. [PMID: 38973271 PMCID: PMC11245586 DOI: 10.22074/ijfs.2024.2016339.1579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Indexed: 07/09/2024]
Abstract
BACKGROUND Following COVID-19 vaccination, some women suffered from menstrual cycle disturbances. This study aimed to investigate menstrual cycle disturbances after COVID-19 vaccination in women of reproductive age. MATERIALS AND METHODS This cross-sectional study was performed on 407 vaccinated women in the vaccination center of Imam Hossein Hospital (Tehran, Iran) between October 2021 and October 2022. They were interviewed based on a research-made checklist which consisted of two areas of questions about the baseline characteristics of participants and menstrual cycle characteristics to explore menstrual characteristics following COVID-19 vaccination. RESULTS The prevalence of menstrual disturbances was higher after the third dose (38.3%) compared with the second (27.9%) and first (17.7%) doses (P<0.001). After the first dose, a history of polycystic ovarian syndrome [PCOS, odds ratio (OR)=7.35, 95% confidential interval (CI)= (3.64-14.82), P<0.001] and menstrual disturbances with unknown etiology [OR=15.23, 95% CI=(6.30-36.80), P<0.001] could predict menstrual disturbances. After the second dose, a history of menstrual disturbances with unknown etiology [OR=3.83, 95% CI=(1.47-9.94), P=0.006] and menstrual disturbances after the first dose [OR=201.96, 95% CI= (40.99-994.90), P<0.001] were predictors of menstrual disturbances. After the third dose, a history of menstrual disturbances with unknown etiology [OR=3.09, 95% CI= (1.00-9.52), P=0.048], menstrual disturbances after the first [OR=9.82, 95% CI=(1.38-69.69), P=0.022] and second [OR=7.83, 95% CI=(1.46-41.92), P=0.016] doses could predict menstrual disturbances. CONCLUSION We detected that many women experienced various menstrual disturbances after vaccination against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Furthermore, a history of menstrual abnormalities (before COVID-19 vaccination and following the previous doses of these vaccines) was associated with developing menstrual disturbances.
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Affiliation(s)
- Farima Rahimi Mansour
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cell & Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Amirreza Keyvanfar
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Najafiarab
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Hooshmand Chayijan
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Farah Farzaneh
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Golnoush Mortezaei
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Licona-Meníndez RD, Peón AN. Anti-COVID-19 Vaccination Alters the Menstrual Cycle and Dose Accumulation Enhances the Effect. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:956. [PMID: 38929574 PMCID: PMC11206152 DOI: 10.3390/medicina60060956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/24/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: New investigations have detected an enhanced probability for women to develop menstrual cycle alterations after anti-COVID-19 vaccination. Moreover, given that the protective immunity provided by anti-COVID-19 vaccination appears to wane quickly, booster vaccination has been recommended. Nonetheless, whether adverse events arise from such repeated immunization has not been studied. Materials and Methods: We studied the incidence of menstrual cycle alterations, the quantity of menstrual cycle alterations per subject, and of altered menstrual cycles in nonpregnant women of fertile age after anti-COVID-19 vaccination in a cohort of vaccinated female subjects by the means of a standardized questionary that was applied via telephone calls each month. Subjects that received up to four doses were studied for 6 months after each dose. We calculated the odds ratio for enhanced incidence, as well as quadratic functions for the tendencies. A sensitivity analysis excluding subjects taking hormonal birth control and those with polycystic ovary syndrome was performed. Results: Anti-COVID-19 vaccination enhanced the probability to develop menstrual cycle alterations (OR 1.52, CI at 95% 1.2-1.8, p < 0.0001) and, interestingly, such a tendency was enhanced when subjects received more doses (R2 = 0.91). Furthermore, the same trends repeated for the quantity of alterations per subject, and of altered cycles. Such an effect was further demonstrated to be independent upon the vaccine brand being applied, the birth control status, and the diagnosis of polycystic ovary syndrome. Conclusions: Vaccination is the most cost-effective measure for primary prevention and is considered to be safe. Nonetheless, in this article, we show data that suggest that repeated vaccination of adult female subjects may lead to an enhanced incidence of menstrual cycle-related adverse events, quantity of alterations per subject, and altered cycles. We therefore think that the development of new vaccine formulations that produce longer-lasting immunity is of paramount importance to reduce the potential for dose accumulation-dependent enhanced risk.
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Nazzal W, Al-Maqati TN, Almulhim MA, Alsulmi ES, Alotaibi JF, AlBahrani S, Alsuhaibani O, Alenezi EH, Albusaili S, Alharbi A, Alqahtani A, Alahmari F, Alshahrani A, Al Otaibi DA, Alfaifi AH, Madkhali OA. Saudi Women's Perception of the Effect of COVID-19 Infection and Vaccination on Menstrual Cycle Length. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:495-502. [PMID: 39035140 PMCID: PMC11257109 DOI: 10.1089/whr.2023.0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 07/23/2024]
Abstract
Background and Aim This study was conducted in the Kingdom of Saudi Arabia to investigate the effects of the COVID-19 virus and the vaccine on menstrual periods. The data from this study would increase people's awareness of the impacts of the virus and its vaccines on menstrual periods and serve as a reference for further studies. Materials and Methods The data was collected through a web link where standardized close-ended questionnaires were distributed via several social media platforms in Saudi Arabia. Results The study included 691 respondents, with 411 women meeting the inclusion criteria. The majority of participants fell within the age range of 35-45, and 64% held at least a bachelor's degree. The Eastern region of Saudi Arabia had the highest percentage of participants, while the Northern region had the lowest. More than half of the participants were married, and 57% reported having been infected with COVID-19. The vast majority (99%) had received the COVID-19 vaccine, primarily the Pfizer/BioNTech vaccine. The study assessed the association between menstruation experience and symptoms in three situations: before infection or vaccination, after COVID-19 infection, and after vaccination. Differences were observed in the length of the menstrual cycle and flow, but no statistically significant differences were found for pelvic and back pain. Conclusions The result of this current study suggests that COVID-19 infection and/or vaccination has several effects on the menstrual cycle which changes in menses are minimal and transient.
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Affiliation(s)
- Wael Nazzal
- Department of Obstetrics and Gynecology, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Thekra N. Al-Maqati
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Muneera Abdulaziz Almulhim
- Department of Obstetrics and Gynecology, King Fahad Hospital University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Eman Saleh Alsulmi
- Department of Obstetrics and Gynecology, King Fahad Hospital University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jassas F. Alotaibi
- Department of Physical Therapy, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Salma AlBahrani
- Internal Medicine Department, King Fahad Military Medical Complex and Department of Internal Medicine, College of Medicine, Imam Abdulrahaman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Eman H. Alenezi
- Preventive Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Sattam Albusaili
- Academic Affairs, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Abdulelah Alharbi
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Ahmed Alqahtani
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Fahad Alahmari
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah Alshahrani
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Dhai A. Al Otaibi
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Asrar H. Alfaifi
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Ohood A. Madkhali
- Department of Pathology and Laboratory Medicine, Armed Forces Hospital, Jubail, Saudi Arabia
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AlRawi HZ, AlQurashi A, AlDahan D, Alkhudhayri M, Alsharidah AR, Wani T, AlJaroudi D. Association between receiving Covid-19 vaccine and menstrual cycle patterns among childbearing women: A cross-sectional study. Health Sci Rep 2024; 7:e1934. [PMID: 38736480 PMCID: PMC11082084 DOI: 10.1002/hsr2.1934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 01/09/2024] [Accepted: 02/01/2024] [Indexed: 05/14/2024] Open
Abstract
Background and Aims Many women reported experiencing abnormalities in their cycle after being vaccinated with Covid-19 vaccination. To understand this issue further, our study aimed to evaluate the menstrual cycle patterns among women of childbearing age after receiving COVID-19 vaccinations. Methods A cross-sectional study was conducted to investigate the impact of COVID-19 vaccine on women aged 18 years and above in Saudi Arabia. A self-administered online questionnaire was distributed among participants who had received at least one dose of COVID-19 vaccine. The questionnaire included questions about the participants' demographic characteristics, medical history, and vaccine-related adverse events. Results The study included 383 female participants with an average age of 30.8 ± 8.1 years. The majority of participants, 92.7%, were Saudi, and more than half, 51.4%, were single. Of the participants, 78.9% were disease-free, and a majority of 67.9% had no history of Coronavirus Disease 2019 infection. A significant proportion of participants reported postvaccination changes in the menstrual cycle. Specifically, 43.1% reported changes after the first dose, and 38.4% reported changes after the second dose (p = 0.044). The severity of premenstrual symptoms increased from 44 (11.5%) to 113 (29.5%) after the first dose. Reported pain on the (WONG-BAKER) scale was also significantly elevated from 34 (8.9%) to 87 (22.7%) (p < 0.001) after the first dose. Conclusion A relatively high prevalence of menstrual cycle irregularities was reported by Saudi vaccinated women, particularly young adults. These findings suggest the need to further research and explore the underlying causes of these irregularities and develop interventions that may help mitigate their impact on women's health. It is also recommended that women who observe long-term changes in their menstrual cycles seek follow-up and consultation with healthcare providers to ensure that any potential health concerns are addressed promptly.
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Affiliation(s)
- Halah Z. AlRawi
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | - Alaa AlQurashi
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | - Doaa AlDahan
- Clinical Trials RegistrySaudi National Institution of Health (SNIH)RiyadhSaudi Arabia
| | - Maha Alkhudhayri
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | | | - Tariq Wani
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | - Dania AlJaroudi
- Reproductive Endocrine and Infertility Medicine Department, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
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Brooks N, Irving SA, Kauffman TL, Vesco KK, Slaughter M, Smith N, Tepper NK, Olson CK, Weintraub ES, Naleway AL. Abnormal uterine bleeding diagnoses and care following COVID-19 vaccination. Am J Obstet Gynecol 2024; 230:540.e1-540.e13. [PMID: 38219855 DOI: 10.1016/j.ajog.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND There is evidence suggesting that COVID-19 vaccination may be associated with small, transitory effects on uterine bleeding, possibly including menstrual timing, flow, and duration, in some individuals. However, changes in health care seeking, diagnosis, and workup for abnormal uterine bleeding in the COVID-19 vaccine era are less clear. OBJECTIVE This study aimed to assess the impact of COVID-19 vaccination on incident abnormal uterine bleeding diagnosis and diagnostic evaluation in a large integrated health system. STUDY DESIGN Using segmented regression, we assessed whether the availability of COVID-19 vaccines was associated with changes in monthly, population-based rates of incident abnormal uterine bleeding diagnoses relative to the prepandemic period in health system members aged 16 to 44 years who were not menopausal. We also compared clinical and demographic characteristics of patients diagnosed with incident abnormal uterine bleeding between December 2020 and October 13, 2021 by vaccination status (never vaccinated, vaccinated in the 60 days before diagnosis, vaccinated >60 days before diagnosis). Furthermore, we conducted detailed chart review of patients diagnosed with abnormal uterine bleeding within 1 to 60 days of COVID-19 vaccination in the same time period. RESULTS In monthly populations ranging from 79,000 to 85,000 female health system members, incidence of abnormal uterine bleeding diagnosis per 100,000 person-days ranged from 8.97 to 19.19. There was no significant change in the level or trend in the incidence of abnormal uterine bleeding diagnoses between the prepandemic (January 2019-January 2020) and post-COVID-19 vaccine (December 2020-December 2021) periods. A comparison of clinical characteristics of 2717 abnormal uterine bleeding cases by vaccination status suggested that abnormal bleeding among recently vaccinated patients was similar or less severe than abnormal bleeding among patients who had never been vaccinated or those vaccinated >60 days before. There were also significant differences in age and race of patients with incident abnormal uterine bleeding diagnoses by vaccination status (Ps<.02). Never-vaccinated patients were the youngest and those vaccinated >60 days before were the oldest. The proportion of patients who were Black/African American was highest among never-vaccinated patients, and the proportion of Asian patients was higher among vaccinated patients. Chart review of 114 confirmed postvaccination abnormal uterine bleeding cases diagnosed from December 2020 through October 13, 2021 found that the most common symptoms reported were changes in timing, duration, and volume of bleeding. Approximately one-third of cases received no diagnostic workup; 57% had no etiology for the bleeding documented in the electronic health record. In 12% of cases, the patient mentioned or asked about a possible link between their bleeding and their recent COVID-19 vaccine. CONCLUSION The availability of COVID-19 vaccination was not associated with a change in incidence of medically attended abnormal uterine bleeding in our population of over 79,000 female patients of reproductive age. In addition, among 2717 patients with abnormal uterine bleeding diagnoses in the period following COVID-19 vaccine availability, receipt of the vaccine was not associated with greater bleeding severity.
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Affiliation(s)
- Neon Brooks
- Kaiser Permanente Center for Health Research, Portland, OR.
| | | | - Tia L Kauffman
- Kaiser Permanente Center for Health Research, Portland, OR
| | - Kimberly K Vesco
- Kaiser Permanente Center for Health Research, Portland, OR; Department of Obstetrics and Gynecology, Kaiser Permanente Northwest, Portland, OR
| | | | - Ning Smith
- Kaiser Permanente Center for Health Research, Portland, OR
| | - Naomi K Tepper
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christine K Olson
- Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Eric S Weintraub
- Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
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12
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Ahmad H, El Oweini A, Hallit S, Malaeb D. Assessment of COVID-19 impact on menstrual symptom variation among women in the United Arab Emirates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-9. [PMID: 38566449 DOI: 10.1080/09603123.2024.2337828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/28/2024] [Indexed: 04/04/2024]
Abstract
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.
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Affiliation(s)
- Huda Ahmad
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Ahmad El Oweini
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Beirut, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
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13
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Ranjbar F, Haghani S, Aghashahi M, Gharacheh M. Changes in menstrual cycles among Iranian women during the COVID-19 pandemic: A cross-sectional study. Int J Reprod Biomed 2024; 22:283-294. [PMID: 39035630 PMCID: PMC11255462 DOI: 10.18502/ijrm.v22i4.16389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/02/2024] [Accepted: 04/21/2024] [Indexed: 07/23/2024] Open
Abstract
Background Some women experienced alterations in their menstrual cycles during the Coronavirus disease 2019 (COVID-19) pandemic. Objective This study aimed to evaluate the changes in menstrual cycles among Iranian women during the COVID-19 pandemic. Materials and Methods This cross-sectional study included 1500 women of childbearing age referred to healthcare centers in Tehran, Iran from April-November 2022. Participants were selected using the stratified sampling method. Data were collected via a questionnaire covering information on menstrual cycle, COVID-19 infection, and COVID-19 vaccination status. The study's outcomes focused on menstrual changes by evaluating cycle regularity, duration, and symptoms based on participant-reported observations. Results The findings revealed that the pattern of menstrual change during the pandemic occurred in the form of a shorter interval in 8.6%, and longer interval in 8.9%, shorter duration in 10.4%, longer duration in 9.4%, heavier bleeding in 12.3%, lighter bleeding in 14.7%. The chance of menstrual changes in women who were infected with COVID-19 was 54% higher than that of women who were not infected, and the chance of menstrual changes in women who received 3 doses of COVID-19 vaccine was 1.5 times higher than women who had not been vaccinated. Conclusion Our research revealed a high incidence of menstrual changes among Iranian women of childbearing age during the COVID-19 pandemic. Healthcare providers should be knowledgeable about the menstrual changes associated with COVID-19 infection and vaccination to provide information and support to affected women.
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Affiliation(s)
- Fahimeh Ranjbar
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Motahareh Aghashahi
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Gharacheh
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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14
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Contreras-Rendon A, Garcia Vences EE, Olguin Ortega AA. The Evaluation of Menstrual Alterations in Mexican Women After Vaccination Against COVID-19. Cureus 2024; 16:e58783. [PMID: 38654961 PMCID: PMC11035497 DOI: 10.7759/cureus.58783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Menstrual changes after COVID-19 vaccination suggest a secondary connection to the immune response to vaccination rather than a specific component of the vaccine. The evaluation of these alterations in women with the same and multiple vaccination schedules will provide valuable information. Methods An observational, cross-sectional study was carried out; data were collected through a survey of 164 vaccinated women at the American British Cowdray (ABC) Santa Fe Medical Center Hospital in Mexico City. The survey was validated by the Delphi method. Results The survey was applied from March 2023 to February 2024. Post-vaccination menstrual alterations occurred in 48.1%; the most frequent alteration was menorrhagia in 20.7% and pain accompanied by menstruation in 27.4%. Fifty-seven percent had a history of previous COVID-19 infection. There were no significant associations between changes in menstrual bleeding after vaccination, history of COVID-19 infection, and age group (p>0.9). However, women who received multiple doses of vaccines had a higher risk of suffering abnormalities in bleeding by 36.6%. Conclusion The incidence of menstrual disorders in this study post COVID-19 vaccination was 49%. Menstrual alterations in patients who received multiple doses and a single regimen were similar at 47% and 48%, where there is no statistical significance. The greatest number of menstrual alterations was seen in the first dose at 36%, probably due to the immunity they acquired after the different types of vaccination. Vaccination is a very effective way to prevent the severity of COVID-19 infection; it has an impact on menstrual bleeding in terms of menorrhagia and metrorrhagia. Vaccination against COVID-19 is associated with small changes in the menstrual cycle, without statistical significance. Women receiving the first dose of the vaccine had changes in the amount of bleeding specifically the amount.
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Affiliation(s)
- Alejandra Contreras-Rendon
- Department of Obstetrics and Gynecology, American British Cowdray (ABC) Medical Center, Mexico City, MEX
- Faculty of Health Sciences, Anahuac University, Mexico City, MEX
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15
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Doğan E, Uncu B, Duman R. Comparison of menstrual cycle irregularities among young women based on coronavirus disease 2019 infection status: a cross-sectional study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20230801. [PMID: 38451576 PMCID: PMC10913787 DOI: 10.1590/1806-9282.20230801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 10/22/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVE The coronavirus disease 2019 pandemic that has emerged recently has significantly affected and continues to affect our lives. The Severe Acute Respiratory Syndrome Coronavirus 2 virus has significant effects on women's health due to gender-related physiological differences. The aim of this study was to compare the menstrual cycle status of young women according to their status of having had coronavirus disease 2019. METHODS This descriptive cross-sectional study was conducted with 220 young women aged between 18 and 25 years who received at least one dose of coronavirus disease 2019 vaccine. The study data were collected as a survey on the online platform. RESULTS The descriptive characteristics of young women who had had and had not had coronavirus disease 2019 were distributed homogeneously between the groups (p>0.05). Furthermore, there was no statistical difference in terms of menstrual cycle patterns (p>0.05). The mean scores from the Premenstrual Syndrome Scale and its subscales and the mean scores from the COVID Stress Scale and its subscales were similar in both groups, and no statistically significant difference was identified (p>0.05). CONCLUSION Although menstrual cycle irregularities due to coronavirus disease 2019 have been reported, these effects are usually observed during the pandemic. A decrease in stress and anxiety with the end of the pandemic may explain the return of the menstrual cycle to normal.
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Affiliation(s)
- Elif Doğan
- Istanbul University-Cerrahpasa, Faculty of Health Science, Department of Midwifery – İstanbul, Turkey
| | - Betül Uncu
- Istanbul University-Cerrahpasa, Faculty of Health Science, Department of Midwifery – İstanbul, Turkey
| | - Rukiye Duman
- Istanbul University-Cerrahpasa, Faculty of Health Science, Department of Midwifery – İstanbul, Turkey
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16
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Lukac S, Friedl TWP, Gruber T, Schmid M, Leinert E, Janni W, Hancke K, Dayan D. Changes in Endometriosis-Associated Symptoms Following Immunization against SARS-CoV-2: A Cross-Sectional Study. J Clin Med 2024; 13:1459. [PMID: 38592272 PMCID: PMC10932077 DOI: 10.3390/jcm13051459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Background: There are many reports about variations in the menstrual cycle after infection with SARS-CoV-2 or vaccination against it. However, data on SARS-CoV-2 infection or vaccination-related changes in menstruation-associated endometriosis-typical symptoms such as dysmenorrhea, dyspareunia, dyschezia, dysuria, and bloating are rare or missing. Methods: This retrospective study was performed as an online survey among employees and students at the University Hospital Ulm, Germany. Changes regarding the presence of mentioned symptoms and after immunization (vaccination and/or infection) were evaluated with the McNemar Test. Additionally, the risk factors associated with these changes and associations between a subjectively perceived general change in menstruation and changes in the symptoms were evaluated. Results: A total of 1589 respondents were included in the final analysis. Less than 4% of respondents reported the occurrence of new symptoms that they had not experienced before immunization. Overall, there was a significant reduction in the presence of dysmenorrhea, back pain, dyschezia, bloating, and dyspareunia after immunization against coronavirus (p < 0.001). Only 2.3% of all participants reported to have been diagnosed with endometriosis. Factors associated with changes in endometriosis-typical symptoms following immunization were body mass index, age, endometriosis, and thyroid disease. Conclusions: Our results provide unique data about a reduction in the incidence of endometriosis-associated symptoms as dysmenorrhea, dyschezia, and dyspareunia after immunization against COVID-19.
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Affiliation(s)
- Stefan Lukac
- Department of Obstetrics and Gynecology, University Hospital Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany
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17
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VanKeulen-Miller R, Fenton OS. Messenger RNA Therapy for Female Reproductive Health. Mol Pharm 2024; 21:393-409. [PMID: 38189262 DOI: 10.1021/acs.molpharmaceut.3c00803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Female reproductive health has traditionally been an underrepresented area of research in the drug delivery sciences. This disparity is also seen in the emerging field of mRNA therapeutics, a class of medicines that promises to treat and prevent disease by upregulating protein expression in the body. Here, we review advances in mRNA therapies through the lens of improving female reproductive health. Specifically, we begin our review by discussing the fundamental structure and biochemical modifications associated with mRNA-based drugs. Then, we discuss various packaging technologies, including lipid nanoparticles, that can be utilized to protect and transport mRNA drugs to target cells in the body. Last, we conclude our review by discussing the usage of mRNA therapy for addressing pregnancy-related health and vaccination against sexually transmitted diseases in women. Of note, we also highlight relevant clinical trials using mRNA for female reproductive health while also providing their corresponding National Clinical Trial identifiers. In undertaking this review, our aim is to provide a fundamental background understanding of mRNA therapy and its usage to specifically address female health issues with an overarching goal of providing information toward addressing gender disparity in certain aspects of health research.
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Affiliation(s)
- Rachel VanKeulen-Miller
- Department of Pharmacology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Owen S Fenton
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
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18
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Fallatah NI, Alrehaili BO, Alsulami SS, Al-Zalabani AH. Menstrual Changes Following COVID-19 Vaccination: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:206. [PMID: 38399494 PMCID: PMC10890281 DOI: 10.3390/medicina60020206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Menstrual changes, including altered cycle length and bleeding patterns, have been reported following COVID-19 vaccination. This study aimed to determine the prevalence and types of menstrual changes occurring after COVID-19 vaccination among female students and staff at a university in Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among women aged 18-39 years who received at least one dose of a COVID-19 vaccine. Eligible participants, including university students and staff, were recruited between May 2022 and November 2022. Participants completed a questionnaire detailing their sociodemographic characteristics, general medical and reproductive history, and menstrual characteristics before and after vaccination. The prevalence of various menstrual changes (cycle length, bleeding days, flow, and mid-cycle spotting) was calculated. The demographic factors associated with menstrual changes were analyzed using chi-squared tests. Results: The 472 included participants had a mean age of 20.9 years, and 95.3% were unmarried. Changes in menstrual cycle characteristics after COVID-19 vaccination were reported by 54.7% of respondents overall. The most common change was in cycle length, followed by the number of menstruation days and bleeding flow. Menstrual changes were not associated with age, BMI, occupation, marital status, or medical history. Changes in intermenstrual bleeding were more frequently reported after the third dose of the Pfizer vaccine compared to the Moderna vaccine (p = 0.014). Conclusions: More than half of the recruited female students and staff reported menstrual changes following COVID-19 vaccination, with altered cycle length being the most common. The potential underlying mechanisms and implications of these menstrual alterations require further investigation. These findings provide evidence of the menstrual side effects of COVID-19 vaccines among women in Saudi Arabia.
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19
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Latif R, Aldossary DA, Aljabari NA, Alowaied SS, Aljabari LA, Albash NJ, Alabdulhadi AS, Rafique N, Al-Asoom LI, Salem AM. Prevalence of menstrual irregularities after coronavirus disease 2019 vaccination: A cross-sectional study in the Eastern Province, Saudi Arabia. J Family Community Med 2024; 31:71-78. [PMID: 38406218 PMCID: PMC10883425 DOI: 10.4103/jfcm.jfcm_115_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/22/2023] [Accepted: 10/06/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Reports indicate that there are menstrual cycle disturbances following coronavirus disease 2019 (COVID-19) vaccination. The present study explored the prevalence of menstrual irregularities after COVID-19 vaccination and the association of menstrual irregularities with vaccine type, doses, immediate adverse effects, history of COVID-19 infection, and its severity. MATERIALS AND METHODS For this cross-sectional study, 406 women of reproductive age completed an online survey about the postvaccine changes in their menstruation (cycle duration, bleeding days, and bleeding amount), COVID-19 vaccine history (doses, type of vaccine, and immediate adverse effects), history of COVID-19 infection, and its severity. Data was analyzed using SPSS; descriptive statistics were computed and Chi-square test, and binary logistic regression analysis were performed. RESULTS Of the total 406 women, 45% reported postvaccine changes in their menstrual cycle. The most common menstrual change was increased dysmenorrhea (68%), followed by an increase in the length of the cycle (52%). There was a significant association between postvaccine menstrual changes and the age, marital status, and family history of menstrual irregularities. No association was observed between postvaccine menstrual changes and COVID-19 vaccine-and COVID-19 infection-related variables. As per the best-fit model of our predictors, the odds of having postvaccine menstrual changes were 0.41 times less in "single" women (confidence interval [CI] = 0.26-0.27; P < 0.001) and 1.714 times greater in women who had a "family history of menstrual irregularities" (CI = 1.092-2.690; P = 0.02), respectively. CONCLUSION A substantial number of women complained of postvaccine menstrual changes regardless of their age, type of COVID-19 vaccine, doses, immediate adverse effects, and COVID-19 infection history/severity. Being "single" decreased the probability, whereas having a family history of menstrual irregularities increased the probability significantly of having postvaccine menstrual changes.
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Affiliation(s)
- Rabia Latif
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Deena A. Aldossary
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Najla A. Aljabari
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saja S. Alowaied
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Latifah A. Aljabari
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Noor J. Albash
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Aseel S. Alabdulhadi
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nazish Rafique
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lubna I. Al-Asoom
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ayad M. Salem
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Kumar N, Gangane N, Mohapatra I, Rukadikar C, Sharmila V, Pushpalatha K, Eerike M, Santhoshi G, Samantaray SR, Seth S, Trigunait P, Reddy NJ, Patel S, Rani S, Mishra R, Negi K. Effect of COVID-19 Vaccination on Menstrual Cycle Patterns of Reproductive-age Women: A Multi-centric Observational Study. Curr Drug Res Rev 2024; 16:237-248. [PMID: 37291775 DOI: 10.2174/2589977515666230608140606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023]
Abstract
AIM The study was conducted to know the impact of COVID-19 vaccination on menstrual cycle patterns and pre- and post-menstrual symptoms in women aged 18-45 years. BACKGROUND COVID-19 vaccination was introduced to combat the dreadful impacts of human coronavirus infection. The two indigenously developed COVID-19 vaccines approved for use in India are COVISHIELD and COVAXIN. OBJECTIVES To investigate the effects of COVID-19 vaccination on the menstrual cycle, pre- and post-menstrual symptoms and to establish the correlation with the type of vaccine received. METHODS Multi-centric observational study conducted in six institutes of national importance in different states of India over one year. A total of 5709 female participants fulfilling inclusion criteria were enrolled. Data about the impact of vaccines (COVISHIELD and COVAXIN) and prior COVID-19 infection on the menstrual cycle and its associated symptoms were obtained using all participants' online and offline interviews. RESULTS Of 5709 participants, 78.2% received COVISHIELD and 21.8% COVAXIN. Of the total 5709 participants, 333 (5.8%) developed post-vaccination menstrual disturbances, with 32.7% having frequent cycles, 63.7% prolonged cycles, and 3.6% inter-menstrual bleeding. A total of 301 participants noticed changes in the amount of bleeding, with 50.2% excessive, 48.8% scanty, and 0.99% amenorrhea followed by heavy bleeding. Furthermore, the irregularities of the menstrual cycle (p = 0.011) and length (0.001) were significantly higher in the COVAXIN group (7.2%) as compared to the COVISHIELD (5.3%) group. A total of 721 participants complained of newly developed/worsening pre- and post-menstrual symptoms. These symptoms were significantly higher in the COVISHIELD group (p = 0.031), with generalized weakness and body pains as the main complaints (p = 0.001). No significant difference was observed in the incidence of COVID-19 infection with these vaccines. No significant associations were observed when comparing menstrual abnormalities among those with COVID-19 infection (p > 0.05). CONCLUSION COVISHIELD and COVAXIN vaccines were associated with menstrual cycle disturbances and pre-and post-menstrual symptoms in a small proportion of participants, with 94.7% having no change in the amount of bleeding during menstruation post-vaccination. The menstrual irregularities observed were significantly higher with the COVAXIN vaccine. Others: Further, long-term studies are required to confirm that the impact of COVID-19 vaccination on the menstrual cycle may be short-lasting, with no severe effects on women's menstrual health.
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Affiliation(s)
- Naina Kumar
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Neha Gangane
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Ipsita Mohapatra
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Charushila Rukadikar
- Department of Physiology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Vijayan Sharmila
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - K Pushpalatha
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Madhavi Eerike
- Department of Pharmacology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - G Santhoshi
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Subha Ranjan Samantaray
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Shikha Seth
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Pragati Trigunait
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Nanditha Jangam Reddy
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Shweta Patel
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Sandhya Rani
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Roopanshi Mishra
- Department of Physiology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Kamlesh Negi
- Department of Physiology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
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Alvergne A, Boniface E, Darney B, Shea A, Weber K, Ventola C, Vitzthum VJ, Edelman A. Associations Among Menstrual Cycle Length, Coronavirus Disease 2019 (COVID-19), and Vaccination. Obstet Gynecol 2024; 143:83-91. [PMID: 37562052 PMCID: PMC10715707 DOI: 10.1097/aog.0000000000005343] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To assess whether coronavirus disease 2019 (COVID-19) is associated with menstrual cycle length changes and, if so, how that compares with those undergoing vaccination or no event (control). METHODS We conducted a retrospective cohort analysis in which we analyzed prospectively tracked cycle-length data from users of a period tracker application who also responded to a survey regarding COVID-19 symptoms and vaccination. We restricted our sample to users aged 16-45 years, with normal cycle lengths (24-38 days) and regular tracking behavior during the five cycles around COVID-19 symptoms or vaccination or a similar time period for those experiencing no event (control group). We calculated the within-user change in cycle length (days) from the three consecutive cycles preevent average (either vaccination, disease, or neither; cycles 1-3) to the event (cycle 4) and postevent (cycle 5) cycles. We used mixed-effects models to estimate the age- and country-adjusted difference in change in cycle length across the groups. RESULTS We included 6,514 users from 110 countries representing 32,570 cycles (COVID-19 symptoms: 1,450; COVID-19 vaccination: 4,643; control: 421). The COVID-19 cohort experienced a 1.45-day adjusted increase in cycle length during cycle 4 (COVID-19) compared with their three preevent cycles (95% CI 0.86-2.04). The vaccinated group experienced a 1.14-day adjusted increase in cycle length during cycle 4 (COVID-19 vaccine) compared with their preevent average (95% CI 0.60-1.69). The control group (neither vaccine nor disease) experienced a 0.68-day decrease (95% CI -1.18 to -0.19) in a similar time period. Post hoc tests showed no significant differences in the magnitude of changes between the COVID-19 and vaccination cohorts. In both cohorts, cycle length changes disappeared in the postevent cycle. CONCLUSION Experiencing COVID-19 is associated with a small change in cycle length similar to COVID-19 vaccination. These changes resolve quickly within the next cycle.
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Affiliation(s)
- Alexandra Alvergne
- Institute for Evolutionary Sciences, Montpellier University, Montpellier, France; the School of Anthropology and Museum Ethnography, University of Oxford, Oxford, United Kingdom; the Department of Obstetrics and Gynecology, Oregon Health & Science University, and the OHSU-PSU School of Public Health, Portland, Oregon; the National Institute of Public Health (INSP), Center for Population Health (CISP), Cuernavaca, Morelos, Mexico; and Clue by BioWink GmbH, Berlin, Germany
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22
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Toktaş İ, Akelma H, Araç E. Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey. Medicine (Baltimore) 2023; 102:e36638. [PMID: 38115291 PMCID: PMC10727619 DOI: 10.1097/md.0000000000036638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023] Open
Abstract
Concerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.
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Affiliation(s)
- İzzettin Toktaş
- Department of Public Health, Mardin Artuklu University, Faculty of Medicine, Mardin, Turkey
| | - Hakan Akelma
- Department of Anesthesiology and Reanimation, Mardin Artuklu University, Faculty of Medicine, Mardin, Turkey
| | - Eşref Araç
- Department of Internal Medicine, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
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23
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Tandon A, Kumar N, Aggarwal S, Anjana Y, Sachdeva MP, Gupta V, Trilok-Kumar G. Assessing Menstrual Changes Among Young Indian Females Post-SARS-CoV-2 Vaccination. Cureus 2023; 15:e50025. [PMID: 38186546 PMCID: PMC10767692 DOI: 10.7759/cureus.50025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/09/2024] Open
Abstract
Background The rollout of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines has significantly enhanced immunity against coronavirus disease 2019 (COVID-19), leading to a reduction in the severity of illness, hospitalizations, and deaths. While various side effects of the vaccine have been reported, its impact on the menstrual cycle remains unclear. Methods We conducted a cross-sectional study involving university students who had received either partial or full vaccination against SARS-CoV-2. Data was gathered through a questionnaire designed to assess the relationship between menstrual changes and the SARS-CoV-2 vaccination. Results A total of 773 participants, with a mean age of 20.6 ± 1.7 years, were included in this study. The participants reported a significant increase in the irregularity of the menstrual cycle. We observed a slight increase in the length of the menstrual cycle, from 30.0 ± 4.0 days (pre-vaccination) to 30.5 ± 5.6 days (post-vaccination), which was statistically significant (p<0.001). The duration of menstruation also increased, from 4.9 ± 1.7 days (pre-vaccination) to 5.0 ± 1.7 days (post-vaccination). However, this increase in menstrual length due to vaccination was not statistically significant (p = 0.898). Notably, there was a significant increase in pain reported by the participants after receiving the SARS-CoV-2 vaccine (p = 0.004). Conclusion The SARS-CoV-2 vaccination significantly impacted the regularity of the menstrual cycle, length of the menstrual cycle, and pain during menstruation, though temporarily. Our study found no significant differences in menstrual changes or the type of vaccine administered (Covishield and Covaxin).
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Affiliation(s)
| | - Naveen Kumar
- Anthropology, University of Delhi, New Delhi, IND
- Biotechnology and Research, Sir Ganga Ram Hospital, New Delhi, IND
| | - Sunita Aggarwal
- Microbiology, Institute of Home Economics, University of Delhi, New Delhi, IND
| | - Yogita Anjana
- Food and Nutrition, Institute of Home Economics, University of Delhi, New Delhi, IND
| | | | - Vipin Gupta
- Anthropology, University of Delhi, New Delhi, IND
| | - Geeta Trilok-Kumar
- Epidemiology and Public Health, Institute of Home Economics, University of Delhi, New Delhi, IND
- Nutrition, Trivedi School of BioSciences, Ashoka University, Haryana, IND
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24
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Li S, Liu H, Li D, Chen F. Female reproductive health during the COVID-19 pandemic: latest evidence and understanding. Arch Gynecol Obstet 2023; 308:1691-1696. [PMID: 36856820 PMCID: PMC9976669 DOI: 10.1007/s00404-023-06976-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/09/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has imposed a heavy burden on medical systems. In addition to the respiratory system, the virus also causes injuries to other organs and systems such as the gastroenteric system, kidneys, and reproductive system. Female reproductive health requires more attention in this context. METHODS We have performed a thorough review of the relevant literature that addresses the impacts of SARS-CoV-2 infection and COVID-19 vaccination on the female reproductive system. RESULTS Most evidence shows that SARS-CoV-2 does not infect the female reproductive system. However, the virus may indirectly influence sex hormone concentrations through inflammation associated with cytokine storms and nervous system damage. Menstrual disorders in women infected with SARS-CoV-2 may be caused by down-regulation of angiotensin-converting enzyme 2, abnormal hormone levels, medications, and stress. There is no significant difference in ovarian follicle quality and in vitro fertilization parameters between the pre- and post-COVID-19 vaccination groups. In addition, most symptoms due to side effects of vaccination could recover within a short period of time. CONCLUSION SARS-CoV-2 infection affects female reproductive system function through multiple mechanisms. It is recommended that women of childbearing age be vaccinated with COVID-19 vaccine.
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Affiliation(s)
- Shuhui Li
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China
| | - Hongxin Liu
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China
| | - Di Li
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China.
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Chaufan C. Is Covid-19 "vaccine uptake" in postsecondary education a "problem"? A critical policy inquiry. Health (London) 2023:13634593231204169. [PMID: 37968946 DOI: 10.1177/13634593231204169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Since the launch of the Covid-19 global vaccination campaign, postsecondary institutions have strongly promoted vaccination, often through mandates, and the academic literature has identified "vaccine uptake" among postsecondary students as a problem deserving monitoring, research, and intervention. However, with the admission that vaccines do not stop viral spread, that older-age and co-morbidities are major determinants of poor outcomes, and that many vaccine side effects disproportionately affect the young, it cannot be assumed that a risk-benefit analysis favors vaccinating postsecondary students. Drawing from critical policy studies, I appraise the literature on Covid-19 vaccine uptake in postsecondary education. I find that this literature reflects the "scientific consensus," hardly acknowledging contradictory medical evidence, ignoring coercive elements underlying "vaccine acceptance," and neglecting ethical tensions built into the very design of vaccination policies. I discuss potential explanations for my findings, and their implications for academia's role in society in the COVID-19 era and beyond.
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Murished GM, Dandachi I, Aljabr W. Side effects of COVID-19 vaccines in the middle eastern population. Front Immunol 2023; 14:1270187. [PMID: 38022593 PMCID: PMC10654979 DOI: 10.3389/fimmu.2023.1270187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine long-term side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects.
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Affiliation(s)
| | | | - Waleed Aljabr
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Lukac S, Hancke K, Janni W, Gruber T, Schmid M, El-Taie Z, Kersten M, Friedl TWP, Dayan D. Disturbances of menstrual cycle after immunization against SARS-CoV-2 and their risk factors: Cross-sectional clinical study. Int J Gynaecol Obstet 2023; 163:445-452. [PMID: 37635685 DOI: 10.1002/ijgo.15060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/24/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Abnormalities of the menstrual cycle were reported after infection with SARS-CoV-2 and vaccination against it, but the available data are very heterogeneous, do not reflect intermenstrual variations or regional differences, and their risk factors are missing. METHODS We performed a survey-based study among 6383 employees and students of Ulm University Hospital in Germany between March 1 and 31, 2021. Attributes of menstrual cycles such as cycle length (CL), menses duration (MD), and bleeding volume (BV) were reported as categorical variables before and after immunization against SARS-CoV-2 (first, second, third vaccination or infection). Additionally, the potential risk factors for cycle changes were evaluated and all participants reported the subjective perception of changes, their duration, and time of occurrence. RESULTS The final analysis included 1726 participants. CL and BV significantly changed after vaccination, but not MD. The subjective perception showed only slight levels of agreement with the objective changes, with the highest Cohen's kappa for CL. The risk factors for the variations in CL were previous cycle irregularities, and risk factors for the changes in BV were age and body mass index. The combination of vaccines (homogenous or heterogeneous) and different types of immunization (infection and vaccination) had no significant effect on cycle irregularities. CONCLUSION In summary, immunization against SARS-CoV-2 causes changes in the characteristics of the menstrual cycle, which are mostly temporary. The individual risk factors, but not the type of immunization, can affect the mentioned changes.
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Affiliation(s)
- Stefan Lukac
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
| | - Katharina Hancke
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
| | - Wolfgang Janni
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
| | - Tobias Gruber
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
| | - Marinus Schmid
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
| | - Ziad El-Taie
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
| | - Maria Kersten
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
| | | | - Davut Dayan
- Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany
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Mahfouz MS, Abdelmageed MM, Alqassim AY, Hakami TKM, Alshekh MM, Hamithi DMA, Alakhdar FDH, Ayyashi NM, Madkhali RMA. Menstrual irregularities associated with COVID-19 vaccines among women in Saudi Arabia: A survey during 2022. Open Med (Wars) 2023; 18:20230804. [PMID: 37829840 PMCID: PMC10566562 DOI: 10.1515/med-2023-0804] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 07/20/2023] [Accepted: 08/31/2023] [Indexed: 10/14/2023] Open
Abstract
Some changes appeared in women's menstrual cycle after receiving the coronavirus disease 2019 (COVID-19) vaccine, but the information about the pattern and characteristics of these symptoms was unclear. This study was conducted to estimate the prevalence of menstruation change and evaluate the association between COVID-19 vaccination and the occurrence of such disturbance. An online web-based survey was conducted during March-April 2022 that targeted 729 COVID-19 vaccinated women aged between 18 and 45 years in the Jazan region of Kingdom of Saudi Arabia. The tool collected demographic information, psychological data, and COVID-19 post-vaccination side effects. The overall prevalence of menstrual change among the women was 60.9% (95% CI 57.3-64.4). 66.3% and 64.1% of women, respectively, in the age group of 25-34 and 35-45 years were more affected. Most of the detected abnormalities were related to delayed menstruation and changes in pain intensity. Menstrual disturbances that occur after immunization are transient and have no long-term implications. Menstrual disorders are prevalent before vaccination, but there is a considerable increase following vaccination. Because there is no apparent cause for these post-vaccine disturbances, and their effects are difficult to anticipate, it is preferable to warn those concerned and encourage them to learn more about the biological changes causing these problems.
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Affiliation(s)
- Mohamed Salih Mahfouz
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan45142, Saudi Arabia
| | - Maha Murtada Abdelmageed
- Obstetrics and Gynecology Department, Faculty of Medicine, Jazan University, Jazan45142, Saudi Arabia
| | - Ahmad Y. Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan45142, Saudi Arabia
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Almomani EY, Hajjo R, Qablan A, Sabbah DA, Al-Momany A. A cross-sectional study confirms temporary post-COVID-19 vaccine menstrual irregularity and the associated physiological changes among vaccinated women in Jordan. Front Med (Lausanne) 2023; 10:1211283. [PMID: 37869161 PMCID: PMC10587412 DOI: 10.3389/fmed.2023.1211283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/04/2023] [Indexed: 10/24/2023] Open
Abstract
Background COVID-19 vaccines continue to save people's lives around the world; however, some vaccine adverse events have been a major concern which slowed down vaccination campaigns. Anecdotal evidence pointed to the vaccine effect on menstruation but evidence from the adverse event reporting systems and the biomedical literature was lacking. This study aimed to investigate the physiological changes in women during menstruation amid the COVID-19 vaccination. Methods A cross-sectional online survey was distributed to COVID-19 vaccinated women from Nov 2021 to Jan 2022. The results were analyzed using the SPSS software. Results Among the 564 vaccinated women, 52% experienced significant menstrual irregularities post-vaccination compared to before regardless of the vaccine type. The kind of menstrual irregularity varied among the vaccinated women, for example, 33% had earlier menstruation, while 35% reported delayed menstruation. About 31% experienced heavier menstruation, whereas 24% had lighter menstrual flow. About 29% had menstruation last longer, but 13% had it shorter than usual. Noteworthy, the menstrual irregularities were more frequent after the second vaccine shot, and they disappeared within 3 months on average. Interestingly, 24% of the vaccinated women reported these irregularities to their gynecologist. Conclusion The COVID-19 vaccine may cause physiological disturbances during menstruation. Luckily, these irregularities were short-termed and should not be a reason for vaccine hesitancy in women. Further studies are encouraged to unravel the COVID-19 vaccine adverse effect on women's health.
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Affiliation(s)
- Ensaf Y. Almomani
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Rima Hajjo
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Jordan CDC, Amman, Jordan
| | - Ahmad Qablan
- Department of Curriculum and Methods of Instruction, United Arab Emirates University, Al Ain, United Arab Emirates
- Faculty of Educational Sciences, Hashemite University, Zarqa, Jordan
| | - Dima A. Sabbah
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Abass Al-Momany
- Department of Clinical Laboratory Sciences, University of Jordan, Amman, Jordan
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Alsalman M, Alhubail F, Bin Obaid F, Algouf I, Alomair B, Albunyan S, AlMudayris L, Alsalman Z, Khan AS. Impact of COVID-19 Vaccinations on Menstrual Bleeding. Cureus 2023; 15:e47360. [PMID: 38021843 PMCID: PMC10659569 DOI: 10.7759/cureus.47360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Vaccination has a fundamental role in protecting against and modifying the severity of several infectious diseases, including COVID-19. Several immune and non-immune adverse events have been reported post-COVID-19 vaccine. The aim of this study was to assess the effect of the COVID-19 vaccine on women's menstrual bleeding. METHODS A cross-sectional study was conducted among 399 vaccinated women in the Eastern Province of Saudi Arabia. Data were collected using a direct interview-based questionnaire including four sections. RESULTS A total of 399 women were recruited, with a mean age of 25.54 ± 6.177 years. More than half (53.9%) of the participants reported post-vaccination menstrual bleeding abnormality in terms of a heavy or irregular cycle. Out of the total number, 40 (21.4%) women reported having heavy menstrual flow, and 67 (16.8%) had non-menstrual bleeding after receiving the COVID-19 vaccine. Fully vaccinated women were at a greater risk of post-vaccination menstrual bleeding abnormality (p = 0.058). However, there was no correlation between booster shot type and menstrual bleeding abnormality (p > 0.05). In addition, there was no significant association between non-menstrual bleeding and the type of booster shot, the type of the first dose, and prior history of COVID-19 infection (p > 0.05). CONCLUSION Despite vaccination being the most effective way to prevent COVID-19, it does have an impact on menstrual bleeding in terms of menorrhagia and metrorrhagia. Therefore, more studies are needed to understand the mechanism and the long-term impact of COVID-19 vaccines on the hemostatic system.
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Affiliation(s)
- Mortadah Alsalman
- Department of Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Fatimah Alhubail
- Department of Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Fidaa Bin Obaid
- Department of Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Ibtisam Algouf
- Department of Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Bayan Alomair
- Department of Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Sara Albunyan
- Department of Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Lina AlMudayris
- Department of Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Zaenb Alsalman
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Abdul Sattar Khan
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al-Hofuf, SAU
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Duijster JW, Schoep ME, Nieboer TE, Jajou R, Kant A, van Hunsel F. Menstrual abnormalities after COVID-19 vaccination in the Netherlands: A description of spontaneous and longitudinal patient-reported data. Br J Clin Pharmacol 2023; 89:3126-3138. [PMID: 37222170 DOI: 10.1111/bcp.15799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/06/2023] [Accepted: 05/16/2023] [Indexed: 05/25/2023] Open
Abstract
AIMS During the COVID-19 vaccination campaigns, the number of reports of menstrual abnormalities increased rapidly. Here, we describe the nature and potential risk factors associated with menstrual abnormalities based on spontaneously reporting data as well as data from a prospective cohort event monitoring (CEM) study as these are poorly studied. METHODS Reports of menstrual abnormalities received by the Netherlands Pharmacovigilance Centre Lareb in the spontaneous reporting system between February 2021 and April 2022 were summarized. In addition, logistic regression analysis was performed on the reported menstrual abnormalities in the CEM study to assess the association between person characteristics, prior SARS-CoV-2 infection and use of hormonal contraceptives and the occurrence of menstrual abnormalities after vaccination. RESULTS We analysed over 24 000 spontaneous reports of menstrual abnormalities and over 500 episodes (among 16 929 included women) of menstrual abnormalities in the CEM study. The CEM study showed an incidence of 41.4 per 1000 women aged ≤54 years. Amenorrhoea/oligomenorrhoea and heavy menstrual bleeding collectively accounted for about half of all abnormalities reported. Significant associations were observed for the age group 25-34 years (odds ratio 2.18; 95% confidence interval 1.45-3.41) and the Pfizer vaccine (odds ratio 3.04; 95% confidence interval 2.36-3.93). No association was observed for body mass index and presence of most comorbidities assessed. CONCLUSION The cohort study showed a high incidence of menstrual disorders among women aged ≤54 years, and this observation was supported by the analysis of spontaneous reports. This suggests that a relation between COVID-19 vaccination and menstrual abnormalities is plausible and should be further investigated.
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Affiliation(s)
- Janneke W Duijster
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Mark E Schoep
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theodoor E Nieboer
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rana Jajou
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Agnes Kant
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | - Florence van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
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Bisgaard Jensen C, Bech BH, Hansen SN, Rask CU, Fink P, Nielsen H, Meinertz Dantoft T, Thysen SM, Rytter D. Prevalence of and risk factors for self-reported menstrual changes following COVID-19 vaccination: a Danish cohort study. Hum Reprod 2023; 38:1825-1834. [PMID: 37437904 DOI: 10.1093/humrep/dead144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/13/2023] [Indexed: 07/14/2023] Open
Abstract
STUDY QUESTION Are there some characteristics that render individuals more susceptible to report menstrual changes following the Coronavirus disease 2019 (COVID-19) vaccination? SUMMARY ANSWER We found that 30% of menstruating women reported menstrual changes following COVID-19 vaccination and several potential risk factors including stress, vaccine concerns, severe COVID-19 infection, and immediate vaccine symptoms were associated with these reports. WHAT IS KNOWN ALREADY Studies suggest that COVID-19 vaccination might temporarily prolong menstrual cycle length by less than 1 day. Specific characteristics may trigger menstrual changes in temporal relation to the vaccination simply by chance or render women more vigilant to potential menstrual changes after being vaccinated. However, research investigating potential risk factors for reporting menstrual changes following COVID-19 vaccination is limited. STUDY DESIGN, SIZE, DURATION A population-based Danish cohort study. Data were collected from May 2021 to December 2021 as a part of the BiCoVac Cohort with the aim of examining non-specific effects following COVID-19 vaccination. The main study population included 13 648 menstruating women aged 16-65 years who completed all surveys, received their first dose of a COVID-19 vaccine during the data collection period, and completed questions related to their menstrual cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS Potential risk factors included 14 biological, physical, or psychological measures. Information on most potential risk factors was self-reported and collected before the participants' first COVID-19 vaccination. Information about any menstrual change following COVID-19 vaccination was self-reported at the end of the data collection period. Logistic regression analyses were used to estimate crude and adjusted odds ratios (ORs) with 95% CIs for the association between each potential risk factor and reporting menstrual changes following COVID-19 vaccination. MAIN RESULTS AND THE ROLE OF CHANCE Any menstrual change following COVID-19 vaccination was reported by 30% of menstruating women. Most of the potential risk factors were associated with reports of menstrual changes following COVID-19 vaccination. In particular, higher odds were found among women who reported ≥5 immediate vaccine symptoms; OR 1.67 [1.50-1.86], had had a prior severe COVID-19 infection; OR 2.17 [1.40-3.35], had a high-stress level at baseline; OR 1.67 [1.32-2.10], or were concerned about COVID-19 vaccines prior to vaccination; OR 1.92 [1.50-2.45]. Lower odds were found among women with regular menstrual cycles using hormonal contraception; OR 0.71 [0.65-0.78]. LIMITATIONS, REASONS FOR CAUTION We were unable to address the causal effect of COVID-19 vaccination on the reported menstrual changes, as information about menstrual changes was not available among non-vaccinated women. WIDER IMPLICATIONS OF THE FINDINGS The study identified several potential risk factors for reporting menstrual changes following COVID-19 vaccination. Further studies are needed to establish causal associations and the clinical impact of self-reported menstrual changes. STUDY FUNDING/COMPETING INTEREST(S) The BiCoVac data collection was funded by TrygFonden (id-number: 153678). No competing interests are declared. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | - B Hammer Bech
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - C Ulrikka Rask
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
| | - P Fink
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - H Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - T Meinertz Dantoft
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - S Marie Thysen
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - D Rytter
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Massy N, Atzenhoffer M, Boulay C, Pecquet PE, Ledys F, Cracowski JL, Masmoudi K, Lepelley M, Gras-Champel V. [COVID-19 and adenovirus vaccines: French experience of enhanced pharmacovigilance]. Therapie 2023; 78:489-498. [PMID: 36759287 PMCID: PMC9862661 DOI: 10.1016/j.therap.2023.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023]
Abstract
As part of the COVID-19 vaccination campaign, the National Agency for the Safety of Medicines and Health Products and all 31 regional pharmacovigilance centers were mobilized in an exceptional reinforced vaccine pharmacovigilance surveillance system. Concerning adenovirus vaccines, Vaxzévria® and Jcovden®, this national system, based on the daily analysis of notified cases of adverse events, has allowed the early identification of safety signals, some of which have been validated, others still under analysis, common to mRNA vaccines or more specific of adenovirus vaccines such as Vaccine Induced Immune Thrombocytopenia. Complementing european and international actions, this follow-up has contributed to a better definition of the safety profile of these vaccines and has led to redefine the vaccine strategy in our country. Although today these two vaccines have no longer place in the national vaccine strategy, they are still used in other countries, where the experience acquired could be useful and will contribute to fuel the reflection on future therapies involving viral vectors.
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Affiliation(s)
- Nathalie Massy
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Rouen, 76031 Rouen, France
| | - Marina Atzenhoffer
- Centre régional de pharmacovigilance, service hospitalo-universitaire de pharmacologie et toxicologie, hospices civils de Lyon, 69424 Lyon, France
| | - Charlène Boulay
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Rouen, 76031 Rouen, France
| | - Pauline-Eva Pecquet
- Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, 80054 Amiens, France
| | - Fanny Ledys
- Centre régional de pharmacovigilance, service hospitalo-universitaire de pharmacologie et toxicologie, hospices civils de Lyon, 69424 Lyon, France
| | - Jean-Luc Cracowski
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Grenoble, 38043 Grenoble cedex 09, France
| | - Kamel Masmoudi
- Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, 80054 Amiens, France
| | - Marion Lepelley
- Centre régional de pharmacovigilance, service de pharmacologie, CHU Grenoble, 38043 Grenoble cedex 09, France
| | - Valérie Gras-Champel
- Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, 80054 Amiens, France.
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Błażejewski G, Witkoś J. The Impact of COVID-19 on Menstrual Cycle in Women. J Clin Med 2023; 12:4991. [PMID: 37568393 PMCID: PMC10419606 DOI: 10.3390/jcm12154991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has become the largest and most diverse to threaten the health of humanity since the 1918 influenza pandemic. METHODS This study involved 113 women who had suffered from COVID-19. The study was conducted as interviews with each woman during visits to a clinic prior to the start of their post-COVID-19 physiotherapy treatment cycle. The aim of this study was to assess the prevalence of changes in the women's monthly cycles related to COVID-19, as well as to analyse correlations between dependent variables relating to changes in the monthly cycle and independent variables relating to other factors, such as age, weight, number and type of vaccinations, and time since illness. Additionally, the study assesses correlations between the monthly cycle and COVID-19 symptoms persisting after the illness (long COVID). RESULTS Women who reported more symptoms of COVID-19 were more likely to report changes in their menstrual cycle occurring after the SARS-CoV-2 infection, compared with women whose disease course was mild. Women who declared that COVID-19 affected their monthly cycles most often indicated increases in abdominal, lower abdominal, and joint and muscle pain, as well as in the severity of headaches during monthly bleeding. A small percentage of women indicated that their monthly cycles were longer and their regularity disrupted. CONCLUSIONS This study shows that the more COVID-19 symptoms a woman had, the more often there were noted changes in monthly cycle. The same relationship was also found for persistent long COVID symptoms. The longer the time lapse since the COVID-19 infection, the less frequently changes in the monthly cycle were recorded.
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Affiliation(s)
- Grzegorz Błażejewski
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, G. Herlinga-Grudzińskiego, Street 1, 30-705 Kraków, Poland
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Pardo-Cabello AJ, Manzano-Gamero V, Luna JDD. Differences in reporting of adverse drug reactions due to COVID-19 vaccines depending on the reporter. Eur J Intern Med 2023; 113:104-106. [PMID: 36966066 PMCID: PMC10030326 DOI: 10.1016/j.ejim.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 03/24/2023]
Affiliation(s)
| | | | - Juan de Dios Luna
- Department of Biostatistics, Faculty of Medicine, University of Granada, Granada Spain
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Abstract
The COVID-19 pandemic has had a profound global impact, affecting people's physical and mental health, and their social and economic circumstances. Mitigation measures have disproportionately affected women. Studies have reported menstrual cycle and psychological disturbance associated with the pandemic. Pregnancy is a risk factor for severe COVID-19 disease. Reports have also demonstrated associations between COVID-19 infection, vaccination and Long COVID syndrome and reproductive health disturbance. However, studies are limited and there may be significant geographical variation. Also there is bias amongst published studies, and menstrual cycle data was not included in COVID-19 and vaccine trials. Longitudinal population based studies are required. In this review we discuss existing data, along with recommendations for further research required in this area. We also discuss a pragmatic approach to women presenting with reproductive health disturbance in the era of the pandemic, encompassing a multi-system assessment of psychological, reproductive health and lifestyle.
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Affiliation(s)
- Michelle Maher
- Department of Endocrinology, St James's Hospital, Dublin, Ireland; Department of Medicine, Trinity College Dublin, Ireland
| | - Lisa Owens
- Department of Endocrinology, St James's Hospital, Dublin, Ireland; Department of Medicine, Trinity College Dublin, Ireland.
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Wesselink AK, Lovett SM, Weinberg J, Geller RJ, Wang TR, Regan AK, Willis MD, Perkins RB, Yland JJ, Koenig MR, Rothman KJ, Hatch EE, Wise LA. COVID-19 vaccination and menstrual cycle characteristics: A prospective cohort study. Vaccine 2023; 41:4327-4334. [PMID: 37301706 PMCID: PMC10239900 DOI: 10.1016/j.vaccine.2023.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/22/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
We prospectively examined the association between COVID-19 vaccination and menstrual cycle characteristics in an internet-based prospective cohort study. We included a sample of 1,137 participants who enrolled in Pregnancy Study Online (PRESTO), a preconception cohort study of couples trying to conceive, during January 2021-August 2022. Eligible participants were aged 21-45 years, United States or Canadian residents, and trying to conceive without fertility treatment. At baseline and every 8 weeks for up to 12 months, participants completed questionnaires on which they provided information on COVID-19 vaccination and menstrual cycle characteristics, including cycle regularity, cycle length, bleed length, heaviness of bleed, and menstrual pain. We fit generalized estimating equation (GEE) models with a log link function and Poisson distribution to estimate the adjusted risk ratio (RR) for irregular cycles associated with COVID-19 vaccination. We used linear regression with GEE to estimate adjusted mean differences in menstrual cycle length associated with COVID-19 vaccination. We adjusted for sociodemographic, lifestyle, medical and reproductive factors. Participants had 1.1 day longer menstrual cycles after receiving the first dose of COVID-19 vaccine (95 % CI: 0.4, 1.9) and 1.3 day longer cycles after receiving the second dose (95 % CI: 0.2, 2.5). Associations were attenuated at the second cycle post-vaccination. We did not observe strong associations between COVID-19 vaccination and cycle regularity, bleed length, heaviness of bleed, or menstrual pain. In conclusion, COVID-19 vaccination was associated with a ∼1 day temporary increase in menstrual cycle length, but was not appreciably associated with other menstrual cycle characteristics.
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Affiliation(s)
- Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
| | - Sharonda M Lovett
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Janice Weinberg
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States
| | - Ruth J Geller
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Tanran R Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | | | - Mary D Willis
- Department of Obstetrics & Gynecology, Boston University Chobanian and Avedesian School of Medicine, Boston, MA, United States
| | - Rebecca B Perkins
- Department of Obstetrics & Gynecology, Boston University Chobanian and Avedesian School of Medicine, Boston, MA, United States
| | - Jennifer J Yland
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Martha R Koenig
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
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Sabat R, Dayton OL, Agarwal A, Vedam-Mai V. Analyzing the effect of the COVID-19 vaccine on Parkinson's disease symptoms. Front Immunol 2023; 14:1158364. [PMID: 37342344 PMCID: PMC10278957 DOI: 10.3389/fimmu.2023.1158364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/10/2023] [Indexed: 06/22/2023] Open
Abstract
Background Parkinson's Disease (PD) is one of the most common neurodegenerative diseases. PD has recently received more attention by researchers in the midst of the COVID-19 pandemic. Objective Yet to be researched is the effect of the COVID-19 vaccines on PD patients. Several PD patients are still hesitant to the vaccine due to this unaddressed fear. The purpose of this study is to address this gap. Methods Surveys were administered to PD patients 50 years and older at UF Fixel Institute who received at least one dose of the COVID-19 vaccine. Survey questions included patients' severity of PD symptoms before and after the vaccine and extent of worsening PD symptoms post-vaccination. After three weeks of collecting responses, the data was analyzed. Results 34 respondents were eligible for data consideration because they fell within the age range being studied. A total of 14 respondents out of 34 (41%, p=0. 0001) reported that their PD symptoms worsened after the COVID-19 vaccine to some extent. Conclusion There was strong evidence of worsening of PD symptoms post COVID-19 vaccination, however it was mostly mild and limited to a couple of days. The worsening had statistically significant moderate positive correlation with vaccine hesitancy and post-vaccine general side effects. A possible causative mechanism of PD symptom worsening using existing scientific knowledge would be stress and anxiety associated with vaccine hesitancy and the extent of post-vaccine general side effects (fever, chills, pain), likely via simulating a mild systemic infection/inflammation the latter already established causes of PD symptom worsening.
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Affiliation(s)
- Revati Sabat
- Eastside High School, Gainesville, FL, United States
| | - Orrin L. Dayton
- Department of Radiology, University of Florida, Gainesville, FL, United States
| | - Amit Agarwal
- Department of Radiology, Mayo Clinic, Jacksonville, FL, United States
| | - Vinata Vedam-Mai
- Department of Neurology, University of Florida, Gainesville, FL, United States
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39
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Boniface ER, Edelman AB, Darney BG. Response to "Vaccination and the Menstrual Cycle". Am J Epidemiol 2023; 192:851-852. [PMID: 36883904 PMCID: PMC10505409 DOI: 10.1093/aje/kwad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Affiliation(s)
| | - Alison B Edelman
- Correspondence to Dr. Alison B Edelman, 808 S.W. Campus Drive, Portland, Oregon 97239 (e-mail: )
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Paik H, Kim SK. Female reproduction and abnormal uterine bleeding after COVID-19 vaccination. Clin Exp Reprod Med 2023; 50:69-77. [PMID: 37258099 DOI: 10.5653/cerm.2023.05925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccines have been widely administered throughout the global community to minimize the morbidity and mortality caused by the COVID-19 pandemic. Although generally well-tolerated, these vaccines have generated some unwanted consequences, including thrombosis and menstrual irregularities. The effect of vaccination on female reproductive function has also been questioned. The aim of this review is to give readers a clear understanding of the effects of COVID-19 vaccines on thrombosis, reproductive function, and menstrual irregularities by systemically analyzing the available literature. The available evidence suggests that COVID-19 vaccines have a minimal impact on ovarian reserve. Furthermore, in vitro fertilization outcomes after COVID-19 vaccination remain unimpaired compared to those who did not receive the vaccines. Current evidence supports a certain degree of impact of COVID-19 vaccines on the menstrual cycle, with the most frequent alteration being menstrual irregularity, followed by menorrhagia. These changes are generally well-tolerated and transient, lasting less than 2 months. This review, by providing information with up-to-date references on this issue, may enhance readers' understanding of the impact of COVID-19 vaccines on female reproductive function and the menstrual cycle.
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Affiliation(s)
- Haerin Paik
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
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Pourmasumi S, Kounis NG, Naderi M, Hosseinisadat R, Khoradmehr A, Fagheirelahee N, Kouni SN, de Gregorio C, Dousdampanis P, Mplani V, Michalaki MA, Plotas P, Assimakopoulos S, Gogos C, Aidonidis G, Roditis P, Matsas N, Velissaris D, Calogiuri G, Hung MY, Koniari I. Effects of COVID-19 Infection and Vaccination on the Female Reproductive System: A Narrative Review. Balkan Med J 2023; 40:153-164. [PMID: 37114907 PMCID: PMC10175880 DOI: 10.4274/balkanmedj.galenos.2023.2023-3-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Several studies and research papers have been published to elucidate and understand the mechanism of the coronavirus disease 2019 (COVID-19) pandemic and its long-term effects on the human body. COVID-19 affects a number of organs, including the female reproductive system. However, less attention has been given to the effects of COVID-19 on the female reproductive system due to their low morbidity. The results of studies investigating the relationship between COVID-19 infection and ovarian function in women of reproductive age have shown the harmless involvement of COVID-19 infection. Several studies have reported the involvement of COVID-19 infection in oocyte quality, ovarian function, and dysfunctions in the uterine endometrium and the menstrual cycle. The findings of these studies indicate that COVID-19 infection negatively affects the follicular microenvironment and dysregulate ovarian function. Although the COVID-19 pandemic and female reproductive health have been studied in humans and animals, very few studies have examined how COVID-19 affects the female reproductive system. The objective of this review is to summarize the current literature and categorize the effects of COVID-19 on the female reproductive system, including the ovaries, uterus, and hormonal profiles. The effects on oocyte maturation, oxidative stress, which causes chromosomal instability and apoptosis in ovaries, in vitro fertilization cycle, high-quality embryos, premature ovarian insufficiency, ovarian vein thrombosis, hypercoagulable state, women’s menstrual cycle, the hypothalamus-pituitary-ovary axis, and sex hormones, including estrogen, progesterone, and the anti-Müllerian hormone, are discussed in particular.
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Affiliation(s)
- Soheila Pourmasumi
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Nicholas G. Kounis
- Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, Patras, Greece
| | - Monavar Naderi
- Knowledge and Information Science, Vice Chancellor for Science and Technology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Robabe Hosseinisadat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Arezoo Khoradmehr
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Niloofar Fagheirelahee
- Department of Anatomy, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Cesare de Gregorio
- Department of Clinical and Experimental Medicine, University of Messina Medical School, Messina, Italy
| | | | - Virginia Mplani
- Intensive Care Unit, Patras University Hospital, Patras, Greece
| | - Marina A. Michalaki
- Department of Internal Medicine, Division of Endocrinology, Fculty of Health Sciences, University of Patras, Patras, Greece
| | | | - Stelios Assimakopoulos
- Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Patras, Greece
| | - Christos Gogos
- COVID-19 Unit, Papageorgiou General Hospital, Thessaloniki, Greece
| | | | - Pavlos Roditis
- Department of Cardiology, Mamatsio Kozanis General Hospital, Kozani, Greece
| | | | | | - Gianfranco Calogiuri
- Pneumonology Department, Civil Hospital “Ninetto Melli”, Pietro Vernoti, Brindisi, Italy
- Department of Internal Medicine, Immunology and Infectious Diseases, Section of Allergology and Clinical Immunology, University of Bari Medical School, Bari, Italy
| | - Ming-Yow Hung
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Ioanna Koniari
- Departmentof Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
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Filfilan NN, Bukhari S, Rizwan M, Bukhari NM, Aref NK, Arain FR, Alabbadi IK. 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; 15:e39640. [PMID: 37388582 PMCID: PMC10306122 DOI: 10.7759/cureus.39640] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
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.
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Affiliation(s)
- Nuha N Filfilan
- Public Health and Preventive Medicine, Taif University, Taif, SAU
| | - Suhaib Bukhari
- Obstetrics and Gynaecology, University of Jeddah, Jeddah, SAU
| | - Maryam Rizwan
- Obstetrics and Gynaecology, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK
| | - Nirmeen M Bukhari
- Obstetrics and Gynaecology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Saleh Alzahrani H, Ali Algashami S, Abdulaziz Alharkan A, Sultan Alotaibi N, Waseem Algahs N. The Effect of COVID-19 Vaccination on the menstrual cycle in female in Riyadh, Saudi Arabia. Saudi Pharm J 2023; 31:746-751. [PMID: 37128295 PMCID: PMC10063452 DOI: 10.1016/j.jsps.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Background Recently, few studies have mentioned minor changes in women's menstrual cycle after the COVID-19 vaccination. There were many reported cases of female menstrual cycle problems in primary healthcare clinics in Riyadh, Saudi Arabia. The study aimed to explore the prevalence of menstrual irregularities after the COVID-19 vaccine among females of childbearing age in Riyadh, Saudi Arabia. Materials and Methods This observational cross-sectional study was conducted from dec 2021 to June 2022 in Saudi Arabia. The study was carried out by using a convenience sampling technique. Results Our analysis includes 1066 participants. Abnormal menstruation was significantly associated with hypertension (p-value = 0.024), polycystic ovary syndrome (p-value = 0.001), and at least one gynaecological condition (p-value < 0.001). However, the multivariate regression analysis showed that menstrual abnormality before receiving the COVID-19 vaccine (OR = 0.09, 95% CI, 0.06 to 0.14, p-value <0.001) was more likely to be associated with abnormal menstruation after receiving the vaccine. Conclusions Our study findings showed a significant association between covid-19 vaccination and menstruation irregularity before administering the covid-19 vaccine, irrespective of vaccine type or the number of doses administered. Future and ongoing clinical trials should investigate menstrual abnormalities, other abnormal vaginal bleeding and hormonal changes post-vaccination, especially the COVID-19 vaccine.
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Affiliation(s)
- Hayat Saleh Alzahrani
- Family Medicine and Medical Education, Department of Clinical Science, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Corresponding author at: Family Medicine and Medical Education, Princess Nourah Bint Abdulrahman University, P.O. box: 84428, Riyadh 11671, Saudi Arabia.
| | - Saba Ali Algashami
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Noura Sultan Alotaibi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Naelah Waseem Algahs
- Family Medicine Resident - King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
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Ata B, Vermeulen N, Mocanu E, Gianaroli L, Lundin K, Rautakallio-Hokkanen S, Tapanainen JS, Veiga A. SARS-CoV-2, fertility and assisted reproduction. Hum Reprod Update 2023; 29:177-196. [PMID: 36374645 PMCID: PMC9976972 DOI: 10.1093/humupd/dmac037] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.
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Affiliation(s)
- Baris Ata
- Obstetrics and Gynecology Department, Koc University, Istanbul, Turkey.,ART Fertility Clinics, Dubai, United Arab Emirates
| | | | - Edgar Mocanu
- Department of Reproductive Medicine, Rotunda Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luca Gianaroli
- Società Italiana Studi di Medicina della Riproduzione, S.I.S.Me.R. Reproductive Medicine Institute, Bologna, Emilia-Romagna, Italy
| | - Kersti Lundin
- Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Juha S Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, Barcelona, Spain
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Sulla F, Camia M, Scorza M, Giovagnoli S, Padovani R, Benassi E. The Moderator Effect of Subthreshold Autistic Traits on the Relationship between Quality of Life and Internet Addiction. Healthcare (Basel) 2023; 11:healthcare11020186. [PMID: 36673554 PMCID: PMC9858939 DOI: 10.3390/healthcare11020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/31/2022] [Accepted: 01/04/2023] [Indexed: 01/10/2023] Open
Abstract
People with sub-threshold autistic traits (SATs) are more prone to develop addictive behaviors such the ones linked to Internet abuse. The restrictions for anti-COVID-19 distancing measures encourage social isolation and, consequently, increase screen time, which may lead to Internet addiction (IA). However, a better quality of life (QoL) may have function as a protective factor against the development of IA. This study wanted to investigate the relation between SATs, QoL, and the overuse of the Internet in a group of 141 university students in the North of Italy. Participants completed a battery of tests. Results suggest that QoL is a predictive factor of IA and that the relationship between QoL and IA is significantly moderated by SATs. This could mean that SATs might represent a risk factor for IA, even when people have a better quality of life. Differences between female and male students are discussed, as well as possible implications for practice.
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Affiliation(s)
- Francesco Sulla
- Department of Human Studies, University of Foggia, 71121 Foggia, Italy
- Correspondence:
| | - Michela Camia
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Maristella Scorza
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Sara Giovagnoli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy
| | - Roberto Padovani
- Child and Adolescent Neuropsychiatry Service, AUSL Modena, 41124 Modena, Italy
| | - Erika Benassi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
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46
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Kajiwara S, Akiyama N, Baba H, Ohta M. Association between COVID-19 vaccines and the menstrual cycle in young Japanese women. J Infect Chemother 2023; 29:513-518. [PMID: 36623727 PMCID: PMC9822555 DOI: 10.1016/j.jiac.2023.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 12/29/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Although several studies have investigated the association between coronavirus disease 2019 (COVID-19) vaccines and the menstrual cycle, available data are limited. Therefore, this study investigated the effect of COVID-19 vaccines on the menstrual cycle and the effect of the menstrual cycle phase on the vaccine side effects during vaccine administration in Japan. METHODS A self-administered questionnaire was used to collect data on the date of vaccination; type of vaccine; type, grade, and duration of the side effects; regularity of menstruation; normal length of the menstrual cycle; and the day one date of menstruation around vaccination. The survey was conducted from October 2021 to March 2022. RESULTS The difference between the predicted and actual menstrual cycle length was 1.9 ± 3.0, 1.6 ± 2.8 (p = 0.557), and 2.5 ± 3.8 (p = 0.219) days before vaccination and after the first and second dose of the vaccine, respectively. In participants who received vaccinations twice within a single menstrual cycle, this difference was 1.3 ± 3.5 and 3.9 ± 3.3 (p = 0.045) days before and after vaccination, respectively. The grade and proportion of the side effects after the second dose of the vaccine was highest during the menstrual period and lowest during the ovulation period, with a significant effect on headache and chills. CONCLUSION COVID-19 vaccines tended to prolong the menstrual cycle. The side effects of the COVID-19 vaccine tended to be at a maximum when vaccination occurred during the menstrual period and minimal during the ovulation period.
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Affiliation(s)
- Shihoko Kajiwara
- School of Nursing, Gifu University of Health Science, 2-92 Higashiuzura, Gifu-city, Gifu, 500-8281, Japan.
| | - Naomi Akiyama
- School of Nursing, Gifu University of Health Science, 2-92 Higashiuzura, Gifu-city, Gifu, 500-8281, Japan
| | - Hisashi Baba
- Center for Nutrition Support and Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu-city, Gifu, 501-1194, Japan
| | - Michio Ohta
- School of Rehabilitation, Gifu University of Health Science, 2-92 Higashiuzura, Gifu-city, Gifu, 500-8281, Japan
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47
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Molina-López A, Ocón Hernández O, Baena García L. [Association of SARS-CoV-2 infection and administration of COVID-19 vaccines with alterations in the menstrual cycle. Literature review]. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2023; 50:100822. [PMID: 36337070 PMCID: PMC9618423 DOI: 10.1016/j.gine.2022.100822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
A number of factors can affect a woman's menstrual cycle, including diseases or drugs, such as COVID-19 disease and vaccinations. The aim of this review is to explore the studies published to date that have studied the presence of alterations that may be related to COVID-19 or vaccination against the SARS-CoV-2 virus.We conducted a review in the PubMed database, selecting 10 articles in which the menstrual cycle of adult women of childbearing age was studied, 3 of them in which the participants had been diagnosed with COVID-19 and 7 in which the participants had been vaccinated against the SARS-CoV-2 virus.Regarding COVID-19-related disturbances, 16%-47.2% of the participants presented a prolongation of their cycle, which was more frequent in those who reported more COVID-19 symptoms, and which normalised after 1-2 cycles.Regarding the alterations described after SARS-CoV-2 vaccination, 45%-78% of participants reported menstrual cycle alterations, with disparate results for the different parameters analysed, except that the alterations resolved in about 2 months.Both COVID-19 disease and vaccination appear to be associated with the occurrence of menstrual disturbances, which are limited in time and not severe. However, studies are scarce to date, and it is important to continue to develop studies that provide scientific evidence.
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Affiliation(s)
- A. Molina-López
- UGC Ginecología y Obstetricia Hospital Universitario San Cecilio, Granada, España,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, España
| | - O. Ocón Hernández
- UGC Ginecología y Obstetricia Hospital Universitario San Cecilio, Granada, España,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, España,Autor para correspondencia
| | - L. Baena García
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, España,Departamento de Enfermería, Facultad de Ciencias de la Salud, Ceuta, España
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48
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Najjar M, Albuaini S, Fadel M, Mohsen F. Covid-19 vaccination reported side effects and hesitancy among the Syrian population: a cross-sectional study. Ann Med 2023; 55:2241351. [PMID: 37544017 PMCID: PMC10405764 DOI: 10.1080/07853890.2023.2241351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/23/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Studying post-vaccination side effects and identifying the reasons behind low vaccine uptake are pivotal for overcoming the pandemic. METHODS This cross-sectional study was distributed through social media platforms and face-to-face interviews. Data from vaccinated and unvaccinated participants were collected and analyzed using the chi-square test, multivariable logistic regression to detect factors associated with side effects and severe side effects. RESULTS Of the 3509 participants included, 1672(47.6%) were vaccinated. The most common reason for not taking the vaccine was concerns about the vaccine's side effects 815(44.4). The majority of symptoms were mild 788(47.1%), followed by moderate 374(22.3%), and severe 144(8.6%). The most common symptoms were tiredness 1028(61.5%), pain at the injection site 933(55.8%), and low-grade fever 684(40.9%). Multivariable logistic regression analysis revealed that <40 years (vs. ≥40; OR: 2.113, p-value = 0.008), females (vs. males; OR: 2.245, p-value< .001), did not receive influenza shot last year (vs. did receive Influenza shot last year OR: 1.697, p-value = 0.041), AstraZeneca (vs. other vaccine brands; OR: 2.799, p-value< .001), co-morbidities (vs. no co-morbidities; OR: 1.993, p-value = 0.008), and diabetes mellitus (vs. no diabetes mellitus; OR: 2.788, p-value = 0.007) were associated with severe post-vaccine side effects. Serious side effects reported were blood clots 5(0.3%), thrombocytopenia 2(0.1%), anaphylaxis 1(0.1%), seizures 1(0.1%), and cardiac infarction 1(0.1%). CONCLUSION Our study revealed that most side effects reported were mild in severity and self-limiting. Increasing the public's awareness of the nature of the vaccine's side effects would reduce the misinformation and improve the public's trust in vaccines. Larger studies to evaluate rare and serious adverse events and long-term side effects are needed, so people can have sufficient information and understanding before making an informed consent which is essential for vaccination.
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Affiliation(s)
- Michel Najjar
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Sara Albuaini
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Mohammad Fadel
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Damascus, Syria
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Ponjoan A, Jacques-Aviñó C, Medina-Perucha L, Romero V, Martí-Lluch R, Alves-Cabratosa L, Ramos R, Berenguera A, Garcia-Gil MDM. Axes of social inequities in COVID-19 clinical trials: A systematic review. Front Public Health 2023; 11:1069357. [PMID: 36891333 PMCID: PMC9987589 DOI: 10.3389/fpubh.2023.1069357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
Objective The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19 vaccines to assess the reporting of age, sex, gender identity, race, ethnicity, obesity, sexual orientation, and socioeconomic status in the results (description of the participants' characteristics, loss of follow-up, stratification of efficacy and safety results). Methods We searched the following databases for randomized clinical trials published before 1st February 2022: PubMed, Scopus, Web of Science, and Excerpta Medica. We included peer-reviewed articles written in English or Spanish. Four researchers used the Rayyan platform to filter citations, first reading the title and abstract, and then accessing the full text. Articles were excluded if both reviewers agreed, or if a third reviewer decided to discard them. Results Sixty three articles were included, which assessed 20 different vaccines, mainly in phase 2 or 3. When describing the participants' characteristics, all the studies reported sex or gender, 73.0% race, ethnicity, 68.9% age groups, and 22.2% obesity. Only one article described the age of participants lost to follow-up. Efficacy results were stratified by age in 61.9%, sex or gender in 26.9%, race and/or, ethnicity in 9.5%, and obesity in 4.8% of the articles. Safety results were stratified by age in 41.0%, and by sex or gender in 7.9% of the analysis. Reporting of gender identity, sexual orientation or socioeconomic status of participants was rare. Parity was reached in 49.2% of the studies, and sex-specific outcomes were mentioned in 22.9% of the analysis, most of the latter were related to females' health. Conclusions Axes of social inequity other than age and sex were hardly reported in randomized clinical trials that assessed COVID-19 vaccines. This undermines their representativeness and external validity and sustains health inequities.
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Affiliation(s)
- Anna Ponjoan
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Constanza Jacques-Aviñó
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Laura Medina-Perucha
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Victor Romero
- Servicio Canario de la Salud, Santa Cruz de Tenerife, Spain
| | - Ruth Martí-Lluch
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lia Alves-Cabratosa
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
| | - Rafel Ramos
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Department of Medical Sciences, School of Medicine, Universitat de Girona, Girona, Spain
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain.,Department of Nursing, Universitat de Girona, Girona, Spain
| | - María Del Mar Garcia-Gil
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
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50
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Matar SG, Nourelden AZ, Assar A, Bahbah EI, Alfryjat AM, Hasabo EA, Matar SA, Bishtawi SN, Alhoubani M, Yahia AB, Ragab KM, Salameh LM, Salameh LSE, Zaazouee MS, Al‐kafarna M, Elshanbary AA, Almadhoon HW, Bakdash ST, Adam OAB, Malih AN, Habash SAE, Basiouny RMT, Ahmad A, Hamid RMA, Habib BY, Elokl DN, Abdalraheem HH, Atia EA, Yousif NIA, Al‐Ali FH, Alshaer IM, Abdulali FE, Ayesh HA, Jabari AY, Egzait RA, Munshar NAA, Alkhraibat AA, ibreerah AH, Basheti IA. Effect of COVID-19 vaccine on menstrual experience among females in six Arab countries: A cross sectional study. Influenza Other Respir Viruses 2022; 17:e13088. [PMID: 36578138 PMCID: PMC9835440 DOI: 10.1111/irv.13088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/29/2022] [Accepted: 12/04/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There have been varying reports on the potential occurrence and severity of changes to menstruation including the median cycle length, days of bleeding, bleeding heaviness, and menstrual pain, following receipt of COVID-19 vaccinations. We aimed to assess potential postvaccination menstrual changes in women residing in the Middle East. METHODS We implemented a cross-sectional online survey-based study. Data about the participants' demographic characteristics, menstruation experience, and vaccination status were collected and analyzed among six Arab countries. RESULTS Among 4942 menstruating females included in this study, females who had received one or more doses of COVID-19 vaccination reported a higher frequency of back pain, nausea, tiredness, pelvic pain with periods, unprescribed analgesics use, and passage of loose stools. They also reported higher scores describing average and worst menstrual pain. Fully vaccinated females reported heavier flow and more days of bleeding. CONCLUSION Our findings indicate that COVID-19 vaccine may have an effect on menstruation in terms of menstrual pain and bleeding heaviness. The evidence needs to be further investigated in longitudinal studies.
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Affiliation(s)
- Sajeda Ghassan Matar
- International Medical Research Association (IMedRA)CairoEgypt,School of PharmacyApplied Science Private UniversityAmmanJordan
| | - Anas Zakarya Nourelden
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar UniversityCairoEgypt
| | - Ahmed Assar
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMenoufia UniversityShebin El‐KomEgypt
| | | | | | - Elfatih A. Hasabo
- International Medical Research Association (IMedRA)CairoEgypt,Department of Anatomy, Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | - Suzan A. Matar
- Department of Clinical Laboratory SciencesThe University of Jordan, School of ScienceAmmanJordan
| | | | | | | | - Khaled Mohamed Ragab
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMinia UniversityMiniaEgypt
| | | | | | - Mohamed Sayed Zaazouee
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar UniversityAssuitEgypt
| | - Mohammed Al‐kafarna
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyAl‐Azhar University – GazaGaza StripPalestine
| | - Alaa Ahmed Elshanbary
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Hossam Waleed Almadhoon
- International Medical Research Association (IMedRA)CairoEgypt,Institute of Biodiversity, One Health and Veterinary MedicineUniversity of GlasgowGlasgowUK
| | - Shahed Toulaq Bakdash
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineKalamoon UniversityRif‐DimashqSyria
| | - Ola Awad Babiker Adam
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Neelain UniversityKhartoumSudan
| | - Abdelkader Nabeel Malih
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineKalamoon UniversityRif‐DimashqSyria
| | - Shimaa Abo elfotoh Habash
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTanta UniversityTantaEgypt
| | - Rakia Mohamed Taha Basiouny
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineOctober 6 UniversityGizaEgypt
| | - Afaf Ahmad
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineDamascus UniversityDamascusSyria
| | - Raghda Mohammed Ahmed Hamid
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyUniversity of KhartoumKhartoumSudan
| | - Balsam Younan Habib
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTartus UniversityTartus CitySyria
| | - Dalia Nasr Elokl
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTanta UniversityTantaEgypt
| | - Hiba Hatim Abdalraheem
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyAl‐Neelain UniversityKhartoumSudan
| | - Esraa Adel Atia
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar UniversityDamiettaEgypt
| | - Nazik Ibrahim Ahmed Yousif
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | - Fida Hussien Al‐Ali
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicinePalestine Polytechnic University‐ HebronWest BankPalestine
| | - Israa Mohammed Alshaer
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineTripoli UniversityTripoliLibya
| | - Fatima Elsidieg Abdulali
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMisurata UniversityMisurataLibya
| | - Hadil Abu Ayesh
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineAl‐Azhar University – GazaGaza StripPalestine
| | - Anwar Yousef Jabari
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicinePalestine Polytechnic University‐ HebronWest BankPalestine
| | - Raneem Ahmed Egzait
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMisurata UniversityMisurataLibya
| | - Nameer Amer Abu Munshar
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicinePalestine Polytechnic University‐ HebronWest BankPalestine
| | - Aseel Ahmad Alkhraibat
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of PharmacyJordan University of Science and TechnologyIrbidJordan
| | - Aisha Hasan ibreerah
- International Medical Research Association (IMedRA)CairoEgypt,Faculty of MedicineMisurata UniversityMisurataLibya
| | - Iman A. Basheti
- Department of Clinical Pharmacy and TherapeuticsFaculty of Pharmacy Applied Science Private UniversityAmmanJordan,Faculty of PharmacyThe University of SydneySydneyAustralia
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