A recent study published by researchers from the Reproductive Health Group of the Sant Pau Research Institute (IR Sant Pau) and the Gynecology and Obstetrics Service of Sant Pau Hospital concludes that there is a clearly direct and significant relationship between the intensity of changes in emotional state due to stress factors during the COVID-19 pandemic lockdown and the incidence of menstrual changes: regularity, duration, and amount of menstruation. The research, published in the journal Medicina Clínica, was conducted based on the responses of more than 6,000 women to a survey and is one of the most extensive studies carried out so far on the impact of the pandemic on Reproductive health.
“Changes in emotional state, but not the duration and intensity of isolation or exposure to the disease, significantly influenced menstrual disorders during the COVID-19 lockdown,” explains Dr. Joaquim Calaf, director of the Reproductive Health Group at IR Sant Pau and Honorary Professor at the Autonomous University of Barcelona (UAB). “Women who experienced greater emotional stress during the lockdown, whether due to restrictions on activities, fear of getting sick, or concern about infecting their relatives, showed an increase in menstrual cycle alterations,” according to Dr. Josep Perelló, from the Reproductive Health Group at IR Sant Pau and adjunct of the Gynecology and Obstetrics Service at Sant Pau Hospital.
The results were obtained from anonymous surveys of women who had menstruation between the ages of 15 and 55 residing in Spain between March 14 and May 2, 2020, with 22 questions related to sociodemographic characteristics and social and work activities; psychological state and sexual activity; and menstrual changes and impact on quality of life during the lockdown. In total, 4,989 survey responses were analyzed.
According to the researchers, in crisis situations like the pandemic, it is essential to consider the impact of emotional well-being on women’s physical health, particularly in aspects such as menstruation, which can be strongly influenced by stress. Moreover, they state that this study opens the door to future research that could help better understand the relationship between mental health and reproductive health, and also to design more effective interventions to support women in times of crisis.
Other results obtained in this study are that 50.1% of women reported a worsening of their quality of life during the lockdown and that 19% indicated that their quality of life associated with menstruation worsened. Furthermore, 49.8% of participants reported a decrease in sexual activity during this period.
In a previous study, the Reproductive Health Group of IR Sant Pau also found that there is an association between the menstrual cycle phase at the time of vaccination and changes in the duration of the menstrual cycle. According to Dr. Calaf, “vaccination during the luteal phase, that is, between ovulation and the first day of menstruation, would have a protective effect on the action of the COVID-19 vaccine and the induction of menstrual cycle disorders, compared to vaccination during the follicular phase, that is, before ovulation.” Both Dr. Calaf and Dr. Perelló point out that the results “suggest considering the menstrual cycle phase for the design of future COVID-19 vaccination policies and vaccination recommendations during the luteal phase.”
Specifically, the researchers observed that women who were vaccinated during the follicular phase had an average increase in cycle duration of one day, while those vaccinated during the luteal phase did not experience any increase. Moreover, in the group of women vaccinated in the follicular phase, 11% experienced an increase in menstrual cycle duration of more than 8 days, a clinically significant value.
This study, published in the American Journal of Obstetrics and Gynecology and developed jointly by researchers from Sant Pau, IIIA-CSIC, the University of Geneva (Switzerland), and the Catalan Agency for Health Quality and Evaluation (AQuAS), was conducted using data collected by the Lunar App.3 mobile cycle tracking app, which allows for a review of the cycle and menstruation, recording the start and end and other data such as pain intensity, amount of blood loss, and COVID-19 vaccination status. The analyzed database included 28,876 women and 126,529 cycles.
Calaf, J. Perelló-Capó, I. Gich-Saladich et al. Effects of SARS-COVID-19 lockdown on menstrual patterns: A transversal large sample survey. Medicina Clínica 2024. Jun, Vol. 162, Issue 12, P. 581-587. https://doi.org/10.1016/j.medcli.2024.01.016
