Medina-Perucha Laura, López-Jiménez Tomàs, Holst Anna Sofie, Jacques-Aviñó Constanza, Munrós-Feliu Jordina, Martínez-Bueno Cristina, Valls-Llobet Carme, Pinzón-Sanabria Diana, Vicente-Hernández Mª Mercedes, Berenguera Anna
Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.
Int J Womens Health. 2022 Apr 13;14:529-544. doi: 10.2147/IJWH.S354655. eCollection 2022.
Available evidence suggests that there might be an association between the stressors experienced during the COVID-19 syndemic and changes in menstrual patterns. The aim of this study was to assess self-reported menstrual alterations during the COVID-19 syndemic among women and people who menstruate aged 18-55 in Spain.
A cross-sectional online survey-based study was conducted (March-July 2021). Descriptive statistics were calculated and multivariate logistic regression models were constructed. This study was conducted as part of the "Equity and Menstrual Health in Spain" research project.
Among participants (N=17,455), 39.4% reported menstrual alterations since the start of the syndemic. Participants self-reporting long COVID-19 presented higher odds of menstrual alterations (aOR: 1.34, 95% CI, 1.15-1.57). In participants with no history of COVID-19, the risk for self-reported menstrual alterations was significantly higher based on employment situation, among participants experiencing financial issues (eg, financial issues always/many times <12 months: aOR: 1.68, 95% CI, 1.48-1.90), poorer self-perceived health (eg, poor: aOR: 2.00, 95% CI, 1.31-3.07), and those diagnosed with polycystic ovary syndrome (aOR: 1.13, 95% CI, 1.02-1.26). Among participants with a self-reported COVID-19 diagnosis, factors that significantly increased the odds for menstrual alterations were experiencing financial strains (eg, financial issues always/many times <12 months: aOR: 1.53, 95% CI, 1.09-2.14), poorer self-perceived health (eg, poor: aOR: 3.09, 95% CI, 1.01-9.52). Overall, factors that decreased the odds of reporting menstrual alterations included age >25, being a carer, not having a gynecological condition and using hormonal contraception.
Findings suggest an impact of the COVID-19 syndemic on menstrual patterns. Social inequities in reporting menstrual alterations were identified. While the risk of reporting menstrual alterations was higher among participants with long COVID-19, evidence is not conclusive. Further research on menstrual health in the context of COVID-19 is needed, also to inform policy and practice.
现有证据表明，2019冠状病毒病（COVID-19）合并流行期间经历的压力源与月经模式变化之间可能存在关联。本研究的目的是评估西班牙18至55岁的女性和有月经的人群在COVID-19合并流行期间自我报告的月经变化情况。
开展了一项基于在线横断面调查的研究（2021年3月至7月）。计算了描述性统计数据，并构建了多变量逻辑回归模型。本研究是“西班牙的公平与月经健康”研究项目的一部分。
在参与者（N=17455）中，39.4%报告自合并流行开始以来有月经变化。自我报告患有长期COVID-19的参与者出现月经变化的几率更高（调整后比值比：1.34，95%置信区间，1.15-1.57）。在无COVID-19病史的参与者中，根据就业情况、经历财务问题（如财务问题总是/多次<12个月：调整后比值比：1.68，95%置信区间，1.48-1.90）、自我感觉健康状况较差（如差：调整后比值比：2.00，95%置信区间，1.31-3.07）以及被诊断患有多囊卵巢综合征（调整后比值比：1.13，95%置信区间，1.02-1.26），自我报告月经变化的风险显著更高。在自我报告确诊为COVID-19的参与者中，显著增加月经变化几率的因素包括经历财务紧张（如财务问题总是/多次<12个月：调整后比值比：1.53，95%置信区间，1.09-2.14）、自我感觉健康状况较差（如差：调整后比值比：3.09，95%置信区间，1.01-9.52）。总体而言，降低报告月经变化几率的因素包括年龄>25岁、作为护理人员、没有妇科疾病以及使用激素避孕。
研究结果表明COVID-19合并流行对月经模式有影响。确定了在报告月经变化方面的社会不平等现象。虽然长期COVID-19患者报告月经变化的风险较高，但证据并不确凿。需要在COVID-19背景下对月经健康进行进一步研究，也为政策和实践提供信息。
