Department of Obstetrics and Gynecology, University Hospital Ulm, Ulm, Germany.
Int J Gynaecol Obstet. 2023 Nov;163(2):445-452. doi: 10.1002/ijgo.15060. Epub 2023 Aug 28.
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.
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.
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.
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.
有报道称，感染 SARS-CoV-2 及其疫苗后会出现月经周期异常，但现有数据非常多样化，无法反映月经周期的变化或地域差异，也缺乏其相关的风险因素。
我们于 2021 年 3 月 1 日至 31 日在德国乌尔姆大学医院对 6383 名员工和学生进行了一项基于调查的研究。在接种 SARS-CoV-2 疫苗（第一、二、三次接种或感染）前后，将月经周期的特征（周期长度[CL]、经期持续时间[MD]和出血量[BV]）报告为分类变量。此外，还评估了周期变化的潜在风险因素，所有参与者均报告了对变化的主观感知、变化的持续时间和发生时间。
最终分析纳入了 1726 名参与者。接种疫苗后 CL 和 BV 明显改变，但 MD 没有改变。主观感知与客观变化只有轻微的一致性，CL 的 Cohen's kappa 值最高。CL 变化的风险因素为既往周期不规则，BV 变化的风险因素为年龄和体重指数。疫苗组合（同源或异源）和不同类型的免疫接种（感染和接种）对周期不规则没有显著影响。
总之，接种 SARS-CoV-2 疫苗会引起月经周期特征的改变，这些改变大多是暂时的。个体风险因素而不是免疫接种类型会影响上述变化。
