Wang Wei, Si Manfei, Qi Xinyu, Hu Hongxia, Sun Xiaole, Liang Juyan, Zhou Jianghua, Bi Xianmin, Zhao Wei, Wang Yuanyuan, Yan Liying, Li Rong, Chen Wei, Qiao Jie
Department of Obstetrics and Gynecology Peking University Third Hospital Beijing China.
National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital) Beijing China.
MedComm (2020). 2025 Jun 11;6(6):e70240. doi: 10.1002/mco2.70240. eCollection 2025 Jun.
Menstruation is a key indicator of female reproductive health, yet clinical features and underlying mechanisms associated with menstrual changes following the coronavirus disease 2019 (COVID-19) infection remain unclear. Here, we recruited 253 participants through questionnaires, and 73 individuals underwent metabolomic analysis of blood serum. Over 60% reported menstrual changes, primarily experiencing longer cycle and lighter bleeding, which were significantly associated with age, general medical conditions, perceived stress, anxiety scores, and depression scores, as well as COVID-19 symptoms including fatigue and headache. General medical conditions were the sole independent risk factor for any menstrual changes. Metabolomic analysis highlighted disturbances in steroid hormone biosynthesis. We identified 52 significantly differential metabolites between groups with and without any menstrual changes (AnyC vs. NoC), with high discrimination achieved by combining phenylglyoxylic acid, PC O-40, traumatic acid, and estrone sulfate. Furthermore, several significantly upregulated metabolites were closely correlated with estradiol (E) levels, including estrone sulfate, which was also positively correlated with T levels. Specifically, T levels decreased with recovery duration in the AnyC group ( = 0.0015). Collectively, our findings uncovered key clinical factors and metabolic disruptions in menstrual changes, underscoring potential adverse long-term effects of COVID-19 on women's health.
月经是女性生殖健康的关键指标，但2019冠状病毒病（COVID-19）感染后月经变化相关的临床特征和潜在机制仍不清楚。在此，我们通过问卷调查招募了253名参与者，其中73人接受了血清代谢组学分析。超过60%的人报告有月经变化，主要表现为月经周期延长和出血量减少，这与年龄、一般健康状况、感知压力、焦虑评分和抑郁评分以及COVID-19症状（包括疲劳和头痛）显著相关。一般健康状况是任何月经变化的唯一独立危险因素。代谢组学分析突出了类固醇激素生物合成的紊乱。我们在有月经变化和无月经变化的组之间（有变化组与无变化组）鉴定出52种显著差异代谢物，通过组合苯甲酰甲酸、PC O-40、创伤酸和硫酸雌酮实现了高辨别力。此外，几种显著上调的代谢物与雌二醇（E）水平密切相关，包括硫酸雌酮，其也与睾酮（T）水平呈正相关。具体而言，有变化组中T水平随恢复持续时间下降（ = 0.0015）。总体而言，我们的研究结果揭示了月经变化中的关键临床因素和代谢紊乱，强调了COVID-19对女性健康潜在的长期不良影响。
