Effects of SARS‐CoV‐2 infection and COVID‐19 pandemic on menstrual health of women: A systematic review

BACKGROUND: The menstrual cycle in women is the main indicator of their reproductive health which is affected by the ongoing coronavirus disease 2019 (COVID‐19) pandemic. This review aims to summarize the effects of the COVID‐19 infection and the global pandemic on the menstrual health of women. METHODS: The literature search was conducted in PubMed, Cochrane library, and Google Scholar using keywords “COVID‐19,” “Menstrual Cycle,” “Menstrual Cycle Irregularities,” “Amenorrhea,” “Polymenorrhea,” and “Dysmenorrhea.” The articles were selected according to the following inclusion criteria: (i) cross‐sectional studies, (ii) cohort studies, (iii) surveys, and (iv) other observational studies observing the effects of SARS‐CoV‐2 infection or COVID‐19 pandemic on menstrual health of women. Exclusion criteria included: case reports, gray literature, and website articles regarding menstrual health. RESULTS: A total of 30,510 articles were shortlisted after a comprehensive search. Sixteen articles were included out of which 13 studies investigated the effects of the COVID‐19 pandemic on the menstrual cycle while 3 evaluated the possible effects of COVID‐19 infection on the menstrual health of women. Menstrual disorders or irregularities were a more common finding during the pandemic as compared to before (p = 0.008). Women affected by pandemic‐related stress were more prone to changes in the duration of their menses (p = 0.0008), reported heavier bleeding (p = 0.028), and increased incidence of painful periods (p < 0.0001). COVID‐19 infected women also reported changes in their menstrual cycle including irregular menstruation, increased symptoms of premenstrual syndrome, and infrequent menstruation. CONCLUSIONS: Women suffering from COVID‐19 infection or pandemic‐associated stress and anxiety were more likely to experience irregular menstruation, dysmenorrhea, amenorrhea, and other menstrual abnormalities compared to those who were less exposed.