Guideline Lifestyle changes caused the shift in the menstrual cycle during the COVID-19 pandemic

A new study finds menstrual cycle irregularities during the pandemic could be linked to shifts in behaviour & lifestyle rather than the virus itself. The study, led by researchers from Imperial College London, including Prof Phillip Bennett who is NIHR Imperial BRC Pregnancy and Prematurity Theme Lead, has shed light on the effects of the COVID-19 pandemic on women’s menstrual cycles. The research, the largest of its kind, uncovers a significant correlation between the pandemic and changes in menstrual cycle characteristics, hormonal symptoms and lifestyle habits. The findings suggest that these changes are more closely related to behavioural shifts prompted by the pandemic rather than the virus itself.

Conducted during the global COVID-19 crisis, the research aimed to investigate the impact of the pandemic on the menstrual cycles of unvaccinated women. While the virus’s direct impact on menstrual health has previously been found to be limited, this study sought to uncover whether broader societal and lifestyle changes during the pandemic might have played a role.

The study employed a retrospective online cross-sectional survey completed by social media users between July 2020 and October 2020. The participants, all residing in the United Kingdom (UK), were premenopausal and over 18 years old.

15,611 social media users participated in the survey, providing a robust dataset for analysis. An overwhelming 75% of the participants reported experiencing changes in their menstrual cycles during the pandemic. The most common changes were:

• Irregular Cycles: A significantly higher proportion of respondents reported irregular menstrual cycles.
• Extended Bleeding: Many participants experienced bleeding episodes lasting more than seven days, leading to longer overall cycle lengths.
• Hormonal Symptoms: Over half of the respondents reported worsening premenstrual symptoms, including low mood, depression, anxiety, and irritability.

Strikingly, the study found that these changes were not significantly different between individuals who had contracted COVID-19 and those who hadn’t.

Including menstrual health considerations in the pandemic recovery plans

The research underscores the far-reaching effects of the pandemic on women’s health beyond the direct medical impact of the virus. The observed menstrual cycle irregularities and hormonal symptoms were primarily attributed to shifts in behaviour and lifestyle during the pandemic rather than the virus itself.

The implications of these findings extend beyond personal well-being. The economic prosperity of a nation is closely tied to the health of its women, a fact highlighted in the United Nations Secretary General’s 2030 Agenda for Sustainable Development. This study’s results suggest that addressing women’s health concerns and gender inequalities should be integral to pandemic recovery strategies.

Speaking about the implication of the findings, Dr Anita Mitra, first author and Clinical Lecturer from the Department of Metabolism, Digestion and Reproduction, said: “While menstrual cycle irregularities might seem inconsequential, they can have far-reaching consequences, affecting the economy, healthcare systems, and population levels. The data strongly supports the inclusion of menstrual health considerations in the pandemic recovery plans developed by governments, healthcare providers, and employers. Furthermore, addressing these health disparities is vital for achieving broader goals of health equity and sustainable development.”

Dr Srdjan Saso, senior author and Honorary Clinical Senior Lecturer also from the Department of Metabolism, Digestion and Reproduction, said: “The COVID-19 pandemic resulted in considerable variation in menstrual cycle characteristics and hormonal symptoms. It appears from our research and the news cycles that this is an area which has been overlooked and sometimes ignored. Menstrual cycle issues can bring about long-term physical, psychological and fertility consequences, which may have far-reaching implications on a personal and societal level.

“The pandemic casts a wide shadow on our healthcare systems; however, more equitable treatment of women should be a normality, and can only happen with adequate early education brought in at a national and international level.”

This study offers a pioneering insight into the intricate interplay between a global crisis like the COVID-19 pandemic and women’s menstrual health. By highlighting the importance of including women’s health in recovery strategies, the research paves the way for a more holistic and comprehensive approach to post-pandemic rebuilding.