The association of the severity of Omicron with menstrual and premenstrual syndrome among reproductive age women in China: a cross-sectional study

Abstract

This study aimed to investigate changes in menstruation and the association of the severity of Omicron with menstruation after the
nationwide outbreak of COVID-19 in China. A cross-sectional study adopted an electronic questionnaire to conduct an anonymous
online survey. The survey targeted women of reproductive age who had been infected with SARS-CoV-2, and were menstruating
regularly in the six months prior to the infection, and experienced at least one menstrual cycle after the infection. The 737 included
participants were divided into mild and severe groups based on the severity of the infection. Deviations in first menstrual cycle postinfection were reported in 46.4% of participants (mild group 40.1% vs. severe group 55.2%, P<0.05). Menstrual changes were
predominantly a late menstrual period (mild group 25.3% vs. severe group 30.4%), a shorter duration of menstrual flow (mild group
10.4% vs. severe group 14.7%), and a decrease in menstrual flow volume (mild group 16% vs. severe group 21.6%). Premenstrual
syndrome symptoms in a small number of women were worse compared with pre-infection, especially in the severe group. During
the second menstrual period after infection, most participants reported their menstrual characteristics had returned to those of preinfection (mild group 88% vs. severe group 80.2%, P<0.05). In this investigation, SARS-CoV-2 infection had a substantial effect
on women's menstrual characteristics, and the changes were mostly transient. Women with more severe COVID-19 symptoms
experienced more significant changes. The potential long-term effects of SARS-CoV-2 on female reproductive health require further
observation and research.