A new study involving researchers from the Hospital Santa Creu i Sant Pau in Barcelona has concluded that Covid-19 infection, its intensity or duration is not the reason why some women had alterations in their menstrual cycle during confinement, but rather it was stress and changes in emotional state that significantly influenced menstrual disorders during confinement due to Covid-19.
During lockdown, for most women, staying at home brought with it inconveniences such as having to look after their children 24 hours a day, seven days a week, manage household responsibilities, share a small space with the whole family, live with their partner 24 hours a day and have to fit in online work.
At the same time, a smaller proportion of society was involved in so-called “essential” activities: most significantly, the provision of health care, but also public transport, dispensing pharmaceuticals, accessing food and essential health items in supermarkets, etc. For this subset, exposure to the public implied a higher risk of contagion.
Fear of carrying the disease
This risk combined the fear of bringing the disease into the family environment and contaminating their loved ones with work overload, and some chose to forgo contact with their families. Overload was especially relevant among healthcare providers caring for people with COVID-19. This group included doctors, nurses, cleaning and transport staff at the hospital or primary care centre, and caregivers in nursing homes. In addition, for many people, the confinement process involved temporary or permanent job loss or a significant decrease in income.
All these circumstances constitute relevant stressors that negatively impact the psychological well-being of the confined population and, as a consequence, alter the menstrual cycle of women.
To clarify the existence of these menstrual changes and their importance and characteristics, researchers conducted an online survey of menstruating women who experienced different situations during the COVID-19 lockdown in Spain.
Online survey of menstruating women
In Spain, an online survey was administered to menstruating women aged 15–55 years who had not contracted COVID-19. It collected information on activities during confinement, sexual activity, perceptions of emotional state, changes in menstrual characteristics, and the impact on quality of life. Analysis of menstrual changes was limited to respondents who did not use hormonal contraceptives.
A total of 6,449 women responded to the survey, and 4,989 surveys were valid for the final analysis. 92.3 percent of women had at least one menstruation during lockdown, while 7.7 percent had amenorrhea. Menstruation-related quality of life (QoL) worsened in 19 percent of women, did not change in 71.7 percent, and improved in 1.6 percent. For 50.1 percent of women, overall QoL worsened during lockdown, with 41.3 percent remaining about the same and 8.7 percent reporting an improvement.
Stressors of confinement
Sexual activity during lockdown decreased in 49.8 percent of respondents, remained unchanged in 40.7 percent, and increased in 9.5 percent. Regarding menstrual changes, there were no statistically significant differences in the incidence of amenorrhea, menstrual cycle regularity, or the amount or duration of menstrual bleeding in non-hormonal contraceptive users when assessed by duration and characteristics of isolation, perception of exposure to COVID-19, and economic or employment status.
On the contrary, statistically significant differences were found depending on the intensity of changes in emotional state due to the stressors of confinement and changes in the regularity, duration and heaviness of menstruation.
