A retrospective case-control study on menstrual cycle changes following COVID-19 vaccination and disease

There is growing public concern that COVID-19 vaccination leads to menstrual cycle disorders, with regard to the relative effect of vaccination versus SARS-CoV-2 infection. Our objectives were to test potential risk factors for menstrual cycle alteration after COVID-19 vaccination and to compare male parameters after COVID-19 vaccination and COVID-19 disease. We performed a secondary analysis of a retrospective online survey conducted in the UK in March 2021. Among pre-menopausal vaccinated participants (n = 4,989), 18% reported menstrual cycle changes after their first COVID-19 vaccine injec- tion. The prevalence of menstrual changes was higher in women who smoked, had a history of COVID-19-related illness or were not using estradiol-containing contraceptives. In a second sample comprising both vaccinated and unvaccinated participants (n = 12,579), COVID-19 vaccination alone was not associated with abnormal menstrual cycle parameters, while a history of COVID-19 disease was associated with an increased risk of reporting heavier bleeding, "missed" periods and intermenstrual bleeding.