The role of menstrual cycle changes in the evaluation of women

Kristina Saravinovska; Ljiljana Marina; Neda Delic; Sojat Antoan Stefan; Nevena Radonjic; Sladjana Mihajlovic; Milan Lackovic; Ilija Gunjic; Tijana Petkovic; Natalija Antic; Emilija Jankov; Zorana Arizanovic; Miomira Ivovic; Svetlana Vujovic

doi:10.1530/endoabs.99.P146

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Endocrine Abstracts (2024) 99 P146 | DOI: 10.1530/endoabs.99.P146

ECE2024 Poster Presentations Reproductive and Developmental Endocrinology (45 abstracts)

The role of menstrual cycle changes in the evaluation of women’s reproductive, sexual and mental health – lessons learned from the covid-19 pandemic

Kristina Saravinovska ¹ , Ljiljana Marina ¹ , Neda Delic ² , Antoan Stefan Sojat ¹ , Nevena Radonjic ³ , Sladjana Mihajlovic ⁴ , Milan Lackovic ⁴ , Ilija Gunjic ⁵ , Tijana Petkovic ¹ , Natalija Antic ¹ , Emilija Jankov ² , Zorana Arizanovic ¹ , Miomira Ivovic ¹ & Svetlana Vujovic ¹

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¹Clinic of Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, National Centre for Infertility and Endocrinology of Gender, Belgrade, Serbia; ²Faculty of Medicine, University of Belgrade, Belgrade; ³Upstate Medical University, Department of Psychiatry and Behavioral Sciences, Syracuse, United States; ⁴Clinical Hospital Centre "Dragisa Misovic, Department of Obstetrics and Gynecology, Belgrade, Serbia; ⁵Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia

Introduction: It has been shown that women with a previous Sars-CoV-2 infection have long-lasting menstrual cycle (MC) changes.

Aim: To investigate the MC changes and their relationship with women’s reproductive, sexual and mental health disturbances during the COVID-19 pandemic.

Methods: Anonymous survey about reproductive, sexual and mental health was shared with women of reproductive age between May 2022 and November 2023. All women used MC diary while filling out the survey. Surveys were stratified based on RT-PCR/Antigen test Results Positive (CP) or negative (CN). All reported changes in CP referred to time after the Sars-CoV-2 infection and in CN to a pandemic timeframe in general.

Results: 1270 women completed the survey. Based on inclusion, exclusion, and complete data availability 676 surveys were taken into the final analysis. 186/28% CN-mean age 29.8±9.2, mean BMI 22.6±3.8 kg/m², and 490/72% CP, mean age 29.6±9, mean BMI 22.4±3.8 kg/m², no difference in age or BMI between the groups (P>0.05). When compared to CN, 365/74.5% CP had MC changes (P<0.001), with 3 different MC patterns detected. 33/6.7% CP had a triad (TR1) - shortening of MC length (sMC), heavier menstrual bleeding (HMB) and PMS worsening (wPMS) (P=0.003); 25/5.1% CP had a different TR (TR2) - sMC, wPMS and painful menstrual bleeding (pMB) (P=0.006); 17/3.5% CP reported a tetrad (TT) - sMC, HMB, wPMS and pMB (P=0.034). 63/14% CP with MC changes reported decreased libido (P<0.001). When compared to CN, 226/46% CP reported low mood (P<0.001) and 125/25% CP poor sleep (P=0.015). 109/22% CP reported difficulty accessing healthcare as the main stressor (P=0.002). 137/38% CP reported that the MC changes are still present (P<0.001) - mean duration 308 days. 208/47% of all surveys reported being vaccinated which had no effect on MC changes (P>0.05). 244/49.8% CP reported gaining weight with a median of 5 kg which had no effect on MC changes (P>0.05). In CP, TR1 was the predictor of decreased libido (R²0.044, P<0.001, OR 4.25, 95% CI=1.942-9.3) and poor sleep (R²0.02, P=0.008, OR 2.629, 95% CI=1.282-5.390) and TR2 was the predictor of low mood (R²0.026, P=0.004, OR 3.947, 95% CI=1.548-10.062). In CP, Sars-CoV2 was the predictor of MC changes (P<0.0001, B=1.577, OR 4.838; 95% CI=3.29-7.09).

Conclusion: Sars-CoV-2 causes long-term MC changes and patterns associated with low mood, poor sleep, and decreased libido. Tracking MC is an easily accessible tool that provides a simple and cost-effective method, making it easy to detect potential health changes.