Infection with SARS-CoV-2 is associated with menstrual irregularities among women of reproductive age

Emily M. Cherenack; Ana S. Salazar; Nicholas F. Nogueira; Patricia Raccamarich; Violeta J. Rodriguez; Alejandro M. Mantero; Allison Marsh; Sophia Gerard; Marissa Maddalon; Deborah L. Jones; Nichole R. Klatt; Maria L. Alcaide

doi:10.1371/journal.pone.0276131

Infection with SARS-CoV-2 is associated with menstrual irregularities among women of reproductive age

Emily M. Cherenack, Ana S. Salazar, Nicholas F. Nogueira, Patricia Raccamarich, Violeta J. Rodriguez, Alejandro M. Mantero, Allison Marsh, Sophia Gerard, Marissa Maddalon, Deborah L. Jones, Nichole R. Klatt, Maria L. Alcaide

Surgery

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14 Scopus citations

Abstract

Background Biological and psychological mechanisms may be responsible for menstrual irregularities occurring among women during the COVID-19 pandemic. Study design From January 2019 to September 2021, women (18- to 45-years-old and not using hormonal contraception) were recruited in Miami-Dade County, Florida. Cross-sectional, self-report surveys collected data on menstrual irregularities, COVID-19 vaccination, stress, depression, and loneliness. A EUA approved rapid test assay using whole blood measured SARS-CoV-2 IgG antibodies. Chi-square and Fisher’s exact tests described menstrual irregularities among women recruited before versus after the start of the COVID-19 pandemic and with detectable versus undetectable SARS-CoV-2 IgG antibodies. A logistic regression examined the relationship between the presence of SARS-CoV-2 IgG antibodies and menstrual irregularities controlling for age, stress, depression, and loneliness. Results Among 182 women enrolled, 73 were enrolled after pandemic onset, and 36 provided vaccination data. Having detectable SARS-CoV-2 IgG antibodies was associated with a higher percentage of menstrual irregularities among unvaccinated women (0% vs. 39%, p = .026) and among all women regardless of vaccination status (31% vs. 5%; p = .005). Adjusting for age and psychological variables, the odds of menstrual irregularities were 7.03 times (95% CI [1.39, 35.60]; p = .019) higher among women with detectable antibodies compared to women without detectable antibodies. Neither enrollment date, age, nor psychological factors were associated to menstrual irregularities. Conclusions Biological mechanisms related to SARS-CoV-2 infection may be responsible for irregular menstruation and should be further examined to mitigate the impact of the COVID-19 pandemic on women’s health.

Original language	English (US)
Article number	e0276131
Journal	PloS one
Volume	17
Issue number	10
DOIs	https://doi.org/10.1371/journal.pone.0276131
State	Published - Oct 2022

Bibliographical note

Funding Information:
Funding: This work was supported by the National Institute of Allergy and Infectious Diseases [grant number R01AI138718 to M. L. A, 1F32AI162229 to E. M. C, www.nih.gov]; Ford Foundation Fellowship to V. J. R [www.fordfoundation.org]; National Institute of Mental Health [grant number R36MH127838 to V. J. R]; the University of Miami Developmental HIV/AIDS Mental Health Research Center funded by the National Institute of Mental Health [grant number P30MH116867]; the Miami Center for AIDS Research (CFAR) at the University of Miami Miller School of Medicine [grant number P30AI1073961] supported by National Institute of Allergy and Infectious Diseases; National Cancer Institute; National Institute of Child Health and Human Development; National Heart, Lung and Blood Institute; National Institute of Drug Abuse; National Institute on Minority Health and Health Disparities; National institute on Aging; National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Dental and Craniofacial Research; National Institute of Mental Health; National Institute of Nursing Research; National Institute of General Medical Sciences; and Office of the Director. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 Cherenack et al.

Keywords

Female
Humans
Adolescent
Young Adult
Adult
Middle Aged
SARS-CoV-2
Pandemics
COVID-19/epidemiology
Cross-Sectional Studies
COVID-19 Vaccines
Menstruation Disturbances/epidemiology
Immunoglobulin G
Antibodies, Viral

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1371/journal.pone.0276131

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Cherenack, E. M., Salazar, A. S., Nogueira, N. F., Raccamarich, P., Rodriguez, V. J., Mantero, A. M., Marsh, A., Gerard, S., Maddalon, M., Jones, D. L., Klatt, N. R., & Alcaide, M. L. (2022). Infection with SARS-CoV-2 is associated with menstrual irregularities among women of reproductive age. PloS one, 17(10), Article e0276131. https://doi.org/10.1371/journal.pone.0276131

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title = "Infection with SARS-CoV-2 is associated with menstrual irregularities among women of reproductive age",

abstract = "Background Biological and psychological mechanisms may be responsible for menstrual irregularities occurring among women during the COVID-19 pandemic. Study design From January 2019 to September 2021, women (18- to 45-years-old and not using hormonal contraception) were recruited in Miami-Dade County, Florida. Cross-sectional, self-report surveys collected data on menstrual irregularities, COVID-19 vaccination, stress, depression, and loneliness. A EUA approved rapid test assay using whole blood measured SARS-CoV-2 IgG antibodies. Chi-square and Fisher{\textquoteright}s exact tests described menstrual irregularities among women recruited before versus after the start of the COVID-19 pandemic and with detectable versus undetectable SARS-CoV-2 IgG antibodies. A logistic regression examined the relationship between the presence of SARS-CoV-2 IgG antibodies and menstrual irregularities controlling for age, stress, depression, and loneliness. Results Among 182 women enrolled, 73 were enrolled after pandemic onset, and 36 provided vaccination data. Having detectable SARS-CoV-2 IgG antibodies was associated with a higher percentage of menstrual irregularities among unvaccinated women (0% vs. 39%, p = .026) and among all women regardless of vaccination status (31% vs. 5%; p = .005). Adjusting for age and psychological variables, the odds of menstrual irregularities were 7.03 times (95% CI [1.39, 35.60]; p = .019) higher among women with detectable antibodies compared to women without detectable antibodies. Neither enrollment date, age, nor psychological factors were associated to menstrual irregularities. Conclusions Biological mechanisms related to SARS-CoV-2 infection may be responsible for irregular menstruation and should be further examined to mitigate the impact of the COVID-19 pandemic on women{\textquoteright}s health.",

keywords = "Female, Humans, Adolescent, Young Adult, Adult, Middle Aged, SARS-CoV-2, Pandemics, COVID-19/epidemiology, Cross-Sectional Studies, COVID-19 Vaccines, Menstruation Disturbances/epidemiology, Immunoglobulin G, Antibodies, Viral",

author = "Cherenack, {Emily M.} and Salazar, {Ana S.} and Nogueira, {Nicholas F.} and Patricia Raccamarich and Rodriguez, {Violeta J.} and Mantero, {Alejandro M.} and Allison Marsh and Sophia Gerard and Marissa Maddalon and Jones, {Deborah L.} and Klatt, {Nichole R.} and Alcaide, {Maria L.}",

note = "Funding Information: Funding: This work was supported by the National Institute of Allergy and Infectious Diseases [grant number R01AI138718 to M. L. A, 1F32AI162229 to E. M. C, www.nih.gov]; Ford Foundation Fellowship to V. J. R [www.fordfoundation.org]; National Institute of Mental Health [grant number R36MH127838 to V. J. R]; the University of Miami Developmental HIV/AIDS Mental Health Research Center funded by the National Institute of Mental Health [grant number P30MH116867]; the Miami Center for AIDS Research (CFAR) at the University of Miami Miller School of Medicine [grant number P30AI1073961] supported by National Institute of Allergy and Infectious Diseases; National Cancer Institute; National Institute of Child Health and Human Development; National Heart, Lung and Blood Institute; National Institute of Drug Abuse; National Institute on Minority Health and Health Disparities; National institute on Aging; National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Dental and Craniofacial Research; National Institute of Mental Health; National Institute of Nursing Research; National Institute of General Medical Sciences; and Office of the Director. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2022 Cherenack et al.",

year = "2022",

month = oct,

doi = "10.1371/journal.pone.0276131",

language = "English (US)",

volume = "17",

journal = "PloS one",

issn = "1932-6203",

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TY - JOUR

T1 - Infection with SARS-CoV-2 is associated with menstrual irregularities among women of reproductive age

AU - Cherenack, Emily M.

AU - Salazar, Ana S.

AU - Nogueira, Nicholas F.

AU - Raccamarich, Patricia

AU - Rodriguez, Violeta J.

AU - Mantero, Alejandro M.

AU - Marsh, Allison

AU - Gerard, Sophia

AU - Maddalon, Marissa

AU - Jones, Deborah L.

AU - Klatt, Nichole R.

AU - Alcaide, Maria L.

N1 - Funding Information: Funding: This work was supported by the National Institute of Allergy and Infectious Diseases [grant number R01AI138718 to M. L. A, 1F32AI162229 to E. M. C, www.nih.gov]; Ford Foundation Fellowship to V. J. R [www.fordfoundation.org]; National Institute of Mental Health [grant number R36MH127838 to V. J. R]; the University of Miami Developmental HIV/AIDS Mental Health Research Center funded by the National Institute of Mental Health [grant number P30MH116867]; the Miami Center for AIDS Research (CFAR) at the University of Miami Miller School of Medicine [grant number P30AI1073961] supported by National Institute of Allergy and Infectious Diseases; National Cancer Institute; National Institute of Child Health and Human Development; National Heart, Lung and Blood Institute; National Institute of Drug Abuse; National Institute on Minority Health and Health Disparities; National institute on Aging; National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Dental and Craniofacial Research; National Institute of Mental Health; National Institute of Nursing Research; National Institute of General Medical Sciences; and Office of the Director. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2022 Cherenack et al.

PY - 2022/10

Y1 - 2022/10

N2 - Background Biological and psychological mechanisms may be responsible for menstrual irregularities occurring among women during the COVID-19 pandemic. Study design From January 2019 to September 2021, women (18- to 45-years-old and not using hormonal contraception) were recruited in Miami-Dade County, Florida. Cross-sectional, self-report surveys collected data on menstrual irregularities, COVID-19 vaccination, stress, depression, and loneliness. A EUA approved rapid test assay using whole blood measured SARS-CoV-2 IgG antibodies. Chi-square and Fisher’s exact tests described menstrual irregularities among women recruited before versus after the start of the COVID-19 pandemic and with detectable versus undetectable SARS-CoV-2 IgG antibodies. A logistic regression examined the relationship between the presence of SARS-CoV-2 IgG antibodies and menstrual irregularities controlling for age, stress, depression, and loneliness. Results Among 182 women enrolled, 73 were enrolled after pandemic onset, and 36 provided vaccination data. Having detectable SARS-CoV-2 IgG antibodies was associated with a higher percentage of menstrual irregularities among unvaccinated women (0% vs. 39%, p = .026) and among all women regardless of vaccination status (31% vs. 5%; p = .005). Adjusting for age and psychological variables, the odds of menstrual irregularities were 7.03 times (95% CI [1.39, 35.60]; p = .019) higher among women with detectable antibodies compared to women without detectable antibodies. Neither enrollment date, age, nor psychological factors were associated to menstrual irregularities. Conclusions Biological mechanisms related to SARS-CoV-2 infection may be responsible for irregular menstruation and should be further examined to mitigate the impact of the COVID-19 pandemic on women’s health.

AB - Background Biological and psychological mechanisms may be responsible for menstrual irregularities occurring among women during the COVID-19 pandemic. Study design From January 2019 to September 2021, women (18- to 45-years-old and not using hormonal contraception) were recruited in Miami-Dade County, Florida. Cross-sectional, self-report surveys collected data on menstrual irregularities, COVID-19 vaccination, stress, depression, and loneliness. A EUA approved rapid test assay using whole blood measured SARS-CoV-2 IgG antibodies. Chi-square and Fisher’s exact tests described menstrual irregularities among women recruited before versus after the start of the COVID-19 pandemic and with detectable versus undetectable SARS-CoV-2 IgG antibodies. A logistic regression examined the relationship between the presence of SARS-CoV-2 IgG antibodies and menstrual irregularities controlling for age, stress, depression, and loneliness. Results Among 182 women enrolled, 73 were enrolled after pandemic onset, and 36 provided vaccination data. Having detectable SARS-CoV-2 IgG antibodies was associated with a higher percentage of menstrual irregularities among unvaccinated women (0% vs. 39%, p = .026) and among all women regardless of vaccination status (31% vs. 5%; p = .005). Adjusting for age and psychological variables, the odds of menstrual irregularities were 7.03 times (95% CI [1.39, 35.60]; p = .019) higher among women with detectable antibodies compared to women without detectable antibodies. Neither enrollment date, age, nor psychological factors were associated to menstrual irregularities. Conclusions Biological mechanisms related to SARS-CoV-2 infection may be responsible for irregular menstruation and should be further examined to mitigate the impact of the COVID-19 pandemic on women’s health.

KW - Female

KW - Humans

KW - Adolescent

KW - Young Adult

KW - Adult

KW - Middle Aged

KW - SARS-CoV-2

KW - Pandemics

KW - COVID-19/epidemiology

KW - Cross-Sectional Studies

KW - COVID-19 Vaccines

KW - Menstruation Disturbances/epidemiology

KW - Immunoglobulin G

KW - Antibodies, Viral

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U2 - 10.1371/journal.pone.0276131

DO - 10.1371/journal.pone.0276131

M3 - Article

C2 - 36288342

AN - SCOPUS:85140808658

SN - 1932-6203

VL - 17

JO - PloS one

JF - PloS one

IS - 10

M1 - e0276131

ER -

Infection with SARS-CoV-2 is associated with menstrual irregularities among women of reproductive age

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Publisher link

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