How lifestyle changes within the COVID-19 global pandemic have affected the pattern and symptoms of the menstrual cycle

  1. Georgie Bruinvels
  2. Esther Goldsmith
  3. Richard C. Blagrove
  4. Dan Martin
  5. Laurence Shaw
  6. Jessica Piasecki

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Abstract

Background

The coronavirus 2019 (COVID-19) pandemic has caused significant changes to homes, working life and stress. The purpose of this research was to investigate the implications that the COVID-19 pandemic has had on the menstrual cycle and any contributing factors to these changes.

Methods

A questionnaire was completed by 749 participants, whom ranged from ‘physically active’ to elite, in their training status. The questionnaire captured detail on menstrual cycle symptoms and characteristics prior to and during the COVID-19 pandemic lockdown period, as well as lifestyle, stress, exercise and nutrition. Descriptive statistics and frequency distribution were reported and decision tree analysis performed. Statistical significance was assumed at p<0.05.

Results

Fifty-two point six percent of females experienced a change in their menstrual cycle during the lockdown period. Psychosocial symptoms had changed in over half of all participants. Participants who reported increased stress/worry in family and personal health were significantly associated with changes in menstrual symptoms. Similarly, job security stress was associated with increases in bleeding time (p<0.05).

Conclusions

It is important that females and practitioners become aware of the implications of stressful environments and the possible long-term implications on fertility, particularly given the uncertainty around a second wave of the global pandemic.

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  1. ScreenIT

    SciScore for 10.1101/2021.02.01.21250919: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIACUC: Ethics and Participant recruitment: The study was conducted in accordance with the declaration of Helsinki and approved by the institutional ethics committee at Nottingham Trent University.
    Consent: The online link provided to the questionnaire began with the participant information sheet, followed by participant consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data Analysis: Data were analysed using IBM SPSS (v. 23.0) and Microsoft Excel.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    As with all research, there are limitations with this study that should be acknowledged. The data herein comes from a range of countries in which there were a range of rules and regulations, and therefore experiences, with regards to lockdown, therefore possibly influencing the participants differently. However, the countries assessed in the study all documented some degree of change in lifestyles and working environments. Our sample also included hormonal contraceptive users as well as non-users. The regularity of cycles when utilising combined oral contraceptives, due to exogenous hormones that they contain, is well documented, thus including such participants may limit the numbers of females that have seen cycle length changes. However, it was important not to exclude such females as it is known 34 % of the general population (Cea-Soriano et al., 2014) and around 50% of elite athletes (Martin et al., 2017) use such methods. Stress may not just change cycle length, it can also contribute to symptoms experienced which we were able to document in both hormonal contraceptive users and non-users. Finally, our data only provides a small insight into the changes experienced by females during the COVID-19 pandemic and does not provide any longitudinal data that could document the rise and fall of symptom exacerbation or the degree of severity that the females may have been affected by such environmental changes.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.02.01.21250919v1 on medRxiv