Will COVID vaccination really lead to a period of instability?

A Swedish registry-based cohort study observed a weak association between vaccination against COVID-19 and healthcare professionals associated with menstrual disorders or bleeding disorders in perimenopausal women.

In a study of more than 2.5 million women who had received at least one dose of the COVID vaccine, the strongest observed association with menstrual disturbances was in women aged 12 to 49 years of The risk window was a 26% increase in risk (HR 1.26, 95% CI 1.11-1.42) reported Rickard Ljung, MD, PhD, MPH and colleagues from the Swedish Medical Products Agency, Uppsala and the Karolinska Institutet, Stockholm. Did.

Only a minor association was observed for premenopausal bleeding. After the first and his third dose he had a 14% increase in risk over the 1-7 day risk window.

In postmenopausal women, the risk of bleeding after the third dose was reduced in both the 1-7 day risk window (HR 1.28, 95% CI 1.01-1.62) and the 8-90 day risk window (HR 1.25, 95) became the highest. % CI 1.04-1.50), BMJMore.

The Pfizer-BioNTech vaccine increased the risk of postmenopausal bleeding by 23% to 33% after 8 to 90 days, and the Moderna vaccine increased the risk by 23% to 33% after the third dose, whereas the Oxford-AstraZeneca vaccine The relationship was not very clear.

“We observed weak and inconsistent associations between SARS-CoV-2 vaccination and bleeding in postmenopausal women by health care professionals, and documented associations with menstrual disturbances or bleeding in premenopausal women. The evidence is even less,” Ljung and co-authors concluded. “These findings do not materially support a causal link between SARS-CoV-2 vaccination and healthcare professionals associated with menstrual or bleeding disorders.”

heather customs MedPage Today “It’s important to remember that we’re not saying women haven’t experienced these conditions…”

“There have been many spontaneous reports from women around the world who have reported suspected adverse events to pharmaceutical companies,” he added. There are 1,000 reports of suspected

Other studies have shown that women have Reports slightly longer menstrual cycles After COVID vaccination, and others have reported Changes in menstrual symptoms After COVID infection.

Becky Sumalin-Dawson, M.P.H., Ph.D., Allegheny College, Meadville, Pennsylvania, said: MedPage Today That the study ticks the box for rigorous, valid, and reliable data that includes few losses to follow up in a large cohort. comes from the question.

“The challenge I’m struggling with right now is that most of us don’t go to the doctor for something they want, like irregular bleeding in menstruating women.”

She pointed out that the study does not answer the more important question of whether and why COVID vaccines and boosters increase or cause menstrual disorders.

“Do you have to look at medical records that you don’t think many women go to medical facilities to make decisions or draw conclusions about the impact of vaccines?” Dawson said. “Do not think [this study] Change public health messages or clinical health messages. “

Ljung said future research should link self-report questionnaires with health data on this topic to get the best of both worlds.

For this study, researchers analyzed data from 2,946,448 Swedish women aged 12 to 74 years (median age 44) from December 2020 to February 2022. People with cancer or types of genital-related cancers, or who had a hysterectomy were excluded from the study.

Most women in the cohort (87.6%) received at least one vaccination and 64% received three doses by the end of the follow-up period.

Covariates included country of birth, age, marital status, education, frequency of previous medical visits, and whether they were health care workers.

More than 99% of menstrual-related visits were made by outpatient specialists.

Ljung and colleagues noted that their dataset did not indicate whether physician visits were planned or acute, a limitation of the study. They also noted that the time between symptom onset and actual interaction with the health care system can be “significantly long, making interpretation of the impact of different risk windows difficult.”