COVID-19 Stressor: Implications for Changes in Menstruation Physiology and Mental Health

Abstract

Background: Stress is a physiological reaction to awful stimuli that is regulated by neuroendocrine pathways. COVID-19 is one of the most stressful events nowadays. Female reproductive function is maintained by menstrual cycle which is negatively affected by hyperstimulation of stress response. This study evaluates the impact of COVID-19 on menstruation and mental health, and the influence of COVID-19-associated mental disorders on menstruation. Methods: Online questionnaire was conducted among Jordanian female medical students during COVID-19. The survey compared menstrual characteristics, depression, anxiety, and stress during COVID-19 with 10-months before. Data were analysed using SPSS software.Results: Significant change in menstrual cycle length and bleeding amount during COVID-19 compared with before was observed. Menstrual signs like nausea, vomiting, breast pain, and urinary urgency during menstruation were significantly increased during COVID-19 (P=0.000, P=0.008, and P=0.024, respectively). Total depression, anxiety, and stress scale 21 (DASS-21) score mean was significantly increased after COVID-19 compared with before (22.68 vs 31.10, P=0.000), and total means of depression, anxiety and stress subscale scores were significantly increased during COVID-19 (P=0.000). During COVID-19, significant positive correlation between total DASS-21 and heavy bleeding was detected. Mental disorders, and amenorrhea, urgency, nausea, and vomiting were positively correlated after COVID-19.Conclusion: This study introduces a general insight into the effect of COVID-19 on menstruation and mental health, and the relationship between them, which could serve as a baseline for planning and introducing stress mitigation interventions in similar crisis situations.Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Declaration of Interests: The authors declare that there is no conflict of interest with regards to this study.Ethics Approval Statement: The Hashemite University Institutional Review Board Committee has reviewed and authorized this study. Additionally, informed electronic consent to attend the study and publish the data was obtained from each participant.