Post-COVID-19 Menstrual Abnormalities among Medical Students at a Tertiary Care Medical College in Southern India: A Cross-sectional Study

Abstract

Introduction: The emergence of Coronavirus Disease-2019 (COVID-19) caught the world by surprise, leading to a widespread global pandemic that has had profound and distressing effects on various levels. Its impact has been far-reaching, causing severe consequences that continue to unfold. COVID-19 is a multisystem inflammatory disease involving all organs, including the female reproductive system. Aim: To determine the prevalence of COVID-19 among students and compare post-COVID-19 menstrual abnormalities in the home and hospital groups. Materials and Methods: A cross-sectional study was conducted to assess post-COVID-19 menstrual abnormalities among medical students at Department of Obstetrics and Gynaecology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, in southern India from April to December 2022. A total of 600 medical students were approached, and 549 responded, among whom 258 students were reported as COVID-19 positive and 291 reported as COVID-19 negative. After excluding risk factors, 204 COVID-19 positive students were selected as the study population. Data were collected using a prevalidated questionnaire. The COVID-19 study population of 204 (100%) was further stratified into two groups based on the treatment taken at home 162 (79.4%) or in the hospital 42 (20.5%). Chi-square test and Fisher’s-exact tests were used to compare post-COVID-19 menstrual abnormalities, including cycle length abnormalities, Heavy Menstrual Bleeding (HMB), dysmenorrhoea, Premenstrual Syndrome (PMS), and hypomenorrhoea. Results: The prevalence of COVID-19 in the study population was 204, accounting for 37.15% of the total population 204/549. Out of the 204 students, 162 (79.4%) received home treatment, and 42 (20.5%) received hospital treatment. PostCOVID-19 menstrual cycle abnormalities were more prevalent in the hospital group 26/42 (61.9%) than in the home treatment group 76/162 (46.9%). The most common abnormality in both groups was PMS, with a prevalence of 21 (50%) in the hospital group and 38 (23.4%) in the home group. In the home group, 37 (22.8%) experienced longer cycles, 33 (20.3%) had dysmenorrhoea, and 19 (11.7%) had shorter cycles. In the hospital group, 14 (33.3%) had longer cycles, 13 (30.9%) experienced dysmenorrhoea, and 9 (21.4%) had shorter cycles. HMB was reported by 6 (14.2%) in the hospital group and 13 (8%) in the home group, while hypomenorrhoea occurred in 11 (6.7%) in the home group and 5 (11.9%) in the hospital group. A significant association (p=0.001) was found between the COVID-19 treatment groups and PMS. However, for other post-COVID-19 menstrual abnormalities, such as cycle length, dysmenorrhoea, HMB, and hypomenorrhoea, there was no significant association between these abnormalities and COVID-19 treatment groups. Conclusion: Post-COVID-19 menstrual abnormalities were more frequently observed in the hospital group compared to the home group. All post-COVID-19 menstrual irregularities resolved within six months, except for PMS.