Self-Reported Menstrual Alterations During the COVID-19 Syndemic in Spain: A Cross-Sectional Study

Laura Medina-Perucha; Tomàs López-Jiménez; Anna Sofie Holst; Constanza Jacques-Aviñó; Jordina Munrós-Feliu; Cristina Martínez-Bueno; Carme Valls-Llobet; Diana Pinzón-Sanabria; Mª Mercedes Vicente-Hernández; Anna Berenguera

doi:10.2147/IJWH.S354655

Self-Reported Menstrual Alterations During the COVID-19 Syndemic in Spain: A Cross-Sectional Study

Int J Womens Health. 2022 Apr 13:14:529-544. doi: 10.2147/IJWH.S354655. eCollection 2022.

Authors

Laura Medina-Perucha^{1

2}, Tomàs López-Jiménez^{1

2}, Anna Sofie Holst^{1

3}, Constanza Jacques-Aviñó^{1

2}, Jordina Munrós-Feliu^{4

5}, Cristina Martínez-Bueno^{5

6}, Carme Valls-Llobet⁷, Diana Pinzón-Sanabria⁸, Mª Mercedes Vicente-Hernández⁵, Anna Berenguera^{1

2

9}

Affiliations

¹ Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
² Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.
³ Universitat Pompeu Fabra, Barcelona, Spain.
⁴ Atenció a la Salut Sexual i Reproductiva (ASSIR) Muntanya/La Mina, Institut Català de la Salut, Barcelona, Spain.
⁵ Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain.
⁶ Servei d'Atenció a la Salut Sexual i Reproductiva (ASSIR), Direcció Assistencial d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain.
⁷ Centro de Análisis y Programas Sanitarios (CAPS), Barcelona, Spain.
⁸ SomiArte Taller, Barcelona, Spain.
⁹ Departament d'Infermeria, Universitat de Girona, Girona, Spain.

Abstract

Introduction: Available evidence suggests that there might be an association between the stressors experienced during the COVID-19 syndemic and changes in menstrual patterns. The aim of this study was to assess self-reported menstrual alterations during the COVID-19 syndemic among women and people who menstruate aged 18-55 in Spain.

Materials and methods: A cross-sectional online survey-based study was conducted (March-July 2021). Descriptive statistics were calculated and multivariate logistic regression models were constructed. This study was conducted as part of the "Equity and Menstrual Health in Spain" research project.

Results: Among participants (N=17,455), 39.4% reported menstrual alterations since the start of the syndemic. Participants self-reporting long COVID-19 presented higher odds of menstrual alterations (aOR: 1.34, 95% CI, 1.15-1.57). In participants with no history of COVID-19, the risk for self-reported menstrual alterations was significantly higher based on employment situation, among participants experiencing financial issues (eg, financial issues always/many times <12 months: aOR: 1.68, 95% CI, 1.48-1.90), poorer self-perceived health (eg, poor: aOR: 2.00, 95% CI, 1.31-3.07), and those diagnosed with polycystic ovary syndrome (aOR: 1.13, 95% CI, 1.02-1.26). Among participants with a self-reported COVID-19 diagnosis, factors that significantly increased the odds for menstrual alterations were experiencing financial strains (eg, financial issues always/many times <12 months: aOR: 1.53, 95% CI, 1.09-2.14), poorer self-perceived health (eg, poor: aOR: 3.09, 95% CI, 1.01-9.52). Overall, factors that decreased the odds of reporting menstrual alterations included age >25, being a carer, not having a gynecological condition and using hormonal contraception.

Discussion and conclusions: Findings suggest an impact of the COVID-19 syndemic on menstrual patterns. Social inequities in reporting menstrual alterations were identified. While the risk of reporting menstrual alterations was higher among participants with long COVID-19, evidence is not conclusive. Further research on menstrual health in the context of COVID-19 is needed, also to inform policy and practice.

Keywords: COVID-19; long COVID-19; menstrual health; menstrual inequity; menstruation; women’s health.

Grants and funding

This study was funded by the European Society of Contraception and Reproductive Health (P-2019-A-01). It was also supported by the Spain's Ministry of Science and Innovation through the Carlos III Health Institute and European Union ERDF funds (European Regional Development Fund) through the Research Network in Preventive Activities and Health Promotion in Primary Care (redIAPP, RD16/0007/0001). The funders had no role in the design of the study, in data collection, analyses, and interpretation and in the writing of the manuscript, or in the decision to publish the results.