The stress of confinement, not the coronavirus infection, has had an impact on women’s menstrual cycles. The lockdown that took place from March to May 2020 caused changes in the form of missed or delayed periods and heavy bleeding. This is confirmed by the study, Effects of confinement due to SARS-CoV-2 on menstrual patterns, conducted by two gynecologists from the Hospital de la Santa Creu i Sant Pau in Barcelona, which collected, in an online survey, women’s observations of their cycles. Until now, there has been research into how the vaccine and even the coronavirus have affected women’s menstrual cycles, but this is the first study to look at whether being confined at home has also disrupted cycles.
In this report, published in the journal Medicina Clínica, a total of 6,440 women, aged between 15 and 55, from all over Spain (this is the largest sample of menstruating women published to date), who did not have coronavirus and answered a long questionnaire via WhatsApp were involved. Women taking hormonal contraceptives were excluded from this sample, because these drugs regulate the menstrual cycle. “We wanted to know to what extent confinement affected menstrual cycle changes. There were two groups of women: those who stayed at home in isolation and those who went out because they were part of essential services, such as health workers or supermarket cashiers,” explains Joaquim Calaf, a gynecologist from Sant Pau and one of the authors of the study. “In contrast, we saw that Covid-19 infection did not change the menstrual cycle.”
The doctors found that women who experienced the most stress during childbirth were the ones who experienced the most menstrual changes. “For example, two emergency room nurses in a very stressful situation, or two bus drivers or a cashier at a supermarket, even though they were exposed to the same stressors, had menstrual irregularities depending on how they experienced the situation,” says Calaf. Thus, the work itself was not as relevant as the “emotional component” of it. “It wasn’t so much the extreme isolation or exploitation at work, but how the situation affected you and the fear of infection. Sometimes it wasn’t the fear of getting infected, but of getting home and contaminating a family member,” adds the gynecologist.
Type of stress
The researchers asked these women what kind of stress they felt: fear of losing their job, getting infected, contaminating a family member, or worrying about being locked up. “We saw that the higher these levels were, the more changes occurred in their menstrual cycles, which mainly consisted of missed or delayed periods or heavy bleeding,” explains Josep Perello, a gynecologist also from Sant Pau.
At the same time, doctors collected information about these women’s activities during childbirth, their sexual activity, their perceptions of their emotional state, changes in menstrual cycle characteristics and daily impact. For 50.1% of those interviewed, their overall quality of life deteriorated during home quarantine, while 41.3% remained approximately the same and 8.7% reported an improvement. Sexual activity decreased during quarantine for 49.8% of participants, remained unchanged for 40.7% and increased by 9.5%.
The researchers found “no statistically significant differences” in menstrual cycle changes among women taking non-hormonal contraception when they assessed changes by length and characteristics of isolation, perceived exposure to COVID-19, and employment status. But they did find “statistically significant differences” in menstrual cycle regularity, duration, and quantity associated with “the intensity of changes in emotional state due to the stressors of confinement.”
Stress and menstruation
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Thus, the study concluded that changes in emotional state, but not the duration or intensity of isolation or exposure to illness, significantly influenced menstrual disorders during the coronavirus quarantine. Thus, the most important predictor of change in menstrual pattern was the individual perception of anxiety, regardless of employment status, degree of isolation, or exposure to illness. However, as the researchers themselves also admit, it is “impossible” to know how many women had their menstrual cycles affected by the lockdown. “We know that the people who answer the survey are the most sensitive to the problem,” Perillo justifies.
This finding confirms the hypothesis that menstrual disturbances are very closely related to an individual’s sensitivity to stress and a woman’s emotional state.
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