Male V. Menstruation and COVID-19 vaccination

Volume 3 - Issue 4

Letter to the Editor

Male V. Menstruation and COVID-19 vaccination. BMJ 2022;376:o142.

(https://www.bmj.com/content/376/bmj.o142)

Karpagambal Sairam*

Consultant Obstetrician, Gynaecologist and Fertility Specialist, Kauvery Hospital, Chennai

*Correspondence: Tel.: +91 98401 51351; email: karpagambal@hotmail.com 

Vaccination against COVID-19 provides protection against the potentially serious consequences of SARS-CoV2 infection, but as the vaccines were rolled out into younger age groups, clinicians were increasingly approached by patients worried that the vaccine had caused a change to their periods.

More than 36,000 reports of menstrual changes or unexpected vaginal bleeding following COVID-19 vaccination have so far been made to UK Medicine and Healthcare Products Regulatory Agency (MHRA). A similar signal appeared in the US vaccine adverse event reporting system (VAERS).

The first of these studies have now reported.

https://www.gov.uk/government/publications/coronavirus-COVID-19-vaccine-adverse-reactions/coronavirus-vaccine-summary-of-yellow-card-reporting#annex-1-vaccine-analysis-print.

The findings from both these studies are reassuring: changes to the menstrual cycle do occur following vaccination, but they are small compared with natural variation and quickly reverse.

MHRA says that current evidence does not support a link between changes to menstrual periods and COVID vaccination in the UK, and it continues to advise that anyone noticing a change to their periods that persists over several cycles, or who has any new vaginal bleeding after the menopause, be treated according to the usual clinical pathways

Comments

COVID vaccination does not affect menstrual cycles, whatever is seen  or reported is purely coincidental. In India,  two vaccines were approved by the government namely COVAXIN AND COVISHIELD. Covaxin was administered at an interval of 4 weeks and  Covishield , 12 weeks. 

Menstrual cycle length ranges from 24-38 days (FIGO definition); this variation is accepted even up to 45- 60 days in clinical practice.  Any stressful situation or event can affect menstrual cycles and fertility to a larger extent.

Fertility - there is absolutely no  proven effect apart from couples  being cautious on embarking on pregnancy before vaccination.

I have seen many come with unplanned pregnancies, asking for termination during the pandemic and few have conceived in the same cycle after vaccination. 

Male factor- no effect regarding vaccination in reproductive age group.

I have been administering HPV Vaccination-3 doses for young girls and women for  many years, with no clinically significant change in cycles. 

Rubella and varicella vaccinations have been given to all women prior to conception after checking their IgG statuses; as these two can cause major congenital anomalies in the fetus, but no  vaccine induced effects  so far.

 Personally, I don't recommend menstrual apps as they cause extreme stress on the girl/woman if they don't get periods on the date mentioned in the app. Lets not technologize human biology with gadgets dictating next expected  menstrual date as they  impact  the mental health of these  young girls and women.

I just ask them to maintain menstrual calendar in a note or  phone, as shown below.

References

1. https://www.kauveryhospital.com/news-events/september-lockdown-blues-and-fertility-2020?fbclid=iwar0blgcvyo7f4cptochs3phlzo83fx5nbl22s5aezp4mfd2eonoduhrdmie 
2. https://www.kauveryhospital.com/news-events/may-COVID-19-in-pregnancy-vaccination-in-pregnancy-lactation-and-during-menstruation-2021?fbclid=iwar2mfatjgxrrdk4m2-oyngg4mkxu8delpq36vdajxrcbet9cqllt7rkzn6s 

Dr. Karpagambal Sairam, DGO, DNB, MRCOG

Consultant Obstetrician, Gynaecologist, and Fertility Specialist