Impact of Stress on Menstrual Cyclicity During the Coronavirus Disease 2019 Pandemic: A Survey Study

Background: The coronavirus disease 2019 (COVID-19) pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the COVID-19 pandemic and its related stressors have impacted women's menstrual cyclicity. Materials and Methods: An online survey instrument designed to capture self-reported information on menstrual cycle changes and perceived stress levels was distributed between July and August 2020. A total of 210 women between the ages of 18-45 years met stringent inclusion and exclusion criteria and completed the survey. Results: Of the 210 respondents, more than half (54%) reported changes in their menstrual cycles. These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses (p < 0.001) and heavier bleeding during menses (p = 0.028) compared with those with moderate Covid PSS scores. Conclusions: By uncovering a trend in increased menstrual cycle irregularities during the early months of the COVID-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.