Male V. Menstruation and COVID-19 vaccination

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.

START	END
05/11/2020	06/11/2020
07/12/2020	05/12/2020
06/02/2021	10/02/2021
28/02/2021	03/03/2021
25/03/2021	28/03/2021
22/04/2021	25/04/2021
28/05/2021	31/05/2021
27/06/2021	29/06/2021
23/07/2021	26/07/2021
22/08/2021	24/08/2021
01/10/2021	04/10/2021

References

Dr. Karpagambal Sairam, DGO, DNB, MRCOG

Consultant Obstetrician, Gynaecologist, and Fertility Specialist

Male V. Menstruation and COVID-19 vaccination

Letter to the Editor

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

Dr. Karpagambal Sairam, DGO, DNB, MRCOG

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