Introduction
COVID-19 infection started in December 2019, and since then it has affected almost every aspect of lives globally. Studies have reported that COVID-19 infection can affect every human organ including reproductive organs causing widespread inflammation, vasoconstriction, hypercoagulability, and edema.1-3 To combat this dreadful disease, numerous vaccines were introduced within a short span of 12-18 months of the onset of the pandemic.4 The adult vaccination against COVID-19 started at the end of 2020 and early 2021 worldwide and around three billion doses were administered globally by mid-2021, hoping to end this pandemic at the earliest.5 The two indigenously developed COVID-19 vaccines approved for use in India are COVISHILED and COVAXIN.6 The common side effects of these vaccines included injection site pain, fever, and myalgia with no severe adverse effects.7 The common side effects of other COVID-19 vaccines used in different countries were soreness of the arm, fever, chills, myalgia, headache, fatigue, and rarely thrombosis and anaphylaxis.8,9 Recent studies from the United States of America and other countries have reported temporary changes in the menstrual cycle including increased cycle length, and dysmenorrhea following COVID-19 vaccination.10,11
Most of the reproductive age women suffer from some kinds of premenstrual symptoms including physical discomfort, mood changes, body pains, etc. Of these 5–8% suffer from a severe premenstrual syndrome that affects their day-to-day activities.12 The menstrual cycle reflects the general health status of women and should be considered a vital sign of health.13 Despite this, the impact of COVID-19 vaccines on the menstrual cycle in women and girls getting vaccinated against COVID-19 infection was not considered and hence, not included in the list of side effects.14The present study was the first of its kind in India that was conducted on a large sample from different states of India to investigate the impact of COVID-19 vaccination on the menstrual cycle and pre- and post-menstrual symptoms in women of the reproductive age group and to establish the correlation with the vaccine type.