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There has been increasing public concern that COVID-19 vaccination causes menstrual disturbance regarding the relative effect of vaccination compared to SARS-CoV-2 infection. Our objectives were to test potential risk factors for reporting menstrual cycle changes following COVID-19 vaccination and to compare menstrual parameters following COVID-19 vaccination and COVID-19 disease. We performed a secondary analysis of a retrospective online survey conducted in the UK in March 2021. In pre-menopausal vaccinated participants (n=4,989), 18% reported menstrual cycle changes after their first COVID-19 vaccine injection. The prevalence of reporting any menstrual changes was higher for women who smoke, have a history of COVID-19 disease, or are not using oestradiol-containing contraceptives. In a second sample including both vaccinated and unvaccinated participants (n=12,579), COVID-19 vaccination alone was not associated with abnormal menstrual cycle parameters while a history of COVID-19 disease was associated with an increased risk of reporting heavier bleeding, ‘missed’ periods and inter-menstrual bleeding.
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