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\begin{document}

\title{Abnormal uterine bleeding during the COVID-19 pandemic: a national
survey}



\author[1]{Gal Issakov}%
\author[2]{Yossi Tzur}%
\author[1]{Talia Friedman}%
\author[3]{Tamar Tzur}%
\affil[1]{Laniado Hospital}%
\affil[2]{Tel Aviv Sourasky Medical Center}%
\affil[3]{Ariel University}%


\vspace{-1em}



  
  \date{May 19, 2024}


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\begin{abstract}
Objective To evaluate and characterize menstrual changes among COVID-19
vaccinated and infected women. Design A national survey. Setting An
online nationwide questionnaire survey, querying about menstrual changes
after COVID-19 vaccination or infection. Population Reproductive-age
non-pregnant women. Methods The questionnaire was distributed via an
online link through social media and directed the participants to an
online anonymous Google questionnaire. Results In total, 10,319 women
responded, of which 7,904 met the inclusion criteria. Changes in
menstrual patterns following the BNT162b2 vaccine were reported by 3,689
(46.7\%). Of these, 2,974 women, (80.6\%) described excessive bleeding
(heavy, prolonged, or intermenstrual) compared with 715 (19.4\%) who
reported scant bleeding (light, short, or prolonged intervals). Among
women who experienced abnormal uterine bleeding (AUB), in most cases
(61.1\%) it occurred between the vaccination and the ensuing menstrual
period. Menstrual disturbances were more common among accurately
vaccinated women compared with inaccurately vaccinated by having
received a single shot or having undergone a prolonged interval between
shots (51\% vs 36.6\%, P \textless{} .001). Menstrual disturbances were
similar in type and distribution among the vaccinated and infected
women. Conclusions AUB emerged as a side effect of the BNT162b2 vaccine
and a symptom of the COVID-19 infection. It was characterized mainly by
excessive bleeding. Although the precise incidence could not be
determined in this study, the type of bleeding disturbance, as well as
the characterization of women at risk, were well defined. The incidence
and the long-term consequences of the BNT162b2 vaccine on uterine
bleeding warrant further investigation.%
\end{abstract}%



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