The COVID-19 pandemic has profoundly affected the lives of the global population. The pandemic's challenges can be stressful and overwhelming. In India, March 2020 onwards lockdown was imposed, and the subsequent "unlock" restricted intra and extra movements of individuals. Social distancing, home-schooling, unemployment, financial concerns, isolation, and a slew of other changes have left us physically and emotionally exhausted in the current times. According to gynaecologists and psychiatrists, the stress of the pandemic has produced alterations in menstrual cycles or a worsening of premenstrual syndrome, or PCOS, in women. Periods of stress and Psychological distress are the one of the causes affecting women’s menstrual cycles.
Even before the pandemic, researchers had identified a link between stress and menstrual changes. According to one study, roughly 90% of women experience some form of PMS symptoms. PMS, or premenstrual syndrome, affects the physical and emotional well-being of menstruating women just before their period. When your anxiety level rises, your body produces more cortisol and epinephrine, which are stress hormones. Stress hormones and insulin, as well as oestrogen and progesterone levels, all have an impact on PMS. Stress causes stressors, which are endocrine factors that interfere with the regulation of body systems such as the menstrual cycle, eventually disrupting the body's normal functioning. Stress influences not only endocrinological and reproductive factors, but also physiological factors.
During Covid 19, women have reported to be more stressed than men. The reason being that women of reproductive age are less likely than men and the elderly to become seriously ill or die from COVID-19, they are frequently asked with increasing domestic responsibilities while also caring for others. School, youth sports, and social organisations, which most women rely on for emotional support, are mostly inaccessible. Women are more likely to feel lonely and overwhelmed as their social connections deteriorate. They may be concerned about their parents and older generations, in addition to their children and partner. Not only PMS, but pandemic related stress can also lead to severe menstrual changes like a heavier or lighter flow, an abnormally long cycle, increased pain with menstruation, or no menstruation at all.
According to research, women who reported one or more of the following symptoms: low mood, anxiety, or significant stress were more likely to report an overall change in their menstrual cycles since the pandemic began (50% versus 34%, p < 0.0001). These women with mental health issues were also more likely to have painful periods (54% versus 36%, p < 0.0001), worsening premenstrual symptoms(62% versus 32%, p < 0.0001), and a decrease in libido(51% versus 31%, p < 0.0001). Since the beginning of the pandemic, 18 percent of women who experienced low mood, anxiety, and/or significant stress reported missing periods, whereas 13 percent of those who did not experience these mental health symptoms reported missing periods; however, this difference was not significant (p = 0.08). Women who reported an overall change in their menstrual cycles were more likely to report poor sleep (41%) than those who did not report a change in their menstrual cycles (28%), p 0.0001. More than half of those surveyed reported that premenstrual syndrome (PMS) symptoms have worsened.This research found that women with high levels of psychosocial stress are more likely to develop PMS.
PMS can have a significant impact on women's health and is linked to impaired daily activities and mental health disorders such as anxiety, postpartum and perimenopausal depression. Almost half of the women reported painful and heavy periods, a significant increase compared to before the pandemic. Almost half of the women said they didn't get enough sleep, and those who said they didn't get enough sleep were more likely to have had a change in their menstrual cycle. It is well understood that sex hormones affect circadian rhythm and vice versa. PMS, which became more prevalent during the pandemic, is also linked to sleep disruption. Sleep disturbance may have an effect on fertility because it has been found to be more prevalent in those with infertility and diminished ovarian reserve.
These women also reported lifestyle changes that may affect the menstrual cycle. The amount of exercise performed has increased overall, with an increase of half an hour per week. Despite this, the weight of these women has increased, with a median of 2 kg. This may be because half of the women reported that their diet was worse since the beginning of the pandemic, and nearly a third of women reported overeating. 40% of women also work harder during the pandemic, which limits the time to prepare healthy meals. Although a large number of women described the negative impact of the pandemic on their menstrual cycle and lifestyle, a small number of women also described the positive impact. Some women notice more regular menstrual periods and less heavy and painful periods with less PMS. Some women report that their sex drive has increased. The average amount of exercise per week has increased, and one in six women has lost weight.
This large anonymous observational study showed that due to the COVID19 pandemic, a large portion of the female population has experienced reproductive health barriers. These disorders are linked to a significant increase in mental health symptoms, as well as weight gain, long work hours, and unhealthy eating. A small number of women have reported improvements in their reproductive health and lifestyle as a result of the pandemic.
Over the last year, the COVID-19 pandemic has had a significant impact on women in a variety of ways. Gynaecologists are aware of it. Psychiatrists and therapists discuss it. Many women have private discussions about it. It is also validated by the occasional survey. However, the pandemic's impact on women's reproductive health has yet to be addressed in public health or workplace culture discussions. Consuming more protein in the form of beans, nuts, legumes, some lean meat, fruits and vegetables, and fiber-rich foods may help to mitigate the stressful effects of a pandemic. Eating within the first hour of waking up helps to reset your blood sugar levels and control stress hormones. Drinking water, getting enough sleep, not using your phone right before bed, limiting your exposure to virus-related news, and so on are all examples of basic care.