Assessment of changes in menstrual pattern, menstrual volume, and sex hormones (FSH, LH, TSH, prolactin, and AMH) in women of childbearing age with COVID-19 in Semnan, Iran: a cross-sectional study

Abstract Introduction and objectives Women’s reproductive and fertility health may be influenced by COVID-19. However, data on whether SARS-CoV-2 infection affects menstrual pattern, menstrual volume, and sex hormone levels remain limited. This study aimed to investigate changes in the pattern and volume of menstruation as well as levels of FSH, LH, TSH, prolactin, and AMH in women of reproductive age following COVID-19. Patients and methods In this cross-sectional study, we enrolled 30 healthy women (aged 18–36 years) who presented with male-factor infertility. Participants were included if they were non-menopausal, had negative pregnancy test results, and no history of significant medical illness or drug treatment. Women using contraceptive treatments or who had undergone specific therapeutic procedures or medications for infertility were excluded. Additionally, women who were vaccinated against COVID-19 were excluded. All participants had a confirmed COVID-19 diagnosis (positive PCR test). To minimize acute-phase fluctuations, we re-evaluated participants 5- to 7-month post-infection. We compared pre- and post-infection hormone levels from their medical records, and we used a screening checklist to assess menstrual pattern (e.g., oligomenorrhea, polymenorrhea) and menstrual volume. Each participant effectively served as her own control. Data were analyzed at a 95% confidence level with P < 0.05 considered significant. Results The mean (± SD) age was 29.23 ± 3.45 years. Nearly one-third (33%) reported new-onset changes in menstrual pattern after COVID-19, including oligomenorrhea (20%) and polymenorrhea (13%). No participants experienced amenorrhea. Post-infection hormone levels showed a slight increase in FSH, LH, TSH, and prolactin and a decrease in AMH; however, only TSH exhibited a statistically significant rise. Changes in hormone levels were not associated with treatment methods, hospitalization, or pulmonary involvement. By contrast, those with a history of hospitalization had more frequent alterations in menstrual volume and pattern ( P = 0.041 and P = 0.006, respectively). Pulmonary involvement did not significantly impact menstrual volume or pattern. Conclusion COVID-19 may be linked to significant increases in TSH and notable shifts in menstrual pattern and volume among healthy women of reproductive age, while other sex hormones remained largely unchanged. Further research with larger sample sizes and a formal control group is needed to clarify these observations.