Examining the Associations Between Menstrual Disorders and SARS-CoV-2 Exposure in Greek Adolescents: A Retrospective Cohort Study

Background: Exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), whether via infection or vaccination, seems to influence the character of the menstrual cycle by disrupting hormonal and immune function. Methods: The main aim of this cohort study was to explore the association between exposure to SARS-CoV-2—through either vaccination or infection—and menstrual disorders in adolescent females. We also aimed at identifying the most prevalent menstrual disorders observed and assessing potential differences between the exposure groups that may contribute to these conditions. Results: This study included data from adolescent females who visited the Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care due to various menstrual disorders. Data from 92 adolescents, 77 participants exposed to SARS-CoV-2 and 15 controls, were retrieved. Significant associations were found between exposure to SARS-CoV-2 and abnormally frequent uterine bleeding (p = 0.032) and abnormal uterine bleeding (p = 0.025). Adolescents with a past confirmed case of coronavirus disease 2019 (COVID-19) demonstrated significantly lower serum concentrations of fibrinogen (p = 0.023) and iron (p = 0.03), as well as higher γ-GT concentrations (p = 0.028), than those who were non-infected, whereas vaccinated adolescents presented with significantly lower concentrations of coagulation factors VIII (p = 0.002), vWFAg (p = 0.023), and Rcof (p = 0.007) than those of their unvaccinated peers. Overall, adolescents exposed [infection (or/and) vaccination] to SARS-CoV-2 demonstrated increased estradiol (E2) concentrations compared to those of the controls. In conclusion, adolescent exposure to SARS-CoV-2 was strongly linked to abnormal uterine bleeding and polymenorrhea, potentially due to decreased coagulation factors or increased E2 concentrations. Conclusions: Further research involving larger samples and a more sophisticated design is needed to validate these findings.