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GP consultations for menstrual disorders after COVID-19 vaccination - A self-controlled cohort study based on routine healthcare data from the Netherlands.

Jajou, R., Lieber, T., Puijenbroek, E.P. van, Mulder, E., Overbeek, J., Hek, K., Hunsel, F.P.A.M., Kant, A. GP consultations for menstrual disorders after COVID-19 vaccination - A self-controlled cohort study based on routine healthcare data from the Netherlands. Vaccine: 2024
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Introduction
Several studies described that COVID-19 vaccinations can cause menstrual disorders. Our study aimed to describe whether this also resulted in more general practitioner (GP) consultations for menstrual disorders after COVID-19 vaccination, based on a large cohort study.

Methods
A retrospective self-controlled cohort study was performed including vaccinated women in 2021 aged 12–49 years from two large, representative GP databases in the Netherlands. Incidence rates and incidence rate ratio’s (IRR) were calculated using Poisson regression, adjusting for SARS-CoV-2 infection as time-varying confounder. The exposed period was set at maximum six months after each COVID-19 vaccination and the non-exposed period was defined as all-time outside the exposed period.

Results
The cohort included 631,802 women, of which 18,986 (3 %) consulted the GP for a menstrual disorder during 2021. Increased GP consultations were observed among 12–14 year olds for amenorrhea/hypomenorrhea/oligomenorrhea (IRR: 1.85, 95 % CI: 1.30–2.65) and irregular/frequent menstruation (IRR: 1.33, 95 % CI: 1.06–1.69) after COVID-19 vaccination in general, and after Pfizer/BioNTech vaccination (IRR: 1.87, 95 % CI: 1.31–2.67 for amenorrhea/hypomenorrhea/oligomenorrhea and IRR: 1.35, 95 % CI: 1.06–1.70 for irregular/frequent menstruation). Persons from this age group were in general also vaccinated with Pfizer/BioNTech. No increase in the frequency of GP consultations were observed for older age groups, other vaccine brands, and potential risk groups.

Conclusion
For the majority of women, no increased GP consultations for menstrual disorders was found. Solely for the youngest age group (12–14 year olds) increased GP consultations for specific types of menstrual disorders was found after Pfizer/BioNTech vaccination.
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