Menstrual cycle characteristics, all participants.

Menstrual cycle characteristics, all participants.</p

Changes in menstrual cycle characteristics and premenstrual symptoms in all participants.

Nodes represent the proportion of participants reporting each symptom before lockdown (left) and the proportion reporting whether they experienced this symptom more, the same or less during lockdown (right).</p

STROBE statement—checklist of items that should be included in reports of observational studies.

STROBE statement—checklist of items that should be included in reports of observational studies.</p

Menstrual cycle characteristics, hormonal contraception vs no hormonal contraception.

Menstrual cycle characteristics, hormonal contraception vs no hormonal contraception.</p

S1 Data -

BackgroundThe impact of COVID-19 virus on menstrual cycles in unvaccinated women is limited.ObjectiveTo investigate the prevalence of changes to menstrual cycle characteristics, hormonal symptoms and lifestyle changes prior to and during the COVID-19 pandemic.MethodsA retrospective online cross-sectional survey completed by social media users between July 2020 to October 2020. Participants were living in the United Kingdom (UK), premenopausal status and, or over 18 years of age.Main outcome(s) and measures(s)The primary outcome was to assess changes to menstrual cycle characteristics during the pandemic following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Secondary outcomes included assessment of hormonal and lifestyle changes.Results15,611 social media users completed the survey. Of which, 75% of participants experienced a change in their menstrual cycle, with significantly greater proportions reporting irregular menstrual cycles (PConclusionThe COVID-19 pandemic resulted in considerable variation in menstrual cycle characteristics and hormonal symptoms. This appears to be related to societal and lifestyle changes resulting from the pandemic, rather than to the virus itself. We believe this may have an impact on the individual, as well as national economy, healthcare, and population levels, and therefore suggest this should be taken into consideration by governments, healthcare providers and employers when developing pandemic recovery plans.</div

Fig 1 -

Menstrual cycle regularity and duration of bleeding in all participants (A & D), according to hormonal contraceptive use (B & E) and COVID-19 infection status (C & F). Nodes represent the proportion of participants in each category before (left) and during lockdown (right) with the flows between representing the proportional change between categories between the two timepoints.</p

Menstrual cycle characteristics, Covid-19 positive (confirmed only) vs Covid-19 negative.

Menstrual cycle characteristics, Covid-19 positive (confirmed only) vs Covid-19 negative.</p

Mean CL (mm)(SD) at screening time-points A, B, C and mean percentage ΔCL (SD) between screening time-points A-B, B-C, and A-C for Group 1 and 2.

<p>Mean CL (mm)(SD) at screening time-points A, B, C and mean percentage ΔCL (SD) between screening time-points A-B, B-C, and A-C for Group 1 and 2.</p

Patient characteristics for women that delivered at term without cerclage (Group 1) and women that had cerclage or delivered prematurely (Group 2).

<p>Patient characteristics for women that delivered at term without cerclage (Group 1) and women that had cerclage or delivered prematurely (Group 2).</p

Sensitivity, specificity, likelihood ratios, and positive and negative predictive values for cerclage intervention and/or preterm birth <37 weeks, for screening time-points A, B and C, and percentage difference in CL between screening time-points A, B and C.

<p>Sensitivity, specificity, likelihood ratios, and positive and negative predictive values for cerclage intervention and/or preterm birth <37 weeks, for screening time-points A, B and C, and percentage difference in CL between screening time-points A, B and C.</p