The Impact of Covid-19 Infection and Vaccinations on the Menstrual Cycle

Background: Coronavirus disease-19 (COVID-19 infection) might present with no clinical symptoms or with mild to severe clinical symptoms. Menstrual cycle issues are one of the long-term clinical characteristics of COVID-19. The menstrual cycle is a biologically important cycle for females, regulated closely by endocrine, autocrine, and paracrine mechanisms, with substantial fluctuation in length (21-35 days) and hormone levels during the cycle. Inactivated viral vaccine, recombinant viral vaccine, subunit vaccine, DNA vaccine, and attenuated vaccine have all been tested for Co-V-19 vaccine efficacy. Few females suffered menstrual problems after immunization, such as Menorrhagia, Metrorrhagia, Polymenorrhea, and Postmenopausal bleeding. Vaccine-associated thrombocytopenia could be one of the causes. Aim: To document menstrual changes in female participants following COVID-19 infection and Covid-19 vaccination with one to two doses and to study the impact of the Corona vaccine on the cycle. Methods: This retrospective investigation occurred in two phases. The first phase recruited 547 females, with an average age of 35 years and who were infected with COVID-19 to complete a questionnaire to record menstrual changes in women after COVID-19 infection without vaccination, while phase two enrolled 673 females with an average age of 33 years (21-49) and who received the vaccine before the study to record menstrual disturbances after vaccination for COVID-19 , at Prince Rashid military hospital, Irbid, JORDAN, during the period March 2020-Apr 2022. A questionnaire with 6 sections was constructed to determine the influence of COVID-19 infection and Covid-19 vaccination on the menstrual cycle. Results: In phase one: 46.98% (257/547) had changes in the number of days between two following periods and in the volume of blood loss. 42.41% of subjects (232/547) had an increase or reduction in the length of menses. In phase two: 24.96% (168/673) of subjects experienced higher volume and 15.6% (105/673) experienced decreased volume. 23.03% (155/673) experienced delayed periods and 53.2% (358/673) experienced no changes. Conclusion: COVID-19 infection might influence the menstrual cycle. There was a discrepancy in menstrual profile after vaccination, irrespective of vaccine type or the number of doses given. However, our study is cross-sectional, and these findings need further investigations or clinical trials to demonstrate the effect of Covid -19 infection or vaccinations on menstrual cycle

Impact and Consequences of Vitamin D Supplementation during Pregnancy: Jordanian Royal Medical Services

It has been hypothesized that taking extra vitamin D while pregnant will protect against unfavorable gestational outcomes. This randomized clinical trial study examined the effects of supplementing with 50,000 IU of vitamin D every two weeks versus expecting mothers who received 400 IU of vitamin D daily on the incidence of gestational diabetes (GDM), gestational hypertension, preeclampsia, preterm labor, vitamin D status at term, and neonatal outcomes. 200 women from Prince Rashid Ben Al-Hasan Military Hospital during October 2022 to January 2023 with gestational age 12-16 weeks and serum 25 hydroxy vitamin D (25 (OH) D ) less than 30 ng/ml randomly categorized in two groups. Group A received 400 IU vitamin D daily and group B 50,000 IU vitamin D every 2 weeks orally until delivery. Maternal and Neonatal outcomes were assessed in two groups. The main results of the current study concluded to 5.9% versus 12.8% respectively, group B had a considerably lower incidence of GDM than group A, and odds ratio (93% Confidence Interval) was 0.42 (0.21-0.85) (P=0.02). At the time of delivery, mothers in group B had mean SD levels of 25 (OH) D that were considerably higher than those in group A (41.1±22.2 versus 25.1±16.4 ng/ml, respectively) (P=0.004). There were no differences in the incidence of preeclampsia, gestational hypertension, preterm labor, and low birth weight between two groups. In comparison to group A, group B had a mean 25 (OH) D level that was considerably higher (34.6±18.6 versus 25.3±17.5 ng/ml). Neonatal anthropometric measurements did not differ considerably from one other. Eventually, , the current study shown that 50,000 IU of vitamin D given every two weeks reduced the prevalence of GDM