Association of COVID19-affected Mental Health with Menstrual Abnormalities among University Students: A cross sectional study from Pakistan

Mental health is crucial for wellbeing. COVID-19 pandemic has caused mental health problems. In this study it was hypothesized that COVID19 related mental health disturbances may have impacted the menstrual health. Objective of this study was to evaluate the impact of COVID-19 affected mental health on the menstrual health of university students. Methods: A cross sectional study was conducted at University of Sindh, Jamshoro between July to August 2021 during fourth wave. A pre-tested questionnaire was administered to collect the data. Healthy unmarried female students were included in the study. Mental health parameters were assessed using DAS Scale. Results:  For a total 400 study participants the mean age was 20.82±1.69. The prevalence of mild to severe depression, mild to severe anxiety, and mild to moderate stress was 46.3%, 62% and 29.3% respectively. In moderately depressed females there was an increased prevalence of oligomenorrhea [2=34.5 p<0.0001], heavy menstrual blood flow [2=21.8 p<0.001], increased duration of menstrual bleeding [2=21.56 p<0.001], and heavy menstrual dysmenorrhea [2=18.78 p<0.002]. In moderately anxious females there was an increased prevalence of oligomenorrhea [2=15.5 p<0.07], heavy menstrual blood flow [2=12.4 p<0.03], and increased duration of menstrual bleeding [2=21.56 p<0.001]. In moderately stressed females there was increased prevalence of polymenorrhagia [2=22.3 p<0.001], increased duration of menstrual bleeding [2=24.23 p<0.0001], heavy menstrual dysmenorrhea [2=21.28 p<0.01] and secondary amenorrhea [2=4.28 p<0.01]. Conclusion: COVID19-affected Mental Health affected menstrual health. Healthcare system of Pakistan should address this issue while planning to mitigate the impacts of COVID-19 on human health.