RT Journal Article SR Electronic T1 Association between menstrual cycle length and covid-19 vaccination: global, retrospective cohort study of prospectively collected data JF BMJ Medicine JO bmjmed FD BMJ Publishing Group Ltd SP e000297 DO 10.1136/bmjmed-2022-000297 VO 1 IS 1 A1 Alison Edelman A1 Emily R Boniface A1 Victoria Male A1 Sharon T Cameron A1 Eleonora Benhar A1 Leo Han A1 Kristen A Matteson A1 Agathe Van Lamsweerde A1 Jack T Pearson A1 Blair G Darney YR 2022 UL http://bmjmedicine.bmj.com/content/1/1/e000297.abstract AB Objectives To identify whether covid-19 vaccines are associated with menstrual changes in order to address concerns about menstrual cycle disruptions after covid-19 vaccination.Design Global, retrospective cohort study of prospectively collected data.Setting International users of the menstrual cycle tracking application, Natural Cycles.Participants 19 622 individuals aged 18-45 years with cycle lengths of 24-38 days and consecutive data for at least three cycles before and one cycle after covid (vaccinated group; n=14 936), and those with at least four consecutive cycles over a similar time period (unvaccinated group; n=4686).Main outcome measures The mean change within individuals was assessed by vaccination group for cycle and menses length (mean of three cycles before vaccination to the cycles after first and second dose of vaccine and the subsequent cycle). Mixed effects models were used to estimate the adjusted difference in change in cycle and menses length between the vaccinated and unvaccinated.Results Most people (n=15 713; 80.08%) were younger than 35 years, from the UK (n=6222; 31.71%), US and Canada (28.59%), or Europe (33.55%). Two thirds (9929 (66.48%) of 14 936) of the vaccinated cohort received the Pfizer-BioNTech (BNT162b2) covid-19 vaccine, 17.46% (n=2608) received Moderna (mRNA-1273), 9.06% (n=1353) received Oxford-AstraZeneca (ChAdOx1 nCoV-19), and 1.89% (n=283) received Johnson & Johnson (Ad26.COV2.S). Individuals who were vaccinated had a less than one day adjusted increase in the length of their first and second vaccine cycles, compared with individuals who were not vaccinated (0.71 day increase (99.3% confidence interval 0.47 to 0.96) for first dose; 0.56 day increase (0.28 to 0.84) for second dose). The adjusted difference was larger in people who received two doses in a cycle (3.70 days increase (2.98 to 4.42)). One cycle after vaccination, cycle length was similar to before the vaccine in individuals who received one dose per cycle (0.02 day change (99.3% confidence interval −0.10 to 0.14), but not yet for individuals who received two doses per cycle (0.85 day change (99.3% confidence interval 0.24 to 1.46)) compared with unvaccinated individuals. Changes in cycle length did not differ by the vaccine’s mechanism of action (mRNA, adenovirus vector, or inactivated virus). Menses length was unaffected by vaccination.Conclusions Covid-19 vaccination is associated with a small and likely to be temporary change in menstrual cycle length but no change in menses length.No data are available. Data were accessed under a data use agreement with Natural Cycles USA Corp, New York and are not available to third parties.