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COVID-19 vaccination and postmenopausal bleeding: a retrospective cohort study

Lucía Pastor-Goutherot1, Ester Miralpeix1,2, Berta Fabregó2

  • 1Pompeu Fabra University, Barcelona, Spain.

Climacteric : the Journal of the International Menopause Society
|August 12, 2024
PubMed

Insights

COVID-19 vaccination is linked to a higher prevalence of postmenopausal bleeding (PMB). However, the vaccine did not increase endometrial cancer risk, though endometrial biopsy is recommended for any PMB.

Area of Science:

  • Gynecology
  • Reproductive Health
  • Vaccinology

Background:

  • Menstrual irregularities have been reported following COVID-19 vaccination.
  • The impact of COVID-19 vaccination on postmenopausal women, specifically regarding postmenopausal bleeding (PMB), remains largely unknown.
  • Understanding potential side effects of widespread vaccination programs is crucial for public health.

Purpose of the Study:

  • To investigate the prevalence of postmenopausal bleeding (PMB) in women after receiving COVID-19 vaccination.
  • To analyze the association between COVID-19 vaccination and the occurrence of PMB in a postmenopausal cohort.
  • To evaluate endometrial pathology in relation to vaccination status and PMB.

Main Methods:

  • A retrospective study included 381 postmenopausal women, categorized into vaccinated (n=91) and unvaccinated (n=290) groups.
  • Data were collected between February 2021 and January 2022, with PMB defined as bleeding occurring more than 30 days post-vaccination.
  • Statistical analyses, including univariable and multivariable regression, were performed to identify risk factors for PMB.

Main Results:

  • The prevalence of PMB was significantly higher in the vaccinated group (75.8%) compared to the unvaccinated group (59.0%) (p < 0.005).
  • No statistically significant increase in malignant endometrial pathology was observed in the vaccinated group (p = 0.189).
  • Multivariable analysis identified COVID-19 vaccination and malignant endometrial biopsy as independent risk variables for PMB.

Conclusions:

  • COVID-19 vaccination is associated with an increased prevalence of postmenopausal bleeding.
  • While vaccination did not correlate with an increased risk of malignant endometrial pathology, PMB necessitates further investigation.
  • Endometrial biopsy remains a critical diagnostic tool for evaluating postmenopausal bleeding, irrespective of vaccination status.
Abstract

Keywords:
COVID-19endometrial biopsypostmenopausal bleedingpostmenopausal womenvaccination

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