OBJECTIVE: Following a significant relaxation of restrictions in China on December 7, 2022, after a surge in SARS-CoV-2 infections, an uptick in women presenting with menstrual disorders was observed in clinics. This study aimed to explore the alterations in menstrual characteristics and associated factors post SARS-CoV-2 infection. METHODS: A cross-sectional online survey was conducted among 869 non-amenorrheic adult Chinese females (aged 18-53) to study the changes in menstrual characteristics and other infection-related factors post initial SARS-CoV-2 infection. The reported menstrual changes (group A) were compared to the reported no menstrual changes (group B). Data collected included basic individual-level information such as age, height, weight, menstrual history, reproductive and menstrual disorders, chronic diseases, SARS-CoV-2 vaccination status, COVID-19 symptoms, and changes in menstrual characteristics (regularity, period volume, and degree of dysmenorrhea) post SARS-CoV-2 infection. RESULTS: Of the 869 participants, 442 (50.9%, group A) reported alterations in at least one menstrual characteristic
171 (19.7%) experienced an extended menstrual cycle, and 122 (14.0%) reported a decrease in menstrual volume. Participants who reported menstrual changes (group A) were more likely to have pre-existing chronic diseases (7.7% vs. 3.0%, P = 0.003) and exhibit more symptoms of COVID-19 during the acute (4.94 vs. 4.03, P <
0.001) and recovery (4.37 vs. 3.41, P <
0.001) phases. These participants were also more likely to report fever as a COVID-19 symptom (93.4% vs. 86.9%, P = 0.001) and experienced a longer duration of fever (2.25 vs. 1.96 days, P = 0.001) as compared to group B. Notably, group A with chronic diseases, fewer vaccine doses, and more COVID-19-related symptoms experienced more frequent menstrual changes post COVID-19 (P <
0.05) than group B. CONCLUSION: Participants with chronic diseases, fewer vaccination doses, and more COVID-19-related symptoms may experience more frequent menstrual changes post COVID-19 infection according to the self-report results in this study.