METHODS
This cross-sectional study was based on retrospective and prospective
inquiries. An online questionnaire prepared using Google Forms
application was sent to 196 women between May 18 and 31, 2021. We
included all volunteers who answered the questionnaire, were aged 18–45
years, had been diagnosed with COVID-19 (based on a confirmed positive
polymerase chain reaction test result that was emailed to us), were
fluent in Turkish, and were in the menstrual phase at the time of
inclusion. Individuals who were in the premenopausal–postmenopausal
period, unable to email their PCR results, or unable to answer the
questionnaire adequately were excluded. The study protocol was approved
by the Non-Interventional Ethics Committee of Biruni University (No:
2021/47-45) and registered at the ClinicalTrials.gov (NCT04806815). The
study was conducted according to the principles of the Declaration of
Helsinki, and all participants provided informed consent at the
beginning of the study.
Data on sociodemographic characteristics, the history of COVID-19, and
prolonged symptoms were recorded. Menstrual symptoms, menstrual pain
severity, fatigue severity, and anxiety levels were assessed using the
Menstrual Symptom Questionnaire (MSQ), Visual Analogue Scale (VAS),
Fatigue Severity Scale (FSS), and Coronavirus Anxiety Scale (CAS),
respectively.
Participants were asked to answer all questions included in the MSQ,
taking into account their menstrual periods before and after their
COVID-19 diagnosis. The MSQ consists of 22 items divided into three
subgroups (Factor 1-negative effects/somatic complaints [1-13],
Factor 2-pain symptoms [14-19], and Factor 3-coping methods
[20-22]), with each item scored from 1 and 5, designed to assess
menstrual pain and symptoms. The total MSQ score is calculated by adding
the mean scores of the items included in the subgroups and ranges from
22 to 110. Higher scores indicate increased menstrual symptom
severity.13,14
VAS was used to score patients’ menstrual pain severity, with scores
ranging from 0 (no pain) to 10 (most severe pain).15
The FSS questionnaire consists of nine Likert-type questions, with each
question scored from 1 to 7, and scores ≥4 indicating severe fatigue.
The participants were asked to answer all questions, while considering
what they experienced before and after their COVID-19 diagnosis. The
total score ranges from 9 to 63, with higher scores indicating greater
severity.16,17
The CAS is used to assess dysfunctional anxiety. Participants were asked
to rate their frequency of anxiety episodes when exposed to thoughts or
information about COVID-19 on a five-point scale, ranging from 0 (not at
all) to 4 (almost every day). A total score of ≥9 indicated
coronavirus-related anxiety.18,19