The impact of Covid-19 on menstrual cycle’s alterations, in relation to depression and sleep disturbances: a prospective observational study in a population of medical students

Background: The sars-Cov-2 pandemic has determined adverse circumstances beyond everyday experience, leading to psychological stress, with particular relevance to the young population of female medical students. This work aims at studying the impact of the pandemic on menstrual cycle alteration in relation to psychological stress, monitoring the presence of depression, sleep disturbances and post-traumatic stress, on a population of medical students. Methods: : 293 female students (23,08 years old ±3,8) were enrolled. One year after quarantine, a personal data sheet on menstrual cycle, the Beck Depression Inventory (BDI) and the Impact of Event Scale (IES-R) have been administered. Results: : A statistically significant association between menstrual alterations and stress during pandemic has been found. The onset of depressive symptoms and sleep disturbances has been observed in 57,1% and in 58,1% of young women with cycle’s alterations, respectively. Amenorrhea was three times more common in female students with depressive symptoms, PMS had a significant correlation with both depression and sleep disturbances. Pandemic has been related to menstrual alterations, with depressive symptoms and sleep disorders. Amenorrhea is connected to depression, as observed on the functional hypothalamic amenorrhea (FHA). Conclusions: : Post-traumatic stress disorder has not been found, it may be more likely associated with high physical and psychological stress in frontline female health workers during the pandemic. New strategies of psychological intervention should be considered after pandemic experience, in order to help students, and particularly medical trainees, with specific attention to women’s needs.