Effect of COVID-19 Vaccine in Women with Adenomyosis and Endometriosis

Anjeza Xholli, Maria Giulia Schiaffino, Ilaria Vacca, Filippo Molinari, Elena Cavalli, Umberto Scovazzi, Francesca Oppedisano, Marina Jakimovska, Ambrogio P. Londero, Angelo Cagnacci
In: Clinical and Experimental Obstetrics & Gynecology · 2023 · vol. 50(12) · doi:10.31083/j.ceog5012265 · W4389792470
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study investigated COVID-19 vaccine side effects in women with adenomyosis or endometriosis, finding 16.8% experienced symptoms, with adenomyosis strongly associated with post-vaccine issues, especially in those not on hormone therapy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective single-center cohort study evaluated whether COVID-19 vaccination triggered abnormal uterine bleeding (AUB) and/or increased menstrual or chronic pelvic pain in 172 premenopausal women with adenomyosis and/or endometriosis, using a historical control group of 63 non-vaccinated women followed with two evaluations. Approximately 16.8% of vaccinated women reported vaccine-related side effects, with multiple regression indicating symptom manifestation was significantly associated with adenomyosis (HR 4.93) but not with deep infiltrating endometriosis; AUB was reported by 14.5% and pain worsening by 9.3%. Among women reporting side effects who had endometrioma, the three who were not on hormone therapy had marked endometrioma volume increases, and one required emergency surgery for rupture with hemoperitoneum. Limitations include the observational design, reliance on retrospective anamnestic reporting, and use of a historical rather than concurrent control group. This paper is centrally about endometriosis and adenomyosis — it specifically examines COVID-19 vaccine–associated AUB and pain in women with these conditions, and reports associations with adenomyosis and endometrioma behavior.

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Abstract

Background: It has been reported that coronavirus disease 2019 (COVID-19) vaccines could provoke flu-like symptoms and changes in menstrual cycles in some women, probably as a result of the immune response caused by the vaccination itself. Altered local immunity and inflammatory processes are found in women suffering from adenomyosis and endometriosis, this having a role in the typical symptomatic manifestations. This study aims to investigate the prevalence of side effects like abnormal uterine bleeding (AUB) or pain following the administration of COVID-19 vaccines in women with adenomyosis or endometriosis. Methods: A retrospective cohort study was performed on 172 patients referring to our Chronic Pelvic Pain Center, who underwent COVID-19 vaccination. A hystorical cohort of sixty-three non-vaccinated women was used as control. We collected anamnestic data and each woman scored menstrual pain, chronic pelvic pain, and the occurrence of AUB before and after vaccination. Results: Among control women, no one showed AUB, and only 2 women experienced a slight worsening of menstrual pain. Side effects were observed in 29/172 (16.8%) of COVID-19 vaccinated women, independent of whether they were on hormone therapy. In comparison to asymptomatic, symptomatic women had a higher prevalence of adenomyosis (82.7% vs 63.6%), adenomyosis being present in 100% of the 6 women with intermenstrual bleeding, in 79% of the 19 women with heavy menstrual bleeding and in 81% of the 16 women with pain worsening. Nine out of 55 (16.3%) women with endometrioma experienced side effects. Among these, the 3 women that were not on hormone therapy experienced a huge increase in endometrioma volume from +208% to +806%. In one case emergency surgery was necessary for endometrioma rupture and hemoperitoneum. Conclusions: In our sample, adenomyosis appears strictly related to the manifestation of post-vaccine side effects. Hormone therapy seems to be insufficient to protect from post-vaccine symptoms, but the increase in endometrioma volume was observed only in cases without hormone therapy.

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Condition tags

endometriosisadenomyosisendometriomachronic_pelvic_pain

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (34)

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