Demographic data |
Age |
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Height (in ft. inches) |
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Weight (in kgs) |
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Marital status |
Married |
Unmarried |
On a scale of 1-4 describe your physical activity |
1 - None |
2 - Light |
3 - Moderate |
4 - Strenuous |
Perceived Stress Scale; for each following question choose from the following alternatives: 0 - never, 1 - almost never, 2 - sometimes, 3 - fairly often, and 4 - very often |
l. In the last month, how often have you been upset because of something that happened unexpectedly? |
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2. In the last month, how often have you felt that you were unable to control the important things in your life? |
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3. In the last month, how often have you felt nervous and stressed? |
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4. In the last month, how often have you felt confident about your ability to handle your personal problems? |
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5. In the last month, how often have you felt that things were going your way? |
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6. In the last month, how often have you found that you could not cope with all the things that you had to do? |
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7. In the last month, how often have you been able to control irritations in your life? |
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8. In the last month, how often have you felt that you were on top of things? |
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9. In the last month, how often have you been angered because of things that happened that were outside of your control? |
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10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? |
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Per-vaccination menstruation |
Did you have regular menstrual cycles before getting the COVID-19 vaccine? |
Yes |
No |
How would you describe your period flow before getting the COVID-19 vaccine? |
Scanty |
Normal |
Heavy |
What are your usual associated symptoms during menses period? (Select all that apply) |
Breast tenderness |
Cramps |
Fatigue |
Mood changes, i.e., irritability, mood swings, sadness, anger, etc. |
Other |
Post-vaccination menstruation |
Q1. Has there been a change in the regularity of your menstrual cycles after getting the COVID-19 vaccine? |
Yes |
No |
Q2. Has there been a change in your average cycle duration after getting the COVID-19 vaccine? |
Yes |
No |
Q3. If yes, then what changes have you experienced regarding cycle duration after getting the COVID-19 vaccine? |
Increased duration between cycles |
Decreased duration during cycles |
Disordered, no regularity |
Q4. Has there been a change in your period flow after getting the COVID-19 vaccine |
Yes |
No |
Q5. If yes, then what changes have you experienced regarding period flow after getting the COVID-19 vaccine? |
Gotten heavier |
Normal/same as before getting vaccinated |
Decreased duration during cycles |
Q6. Have you experienced any change in your usual associated symptoms during menses period after getting the COVID-19 vaccine? |
Yes |
No |
Q7. If yes, then what changes have you experienced regarding your usual associated symptoms during the menses period after getting the COVID-19 vaccine? |
Gotten better |
Gotten worse |