Introduction: The purpose of this study was to delve more deeply into the medium and long-term relation between mRNA-based vaccines and changes in menstrual pain, cycle length, and amount of bleeding in Spanish women. Material and Methods: A total of 746 women (63% between 18–30 and 37% between 31–45 years old) participated in the study. A numerical rating scale was used for recording pain intensity, a pictorial chart for menstrual bleeding, and data from menstrual cycle duration, type of vaccine, number of doses and time from vaccination. Results: Sixty-five per cent of the women perceived changes in their menstrual cycle after receiving the vaccines, irrespective of type of vaccine or number of doses; all p values were >0.05. Most of them (n = 316 out of 484) reported more than one alteration in their menstrual cycle. Almost half of the participants had been vaccinated over 5 months (45%), 3–4 months (15%) 2–3 months (26%), and one month or less (13%) before. The percentage of women that reported alterations remained strongly constant across time, p > 0.05, ranging from 64 to 65%. Conclusions: Reported alterations in Spanish women after COVID vaccination remained more than 5 months after the last dose.

Introduction: Transgender men undergoing testosterone-based gender-affirming therapy experience physiological changes that may influence pelvic floor structure and function; however, empirical evidence remains limited and heterogeneous. Objective: To analyze the relationship between pelvic floor function, sexual health, and biopsychosocial variables in transgender men receiving testosterone therapy. Materials and methods: A pilot cross-sectional observational study was conducted in 15 transgender men aged 18-45 years living in Spain and receiving testosterone therapy for at least 1 year. Data were collected using validated instruments (PFDI-20, ICIQ-SF, FSFI, STAI, PSS-14, and IPAQ-SF). Spearman’s rank correlation coefficient was calculated to assess correlations between continuous variables. Given the small sample size and sparse distribution of participants across categories, categorical variables were excluded from inferential analyses. A significance level of a=0.05 was considered. Results: Participants showed low levels of pelvic floor distress (median PFDI-20: 15.6; IQR=7.8-39.6; minimum: 0 maximum: 112), with 93.33% of them presenting mild symptoms. Urinary incontinence scores were low (median ICIQ-SF: 1; IQR=1-1). Sexual function varied widely (median FSFI: 27.1; IQR=19.3-31.6). Significant negative correlations were found between testosterone therapy duration and the orgasm (rS=-0.530, p=0.042) and satisfaction (rS=-0.610, p=0.016) domains of the FSFI. Age was negatively associated with pelvic floor distress and trait anxiety. Conclusions: Pelvic floor dysfunction and urinary symptoms were generally mild in this sample. Associations between testosterone exposure and specific sexual function domains suggest potentially heterogeneous effects over time. No significant correlations were observed between the psychological variables evaluated (perceived stress [PSS-14] and anxiety [STAI]) and indicators of sexual and pelvic floor dysfunction.