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Background: COVID-19 is linked to multiple health disruptions, such as menstrual disruptions. The patterns of the cycles may be affected by both infection and vaccination. Objective: The study aimed to investigate the association between COVID-19 infection, vaccination, and menstrual disturbances. Study Design: Cross-sectional study. Settings: Khyber Teaching Hospital, Peshawar Pakistan. Duration: July to December 2021. Methods: 168 female COVID-19 hospitalized patients aged 18-45 years. A questionnaire was used to gather information, which included demographics, details of infection, vaccination history, and menstrual history. The statistical analysis involved descriptive statistical analysis, chi-square, and logistic regression. A p-value of <0.05 was considered statistically significant. Results: Out of 168 individuals, 28.57% had COVID-19, and 71.43% were immunized. Infection-related menstrual abnormalities affected 50% of women, with 28.57% experiencing discomfort. 14.29% stopped or missed periods. 45% of subjects reported cycle length alterations, while 42% reported lengthier cycles. 50% of participants said menstrual abnormalities impaired their quality of life socially and psychologically. Treatment with Tranexamic Acid reduced menstrual change length (p = 0.0019). Tranexamic Acid and OCPs were used to address menstruation issues in 62.5% of subjects. These data suggest that COVID-19 infection and immunization may lead to substantial menstrual abnormalities that can be treated. Conclusion: COVID-19 infection and immunization are associated with menstrual abnormalities, affecting social and psychological well-being. Menstrual care interventions, such as Tranexamic Acid, mitigate these disturbances, underscoring the need for specialized post-COVID care. Additional investigation is required to comprehend the fundamental mechanics.