Am I supposed to reconcile my PayPal bank account each month in quickbooks?

Reconciling any account is optional.

Perfect! 

If it isn't reconciled,  does it cause any issues? 

And not reconciling it doesn't cause any issues, right? 

You may encounter issues if your account isn't reconciled, @Tidyingbykimberlymay. Let me share further details about this and guide you on how you can perform the process in QuickBooks Online (QBO), so you can keep your financial data accurate.

The reconciliation process lets you review your accounts in QuickBooks to make sure they match your real-life bank and credit card transactions. Yes, it's optional. However, I encourage you to do this every month to effectively monitor your income and expense transactions and detect possible errors accordingly.

Whenever you're ready to start a reconciliation, follow these steps:

1. If your accounts are connected to online banking, make sure you match and categorize all of your downloaded transactions.
2. In QuickBooks Online, select Settings ⚙ and then Reconcile. If you're reconciling for the very first time, select Get started to continue.
3. From the Account ▼ dropdown, select the account you want to reconcile. Make sure it's the same one on your statement.
4. Review the Beginning balance. Make sure the beginning balance in QuickBooks matches the one on your statement. Here's what to do if they don't match.
5. Enter the Ending balance and Ending date on your statement. Some banks call the ending balance a "new balance" or a "closing balance".
6. If you see it, review the Last statement ending date. This is the end date of your last reconciliation. Your current bank statement should start the day after.
7. When you're ready to start, select Start reconciling.

Once done, compare the transactions on your statement with what's in QuickBooks. For the step-by-step guide, please see this article: Reconcile an account in QuickBooks Online.

Also, you may want to check out this article as your reference to guide you in case you need help in doing or fixing a reconciliation in QBO: Learn the reconcile workflow in QuickBooks.

Please feel free to leave a comment below if you have other banking and reconciliation concerns or questions about managing transactions in QBO. I'm always ready to help. Take care, and I wish you continued success, @Tidyingbykimberlymay.

@Tidyingbykimberlymay 

Imho, reconciliation is not mandatory but necessary for your own benefit. You can do it whenever you need but it will eat up your time later if you don't do it regularly.