Do sexually transmitted infections exacerbate negative premenstrual symptoms? Insights from digital health

Abstract

Background and objectivesThe underlying reasons why some women experience debilitating premenstrual symptoms and others do not are largely unknown. Here, we test the evolutionary ecological hypothesis that some negative premenstrual symptoms may be exacerbated by the presence of chronic sexually transmitted infections (STIs).Methodology34 511 women were recruited through a digital period-tracker app. Participants were asked: (i) Have you ever been diagnosed with a STI? (ii) If yes, when was it, and were you given treatment? Those data were combined with longitudinal cycle data on menstrual bleeding patterns, the experience of pain and emotions and hormonal contraceptive use.Results865 women had at least two complete menstrual cycle data and were eligible for analysis. Before diagnosis, the presence of an infection predicts a ca. 2-fold increase in the odds of reporting both headache, cramps and sadness during the late luteal phase and sensitive emotions during the wider luteal phase. After diagnosis, the odds of reporting negative symptoms pre-menstrually remain unchanged among STI negative individuals, but the odds of reporting sensitive emotions decrease among STI positive individuals receiving a treatment. No relationships between STIs, pain and emotions are observed among hormonal contraceptive users.Conclusions and implicationsThe results support the idea that a negative premenstrual experience might be aggravated by the presence of undiagnosed STIs, a leading cause of infertility worldwide. Caution is warranted in extrapolating the results as the data are self-reported, inflammatory levels are unknown and the tracker is biased towards recording negative premenstrual symptoms among Western individuals.

Menstrual Justice: A Missing Element in India’s Health Policies

“…Yet it fails to address the mental health consequence of high levels of stress women suffer because of gender discriminatory practices such as neglect, child marriage, infertility, failure to give birth to sons, witch-hunting, and sexual assault within marriage (Ramasubban and Jeejebhoy 2000a, 34;Sarojini et al 2006, 41). The policy also seems blind to the emotional anguish women suffer because of chronic issues related to menstruation and the impact of other diseases on menstruation (Oomman 2000, 253-55;Alvergne, Wheeler, and Tabor 2018). For instance, it fails to recognize the negative psychosocial health impacts of the perception that girls and women are 'polluting' during menstruation (FSG 2016).…”

Assessment of menstrual health status and evolution through mobile apps for fertility awareness

“…Notably, a 2018 study by Alvergne et al suggests that negative premenstrual experiences might be aggravated by the presence of undiagnosed sexually transmitted infections. 19 Recently, studies have used similar data, including menses reports but no fertility awareness data, to develop novel machine learning methods suited to study rhythmic human behaviors 20 or predict pregnancy. 21 The latest study compares several models, including neural networks, to predict pregnancy chances in an on-going cycle.…”

The menstrual cycle is a primary contributor to cyclic variation in women’s mood, behavior, and vital signs

“…Such data from women's health tracking apps has only recently become available on a large scale as the apps have grown in popularity; a critical advantage these datasets offer is information on menstrual cycle starts, enabling comparison of the menstrual cycle to daily, weekly, and seasonal cycles for the first time. The Clue app has been rated the most accurate menstrual cycle tracking app by gynecologists (13) and previously used in studies which show that it replicates known biological findings (14)(15)(16)(17). Using the Clue dataset, we analyze menstrual, daily, weekly, and seasonal cycles in nine dimensions of mood, three vital signs -resting heart rate (RHR), basal body temperature (BBT), and weight -and three dimensions of behaviorsleep, exercise, and sexual activity (Tables S2 and S3).…”

“…Again, multiple lines of evidence mitigate this concern: first, a review of more than a hundred menstrual cycle tracking apps rated the Clue app as the best on the basis of accuracy, comprehensiveness, and functionality (13); second, we apply numerous quality control filters to increase the accuracy of logged data. The medical community is already making use of menstrual app tracking data (14)(15)(16)(17)25), suggesting that neither of these limitations precludes its usefulness.…”