--- title: Do sexually transmitted infections make premenstrual symptoms worse? description: Possibly. Before diagnosis, undiagnosed STIs predicted about 2-fold increased odds of headache, cramps, and sadness during the late luteal phase. After treatm url: https://niyora.com/research/papers/do-sexually-transmitted-infections-exacerbate-negative-premenstrual-symptoms-2018/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Do sexually transmitted infections make premenstrual symptoms worse? Cohort study, 2018 # Do sexually transmitted infections make premenstrual symptoms worse? Possibly. Before diagnosis, undiagnosed STIs predicted about 2-fold increased odds of headache, cramps, and sadness during the late luteal phase. After treatment, emotional symptoms improved. Early or limited evidence 34,511 women using a digital period-tracking app (865 with complete menstrual cycle data analyzed) ## What they did Online cohort using a period-tracking app. 34,511 women were asked about STI history and when diagnosed. Data on menstrual patterns, pain, emotions, and contraceptive use came from the app. 865 women had complete menstrual cycle data and were eligible for analysis. ## What they found Before diagnosis, undiagnosed STI predicted about 2-fold increase in odds of headache, cramps, and sadness in the late luteal phase and sensitive emotions in the wider luteal phase. After diagnosis, odds of sensitive emotions decreased in those treated. No relationships were found in women using hormonal contraceptives. ## What it means for you The study suggests undiagnosed STIs may worsen premenstrual symptoms, particularly emotional ones. However, all data is self-reported from app users who are mostly Western. Inflammatory levels were not measured and the app may be biased toward recording negative symptoms. 34,511 women recruited 865 eligible for analysis 2-fold increase in odds of pain and sadness ## About the study Original title Do sexually transmitted infections exacerbate negative premenstrual symptoms? Insights from digital health Authors Alvergne A, Vlajic Wheeler M, Högqvist Tabor V Journal Evolution, medicine, and public health Year 2018 Study design Cohort study Participants 34,511 What was tested Diagnosis and treatment of sexually transmitted infections (observational) Open access Yes Read the paper [doi.org/10.1093/emph/eoy018](https://doi.org/10.1093/emph/eoy018) Original abstract Background and objectives: The 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). Methodology: 34 511 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. Results: 865 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 implications: The 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. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Pain and headache](https://niyora.com/research/topics/symptom-pain/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/)[Apps and digital interventions](https://niyora.com/research/topics/treatment-digital-health/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Systematic review, 2023 What hormonal treatments have been tested for PMDD, menstrual migraine, and catamenial epilepsy? Randomised trial, 2015 Which birth control pill better reduces PMS and menstrual symptoms: nomegestrol acetate or drospirenone? 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