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

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.

SUBMITTER: Alvergne A

PROVIDER: S-EPMC6070031 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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

Alvergne Alexandra A Vlajic Wheeler Marija M Högqvist Tabor Vedrana V

Evolution, medicine, and public health 20180703 1

<h4>Background and objectives</h4>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).<h4>Methodology</h4>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 ...[more]

PMID: 30090631

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Project description:BackgroundProviding reproductive and sexual health services is an important and challenging aspect of caring for displaced populations, and preventive and curative sexual health services may play a role in reducing HIV transmission in complex emergencies. From 1995, the non-governmental "Reproductive Health Group" (RHG) worked amongst refugees displaced by conflicts in Sierra Leone and Liberia (1989-2004). RHG recruited refugee nurses and midwives to provide reproductive and sexual health services for refugees in the Forest Region of Guinea, and trained refugee women as lay health workers. A cross-sectional survey was conducted in 1999 to assess sexual health needs, knowledge and practices among refugees, and the potential impact of RHG's work.MethodsTrained interviewers administered a questionnaire on self-reported STI symptoms, and sexual health knowledge, attitudes and practices to 445 men and 444 women selected through multistage stratified cluster sampling. Chi-squared tests were used where appropriate. Multivariable logistic regression with robust standard errors (to adjust for the cluster sampling design) was used to assess if factors such as source of information about sexually transmitted infections (STIs) was associated with better knowledge.Results30% of women and 24% of men reported at least one episode of genital discharge and/or genital ulceration within the past 12 months. Only 25% correctly named all key symptoms of STIs in both sexes. Inappropriate beliefs (e.g. that swallowing tablets before sex, avoiding public toilets, and/or washing their genitals after sex protected against STIs) were prevalent. Respondents citing RHG facilitators as their information source were more likely to respond correctly about STIs; RHG facilitators were more frequently cited than non-healthcare information sources in men who correctly named the key STI symptoms (odds ratio (OR) = 5.2, 95% confidence interval (CI) 1.9-13.9), and in men and women who correctly identified effective STI protection methods (OR = 2.9, 95% CI 1.5-5.8 and OR = 4.6, 95% CI 1.6-13.2 respectively).ConclusionOur study revealed a high prevalence of STI symptoms, and gaps in sexual health knowledge in this displaced population. Learning about STIs from RHG health facilitators was associated with better knowledge. RHG's model could be considered in other complex emergency settings.

Project description:ObjectivesPeople aged 16-24 are more likely than other age groups to acquire sexually transmitted infections (STI). Safetxt was a randomised controlled trial of a theory-based digital health intervention to reduce STIs among 16-24 year-old people in the UK. We report results of qualitative research regarding participants' perceptions and experiences of the intervention and trial participation.DesignQualitative thematic analysis following a critical realist paradigm of written open feedback comments provided in the 12-month follow-up questionnaire and semistructured interviews.SettingSafetxt trial participants were recruited from UK sexual health clinics.ParticipantsTrial inclusion criteria: people aged 16-24 diagnosed with or treated for chlamydia, gonorrhoea or non-specific urethritis. Optional open feedback provided by 3526 of 6248 safetxt participants at 12 months and interviews with a purposive sample of 18 participants after the trial.ResultsWe summarise and report results in seven broad themes. According to recipients, the safetxt intervention increased awareness of the importance of avoiding STIs and ways to prevent them. Participants reported improved confidence, agency, sexual well-being and communication about sexual health with partners, friends and family. Recipients attributed increased condom use, increased STI testing after (rather than before) sex with new partners, and more confident partner notification to the intervention. Recipients described a reduced sense of isolation and stigma in having an STI. Control group participants reported that having had an STI and receiving control texts asking them to report any changes in contact details acted as reminders to use condoms and get tested. We also summarise participant recommendations for future interventions and studies.ConclusionsWhile control group participants reported precautionary behaviours were 'triggered' by trial participation, intervention recipients reported additional benefits of the intervention in increasing precautionary behaviours and in broader aspects of sexual health such as confidence, communication, emotional well-being and agency.Trial registrationISRCTN registry ISRCTN64390461.

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

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

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