Menstruation-Related Disorders Linked to Higher Risk of STI Diagnosis: Study
Japan: A large study suggests that women with menstruation-related disorders, including endometriosis and painful menstrual periods (dysmenorrhea), are more likely to be diagnosed with sexually transmitted infections (STIs).
The findings indicate a strong association between these gynecological conditions and STI diagnoses, highlighting the need for increased awareness, screening, and comprehensive reproductive healthcare in affected women. While the study demonstrates a significant link, it does not establish a direct cause-and-effect relationship between menstruation-related disorders and STIs.
The findings were reported in a study published in PLOS One by Tatsuya Yoshihara from the Department of Obstetrics and Gynecology, University of Yamanashi, Japan, and colleagues.
Endometriosis and dysmenorrhea are common menstrual-related disorders that can adversely affect women's health and quality of life. To better understand their relationship with sexually transmitted infections (STIs), researchers analyzed STI prevalence among young women with and without these conditions using a large nationwide database in Japan.
For the cross-sectional study, data were obtained from the Japan Medical Data Center Claims Database and included women younger than 40 years who had at least one healthcare visit in 2023. Endometriosis and dysmenorrhea were identified using ICD-10 diagnostic codes.
The researchers evaluated the prevalence of five STIs—gonorrhea, genital chlamydia infection, trichomoniasis, genital herpes, and other sexually transmitted conditions—and also examined differences according to disorder type and hormonal therapy use, including low-dose estrogen-progestin combinations and dienogest.
Key Findings:
- The study included 3,440,929 women younger than 40 years, of whom 257,897 (7.5%) had endometriosis or dysmenorrhea.
- Women with menstrual-related disorders had substantially higher rates of all evaluated sexually transmitted infections (STIs) compared with women without these conditions.
- The likelihood of receiving an STI diagnosis was 4.31 to 5.29 times higher among women with menstrual-related disorders.
- Endometriosis showed the strongest association with STI diagnoses among the menstrual-related disorders examined.
- Genital chlamydia infection was the most common STI among women with endometriosis, affecting nearly 5% of patients.
- Women with endometriosis were more than seven times as likely to be diagnosed with genital chlamydia infection compared with women without menstrual-related disorders.
- Dysmenorrhea was also consistently associated with higher rates of STI diagnoses across all infection categories studied.
- STI prevalence differed only slightly according to hormonal therapy use among women with menstrual-related disorders.
- Differences in STI prevalence between hormonal therapy users and non-users were generally less than one percentage point.
The authors concluded that endometriosis and dysmenorrhea are strongly associated with higher rates of STI diagnoses among young women in Japan. They highlighted the need to integrate STI screening, reproductive health education, and counseling into routine gynecological care for affected women.
The researchers cautioned that healthcare-seeking behavior and diagnostic practices may have influenced the findings. However, the results highlight the potential value of earlier STI detection and management in women with menstrual-related disorders.
Reference:
Yoshihara, T., Owada, S., Arita, H., Nakagomi, A., Tanaka, K., Ono, Y., & Yoshino, O. (2026). Association between menstrual-related disorders and sexually transmitted infections: A nationwide cross-sectional study in Japan. PLOS ONE, 21(6), e0351855. https://doi.org/10.1371/journal.pone.0351855
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