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Is the stage of the menstrual cycle related to chlamydia detection?

Is the stage of the menstrual cycle related to chlamydia detection?

We investigated the association between chlamydia detection and stage in the menstrual cycle to investigate whether chlamydia detection was higher at different stages of the cycle. Electronic medical records for women attending Melbourne Sexual Health Centre March 2011 – 31st December 2012, who were tested for chlamydia by nucleic acid amplification of high vaginal, cervical, or urinary samples, and who recorded a date of last normal menstrual period (LNMP) between 0-28 days were included in the analysis. Logistic regression was used to calculate OR (95%CI) for the association of chlamydia with menstrual cycle adjusted by demographics and behavioural variables.

Of the 10,017 consultations during the study period in which a woman a tested for chlamydia and had a valid LNMP, there were 417 in which chlamydia was detected. Detection rates were 3.4% (233/6816) in the follicular and 4.8% (184/3831) in the luteal phase of the menstrual cycle (OR 1.29 95%CI 1.1 – 1.6, p=0.01). Detection was significantly associated with the luteal phase (adjusted odds ratio (aOR) 1.4, 95%CI 1.1 – 1.8, p=0.004) when adjusted for age, number of male partners, symptoms, inconsistent use of condoms, site of sample and sexual partners overseas/from overseas. Among women using hormonal contraception, there was no association with the latter half of the menstrual cycle (aOR 1.3, 95%CI 0.9, 1.8, p=0.18); among women not using hormonal contraception, association with the luteal phase was significant (aOR 1.6, (95% CI 1.1 – 2.3, p=0.007). The positive stored samples will undergo analysis to quantify bacterial load and determine if mean load differs across the cycle.
Chlamydia detection rates are substantially and significantly higher in the luteal phase of the menstrual cycle. This finding was only significant in women not using hormonal contraception, suggesting that hormonal variation across the menstrual cycle may influence chlamydia infection. 

Speakers: Dana Forcey
Conference: AIDS 2013, HIV
Areas of Interest / Categories: AIDS 2014, Sexually Transmitted Disease

AIDS 2014

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