The Missing Link: How Inflammation Mediates the Relationship between Expectation, Infection and Diversity

The experience of premenstrual syndrome (PMS) varies between individuals and across cultures, but the causes of such variation are not fully understood. PMS has been described as an inflammatory disease, and while biomedical advances treat symptoms of PMS, there is a dearth of data on the root cause of these symptoms. I propose that variation in the premenstrual experience could be partially explained by ecology, both internal ecology (infection) and external ecology (expectation of menstruation), mediated by inflammation. The research will use experimental designs to investigate how inflammation mediates the relationship between ecology and the experiences of PMS and menstruation. First, I will examine the possibility that the presence of undiagnosed infections such as chlamydia can aggravate PMS symptoms (PMSx). Second, I will examine the influence of expectation about upcoming menses to quantify its effects on inflammatory levels. Participants will be recruited through the app, Clue, a digital period tracker app with which a collaboration has been established. The app will enable us to collect data on volunteers PMSx, cycles, weight, height and sexual activity. Cycling levels of inflammation will be quantified through the tracking of a biomarker for inflammation, neopterin, in partnership with the department of reproductive immunology at Oxford. The findings will have implications for public health and reproductive anthropology, as well as for developing novel ways to diagnose STIs (sexually transmitted infections) as well as pave the way for an interdisciplinary approach to epidemiology and anthropology.