Gut feelings: The link between digestive symptoms, mood and PMS

Clue recently worked with researchers from Johns Hopkins University on the largest study to date examining the relationship between gastrointestinal (GI) symptoms, mood, and the menstrual cycle. The new study provides important insights into the complex link between GI and mood symptoms across the menstrual cycle, particularly for individuals with premenstrual syndrome (PMS). 

The study analyzed data from more than 33,000 menstrual cycles over a four year period, across more than 32,000 participants, making it the most comprehensive study of its kind. Participants used Clue to identify and track their symptoms and opted-in to share their data anonymously for research.

"These findings not only validate the experiences of millions of women and people with cycles, but also pave the way for more effective support and treatment during especially difficult times of their menstrual cycles,” said Amanda Shea, Fractional Chief Science Officer at Clue. 

Key findings from the study 

• GI symptoms such as bloating, constipation, diarrhea, and nausea were more frequently tracked in the days leading up to menstruation as compared to the days following it, with a stronger effect observed in those with PMS.

• A strong positive association was found between mood symptoms and GI symptoms across all phases of the menstrual cycle, for both PMS and non-PMS groups, indicating that these symptoms often occur together.

• Participants with self-reported PMS tracked more GI symptoms throughout their entire menstrual cycle compared to those without PMS.

“We hope this study leads to more research on the gut-brain axis in the context of menstrual health, “ said Liisa Hantsoo, Ph.D., Assistant Professor in Psychiatry and Behavioral Sciences at the Johns Hopkins School of Medicine, and Director of Research in the Johns Hopkins Reproductive Mental Health Center.

“This study was exciting because it drew from such a large dataset of menstrual cycles, to give a representative look at GI symptoms and mood across the cycle. We were able to see a clear relationship between GI symptoms and mood at multiple points in the menstrual cycle. Previous studies have found links between GI symptoms and mood in people with major depression, but this had not been assessed in the context of the menstrual cycle or premenstrual mood symptoms.” 

With the Clue app, members can track when they feel bloated or gassy, monitor constipation or diarrhea, and log mood fluctuations throughout their cycle. By customizing additional tags, members can capture their unique experiences, and get a clear overview of how gastrointestinal symptoms and mood changes interact during their cycles. 

"Reporting your experiences and discomforts to your healthcare provider from memory alone often doesn't reflect the true condition of your health and might not be the most reliable. We recommend tracking both your digestion and feelings daily, and over a longer period, to help you and your healthcare provider analyze cycle-related patterns,” adds Shea.

The full study can be found here. 

Clue is committed to advancing society’s understanding of menstrual health through data-driven research. You can find out more about Clue’s approach to research here.