Questionnaires and twice daily peak expiratory flow measurements were used to evaluate the effects of the menstrual cycle in asthmatic women. Forty per cent of women reported premenstrual deterioration in their symptoms and this was confirmed by peak flow recordings. No correlations were found between premenstrual exacerbation of asthma and symptoms of premenstrual tension, consumption of aspirin, use of the contraceptive pill, cycle length, or behaviour of asthma during pregnancy.Although premenstrual worsening of asthma is recognised,'-3 little attention has been paid to the problem. In particular, little is known of the frequency with which it occurs, its severity, the relevance of medication such as analgesics or the contraceptive pill, or its relationship to other premenstrual symptoms. We have studied this phenomenon by means of a self administered questionnaire and by analysis of home peak flow recordings. Patients and methodsOne hundred and twenty six consecutive women aged 14-46 years attending an outpatient clinic for asthma were asked about variation of their asthma during the menstrual cycle. A questionnaire was then sent to the 114 women who had responded and it was returned by 91 of them. It included questions on the timing of any exacerbation in relation to menstruation, the frequency with which this occurred, and the perceived severity of the deterioration. The patients were also asked if they ever experienced any of the following premenstrual symptoms: headache, breast tenderness, stomach bloating, swollen ankles, nervous tension, irritability, depression, acne rash, or period pains; and the frequency of these symptoms was compared in the women with and without premenstrual asthma. We also enquired about the contraceptive pill and any drugs taken for premenstrual symptoms, and the effect of pregnancy on the severity of asthma was recorded.Twenty one women who complained of premenstrual asthma and 12 who did not recorded their peak Address for reprint requests: Dr RJ White, Department of Medicine, Frenchay Hospital, Bristol. Accepted 2 May 1984flow rate twice daily, using a mini Wright peak flow meter before bronchodilator treatment, for three consecutive months. We compared the mean morning and evening peak flow rates during the premenstrual week (the seven days preceding the menstrual period) and during the mid cycle week (days 10-16), using Student's t test. ResultsIn response to the initial question " Has your asthma ever varied with your monthly period?" 49 patients (43%) answered "Yes" and 65 (57%) answered "No." QUESTIONNAIRE RESULTSWhen asked "Does your asthma ever seem worse before the menstrual period?" 36 patients (40%) answered "Yes" and 55 (60%) said "No." Most of the women had developed asthma in childhood and adolescence, but the mean age of onset of the premenstrual exacerbations was 25 (SD 8) years. The age of the women who complained of premenstrual worsening was not significantly different from those who did not.Of those who experienced premenstrual asthma, 27 (75%) ha...

Buprenorphine is at least as effective as lofexidine detoxification treatment. Whether or not individuals were randomized to, or chose, a treatment appeared not to affect the study's outcome.

No abstract