Morbidity in asthma in relation to the menstrual cycle

Eliasson, Orn; Scherzer, Herbert H.; DeGraff, Arthur C.

doi:10.1016/0091-6749(86)90328-3

Cited by 156 publications

(96 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although asthma is more common in boys, at the time of puberty Other small retrospective studies suggested that PMA identifi es a group of high-risk women with asthma with similar prevalence. 15,[23][24][25] In a study of 57 women, 33% reported worsening asthma symptoms perimenstrually, 15 and a retrospective study of 44 near-fatal asthma events in women with asthma reported that 25% occurred perimenstrually. 24 Similarly, 46% of 182 women visiting the ED for asthma exacerbations presented during their perimenstrual phase (day 26 to day 4 of a 28-day cycle).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of Perimenstrual Asthma and Its Relation to Asthma Severity and Control

Rao

Moore

Bleecker

et al. 2013

Chest

View full text Add to dashboard Cite

A sthma is a complex disease with recognized sex differences. Adult asthma affects more women than men, and women may be predisposed to greater severity. [1][2][3][4] Additionally, women report onset of asthma later in life, often associated with times of hormonal change.In small studies, about 30% to 40% of women report worsening of asthma symptoms in relation to menstruation. [5][6][7][8] The presence of perimenstrual asthma (PMA) has been related to increases in asthmarelated ED visits, hospitalizations, ICU admissions, intubations, and near-fatal and fatal events. 5 Unfortunately, the small nature of previous studies limits the ability to characterize contributing factors or implications of PMA.There is growing support for the concept that asthma consists of multiple phenotypes, which may be more easily recognized in severe asthma. 9,10 Although the National Heart, Lung, and Blood Institute Severe Asthma Research Program (SARP), a large network to study severe asthma mechanisms, recently identifi ed a female-predominant, late-onset phenotype, 11Background: Although perimenstrual asthma (PMA) has been associated with severe and diffi cultto-control asthma, it remains poorly characterized and understood. The objectives of this study were to identify clinical, demographic, and infl ammatory factors associated with PMA and to assess the association of PMA with asthma severity and control. Methods: Women with asthma recruited to the National Heart, Lung, and Blood Institute Severe Asthma Research Program who reported PMA symptoms on a screening questionnaire were analyzed in relation to basic demographics, clinical questionnaire data, immunoinfl ammatory markers, and physiologic parameters. Univariate comparisons between PMA and non-PMA groups were performed. A severity-adjusted model predicting PMA was created. Additional models addressed the role of PMA in asthma control. Results: Self-identifi ed PMA was reported in 17% of the subjects (n 5 92) and associated with higher BMI, lower FVC % predicted, and higher gastroesophageal refl ux disease rates. Fifty-two percent of the PMA group met criteria for severe asthma compared with 30% of the non-PMA group. In multivariable analyses controlling for severity, aspirin sensitivity and lower FVC % predicted were associated with the presence of PMA. Furthermore, after controlling for severity and confounders, PMA remained associated with more asthma symptoms and urgent health-care utilization. Conclusions: PMA is common in women with severe asthma and associated with poorly controlled disease. Aspirin sensitivity and lower FVC % predicted are associated with PMA after adjusting for multiple factors, suggesting that alterations in prostaglandins may contribute to this phenotype. CHEST 2013; 143(4):984-992Abbreviations: F eno 5 fraction of exhaled nitric oxide; GERD 5 gastroesophageal refl ux disease; HCU 5 health-care utilization; PG 5 prostaglandin; PMA 5 perimenstrual asthma; SARP 5 Severe Asthma Research Program

show abstract

Section: Discussionmentioning

confidence: 99%

“…Defi nitions have differed across studies, and no large-scale analyses have been performed. 15,16 To this end, . 500 women with a range of asthma severity recruited for SARP were analyzed for PMA.…”

Section: Hormonal Immunoinfl Ammatory Factors and Comorbiditiesmentioning

confidence: 99%

Characteristics of Perimenstrual Asthma and Its Relation to Asthma Severity and Control

Rao

Moore

Bleecker

et al. 2013

Chest

View full text Add to dashboard Cite

show abstract

“…During low-oestrogen phases of the menstrual cycle hospitalisation and exacerbation rates appear to be increased and lung function reduced [27][28][29]. In addition, OC use has reduced exacerbation rates and improved lung function in some asthmatic females [17].…”

Section: Cystic Fibrosis Ng Kernan Et Almentioning

confidence: 99%

Oral contraceptives do not appear to affect cystic fibrosis disease severity

et al. 2012

View full text Add to dashboard Cite

Several studies suggest that sex may affect cystic fibrosis (CF) disease severity, with females with CF being more severely affected. In this context, it has been suggested that sex hormones may influence the CF phenotype. A large proportion of females with CF regularly use oral contraceptives (OCs), but the effect of their use on disease severity is unclear. Here, we retrospectively assessed the effects of OCs on clinical outcomes in females with CF.Data from 681 females were available, of whom 42% had taken OCs for varying periods of time. We first performed an inter-patient analysis comparing annual change in % predicted forced expiratory volume in 1 s, body mass index and total days of intravenous antibiotic use over a 5-yr study period in 57 females exposed to and 57 females not exposed to OCs. There were no differences between the two groups. We next performed an intra-patient analysis of the same outcomes over a 3-yr period of OC exposure and a 3-yr period of no OC exposure in the same patient (exposure followed by non-exposure, n527; non-exposure followed by exposure, n523), but again did not detect any differences in any of the clinical outcomes.Our data suggests that the use of OCs does not affect CF disease severity.

show abstract

“…While some authors require only the patient's subjective manifestation of the premenstrual deterioration of the asthmatic symptoms, others need a methodology with a series of objective criteria that show premenstrual deterioration of the symptoms or of functional parameters such as PF values [1,4]. Likewise, while some studies require these criteria to be satisfied in one cycle [4], others deem it necessary for them to occur in two consecutive cycles [5].…”

mentioning

confidence: 99%

“…The exacerbation of the respiratory symptoms and/or peak flow (PF) deterioration affects .30% of asthmatic females, according to various studies [1,2]. The most notable asthmatic symptoms evaluated are coughing, wheezing, tightness across the chest and breathlessness [1][2][3][4].…”

mentioning

confidence: 99%

Variability in the prevalence of premenstrual asthma

Vega¹,

Sánchez-Ramos²,

Pérez³

et al. 2009

Eur Respir J

View full text Add to dashboard Cite

Our aim is to analyse the differences in the prevalence of premenstrual asthma (PMA) according to a set of criteria, the relationship between them and the influence of asthma severity.The answer ''Yes'' to ''Does your asthma get worse before menstruation?'' was considered subjective PMA. A daily respiratory symptoms register of fertile asthmatic females was taken during two consecutive menstrual cycles. For the semi-objective diagnosis, an exacerbation of o20% was required in the symptoms register. Objective diagnosis was a premenstrual worsening of o20% of peak flow.We selected 103 patients. Subjective premenstrual deterioration was perceived in 43.7%. The semi-objective deterioration of symptoms in the first cycle occurred in 44.7%, and in 22.3% in both cycles. A total of 54.3% of females with semi-objective criteria in the first cycle perceived a subjective deterioration of symptoms, versus 35.1% of those without semi-objective criteria (p50.05). PMA was present at all levels of asthma severity, with no clear link to the degree of severity.The detection of PMA prevalence, the subjective perception of this deterioration and its presence at all levels of asthma severity lead us to urge research into possible premenstrual deterioration in all fertile asthmatic females.

show abstract

Morbidity in asthma in relation to the menstrual cycle

Cited by 156 publications

References 17 publications

Characteristics of Perimenstrual Asthma and Its Relation to Asthma Severity and Control

Characteristics of Perimenstrual Asthma and Its Relation to Asthma Severity and Control

Oral contraceptives do not appear to affect cystic fibrosis disease severity

Variability in the prevalence of premenstrual asthma

Contact Info

Product

Resources

About