Variability in the prevalence of premenstrual asthma

Abstract

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.

Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis

“…Gender differences have been reported in the incidence of anaphylactic reactions, demonstrating that anaphylaxis is more frequent in women than men ( 43 , 44 ), but only during the reproductive years, suggesting that sexual hormones might play a role. Additionally, like the episodes of asthma or urticaria associated with the menstrual cycle ( 45 , 46 ), recurrent episodes of anaphylactic reactions around menstruation have been described, pointing at the estrogens or progesterone as the augmenting factors involved ( 47 ).…”

Gender-Specific Asthma Treatment

“…Recently, in a study monitoring daily respiratory symptoms of fertile asthmatic females during two consecutive menstrual cycles, Pereira Vega et al43 reported that 59.6% of patients showed premenstrual exacerbation of symptoms in at least one of the two cycles, but only 22.3% in both cycles. Autoantibodies against sex hormones are also able to induce perimenstrual asthma and miscarriage 44.…”

Relationship Between Gender and the Effectiveness of Montelukast: An Italian/Danish Register-Based Retrospective Cohort Study

“…In line with this hypothesis, it should be emphasized that women in the fertile age, when compared to men, tend to have especially during the preovulatory phase (Osborne et al, 1998 ; Cydulka et al, 2001 ; Brenner et al, 2005 ; Ostrom, 2006 ; Pereira Vega et al, 2010 ; Graziottin and Zanello, 2015 ; Graziottin and Serafini, 2016 ) a different perception of their symptoms which lead to a poorer control of asthma and to an increase in asthma treatments and healthcare use (Pignataro et al, 2017 ). Specifically, during preovulatory and perimenstrual phases when serum estradiol levels decrease sharply after the prolonged peak, there is a higher concentration of serum leukotriene C4 levels which is associated with a higher risk of asthma exacerbation (Skobeloff et al, 1996 ; Nakasato et al, 1999 ; Green et al, 2004 ; Brenner et al, 2005 ; Matteis et al, 2014 ).…”