Respiratory symptoms vary significantly
during different stages of the menstrual cycle, with higher
frequencies during the mid-luteal to mid-follicular stages,
according to a new study.
"The effects of the menstrual cycle on
respiratory symptoms in the general population have not been well
studied," said lead author Ferenc Macsali, MD, of the Haukeland
University Hospital in Bergen, Norway. "In a cohort of nearly 4,000
women, we found large and consistent changes in respiratory symptoms
according to menstrual cycle phase, and, in addition, these patterns
varied according to body mass index (BMI), asthma, and smoking
status."
For example, wheezing spiked just before
and just after mid-cycle (ovulation). The dip in between corresponds
to peaks in estrogen, follicle stimulating hormone and luteinizing
hormone.
Complaints of shortness of breath and
coughing both declined just after women got their periods, and
shortness of breath was also more rare right before menses started.
A total of 3,926 women with regular
cycles who were not taking exogenous sex hormones were enrolled in
the study. Menstrual cycles, respiratory symptoms, BMI, asthma, and
smoking status were determined by postal questionnaire.
"Our finding that respiratory symptoms
vary according to the stage of the menstrual cycle is novel, as is
our finding that these patterns vary according to BMI and smoking
status," said Dr. Macsali. "These relationships indicate a link
between respiratory symptoms and hormonal changes through the
menstrual cycle."
Significant variations over the
menstrual cycle were found for each symptom assessed in all subjects
and subgroups. Reported wheezing was higher on cycle days 10-22,
with a mid-cycle dip near the putative time of ovulation (~days
14-16) in most subgroups. Shortness of breath was highest on days
7-21, with a dip just prior to mid-cycle in a number of subgroups.
The incidence of cough was higher just after putative ovulation for
asthmatics, subjects with BMI = 23kg/m2, and smokers, or just prior
to ovulation and the onset of menses in subgroups with a low
incidence of symptoms.
The study had a few limitations,
including the use of questionnaires to gather data and variation in
the length of menstrual cycles in the study population, which may
affect the accuracy of determining menstrual cycle stage.
Our results point to the potential for
individualizing therapy for respiratory diseases according to
individual symptom patterns," concluded Dr. Macsali. "Adjusting
asthma medication, for example, according to a woman's menstrual
cycle might improve its efficacy and help reduce disability and the
costs of care."
The findings were published online ahead
of print publication in the American Thoracic Society's American
Journal of Respiratory and Critical Care Medicine.
For more information
The American Journal of Respiratory and Critical Care Medicine
Menstrual cycle and respiratory symptoms in a general Nordic-Baltic
population
(MDN) |