Near-fatal asthma related to menstruation

Abstract

Menstruation has been reported to be a possible trigger of near-fatal asthma episodes. However, the evidence of this correlation remains weak. The current study further investigated the role of menstruation as a contributor to the development of near-fatal asthma episodes in women of reproductive age. Forty-four women with near-fatal asthma were included in the multicenter trial. Patients and clinical data were obtained. Spirometric and allergy studies were also performed when the patients were in stable condition. A near-fatal asthma episode was defined as a severe exacerbation with one or more of these events: respiratory arrest, need for mechanical ventilation, Paco2 exceeding 50 mm Hg, and pH of less than 7.30. Significantly more near-fatal asthma episodes occurred on the first day of menstruation than on the remaining days. Twenty-five percent of women experiencing near-fatal asthma episodes had these exacerbations on the first day of their menstrual cycle. In addition, patients seeking care on the first day of menstruation used more inhaled salbutamol as rescue medication. In women with unstable asthma, menstruation may be a contributing factor to the development of near-fatal asthma episodes. Self-management plans of asthmatic women of reproductive age should include systematic recording of asthma symptoms and pulmonary function during the perimenstrual phase.