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Multidisciplinary Respiratory Medicine

, 11:30

First Online: 01 August 2016Received: 17 February 2016Accepted: 05 May 2016


The prevalence of asthma is about 9,7 % in women and 5,5 % in men.

Asthma can deteriorate during the perimenstrual period, a phenomenon known as perimenstrual asthma PMA, which represents a unique, highly symptomatic asthma phenotype. It is distinguished from traditional allergic asthma by aspirin sensitivity, less atopy, and lower lung capacity.

PMA incidence is reported to vary between 19 and 40 % of asthmatic women. The presence of PMA has been related to increases in asthma-related emergency department visits, hospitalizations and emergency treatment including intubations.

It is hypothesized that hormonal status may influence asthma in women, focusing on the role of sex hormones, and specifically on the impact of estrogens’ fluctuations at ovulation and before periods.

This paper will focus on the pathophysiology of hormone triggered cycle related inflammatory-allergic events and their relation with asthma. We reviewed the scientific literature on Pubmed database for studies on PMA. Key word were PMA, mastcells, estrogens, inflammation, oral contraception, hormonal replacement therapy HRT, and hormone free interval HFI.

Special attention will be devoted to the possibility of reducing the perimenstrual worsening of asthma and associated symptoms by reducing estrogens fluctuations, with appropriate hormonal contraception and reduced HFI. This novel therapeutical approach will be finally discussed.

KeywordsMenstrual asthma Mastcells Estrogens Inflammation Oral contraception Hormone free interval  Download fulltext PDF

Autor: Alessandra Graziottin - Audrey Serafini


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