Asthma diagnosis and treatment
Menstrual irregularity and asthma and lung function

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Background

Oligomenorrhea was associated with more asthma (Respiratory Health in Northern Europe study), but a possible association with lung function has not been investigated previously.

Objective

To investigate whether oligomenorrhea was related to lung function and asthma, and whether body mass index and physical activity modified associations.

Methods

Women age 28 to 44 years (n = 1631) participating in the European Community Respiratory Health Survey were included. Women who were taking exogenous sex hormones, were pregnant, or had recently given birth were excluded.

Results

Long or irregular menstrual cycles were reported by 313 women (19%). Oligomenorrhea was significantly associated with more asthma symptoms (odds ratio [OR], 1.76; 95% CI, 1.29-2.40), allergic asthma (OR, 2.46; 95% CI, 1.43-4.23), and lower forced vital capacity (FVC; adjusted difference, 63 mL; 95% CI, −124 to −1). When excluding women using asthma medication, very lean women, or women exercising daily, these associations remained significant. Effects of oligomenorrhea were additive to those of body mass index (BMI) on asthma and FVC. Asthma symptoms increased significantly with BMI. FVC and FEV1 increased with BMI until 25 kg/m2 and thereafter decreased with increasing BMI. Excluding women exercising daily, asthma symptoms increased significantly with decreasing physical activity (OR, 1.09; 95% CI, 1.001-1.19) per category of physical activity) independently of oligomenorrhea. Among women exercising daily, oligomenorrhea predicted very high risk for asthma symptoms (OR, 12.6; 95% CI, 3.7-43).

Conclusion

Women with oligomenorrhea have reduced lung function and more asthma, particularly allergic asthma, independent of BMI and physical activity. Airways pathology may have not only a hormonal but also a metabolic component.

Clinical implications

Women with oligomenorrhea should be investigated with regard to asthma and lung function. Underlying metabolic disturbance should be considered in asthma.

Section snippets

Study design

This study is a cross-sectional analysis of the ECRHS II. ECRHS I29 was an international survey performed from 1991 to 1992 in randomly selected individuals from the general populations within administrative boundaries of 36 centers in 16 countries. A random sample and a smaller symptomatic sample were invited to a follow-up study, ECRHS II,30 which took place from 1998 to 2002. The examinations performed at both surveys included an interviewer-led questionnaire and measurements of lung

Results

Of 1631 women age 28 to 44 years participating in the study, 313 (19 %) reported having irregular menstrual cycles and/or cycles longer than 32 days. The prevalence of IM varied between 28% in Basel and 7.1% in Bergen (Table I). The median BMI varied from 21.2 kg/m2 in Montpellier to 26 kg/m2 in Portland.

Women with IM were slightly younger and less educated than the controls, and had about the same median BMI (Table II). Women with IMs did not differ significantly from the controls regarding

Discussion

In this cross-sectional analysis of a multinational population, women reporting long or irregular menstrual cycles had significantly lower FVC and more asthma, particularly allergic asthma. These associations were not modified by BMI or physical activity. On the other hand, FVC was lower in women with oligomenorrhea at any level of BMI, and asthma was more common in women with oligomenorrhea at any level of BMI or physical activity. The associations were consistent across centers, and remained

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  • Cited by (0)

    F.G.R. was supported exclusively by the Norwegian Research Council (grant NFR 161299/V50). ECRHS II was supported by the European Commission as part of their Quality of Life program. Bodies funding the local studies in ECRHS II are listed in this article's Online Repository at www.jacionline.org.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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