Perimenstrual increase in bronchial hyperreactivity in premenopausal women: Results from the population-based SAPALDIA 2 cohort

• Published in: Journal of allergy and clinical immunology Vol. 125; no. 4; pp. 823 - 829
• Main Authors: Dratva, Julia, Schindler, Christian, Curjuric, Ivan, Stolz, Daiana, Macsali, Ferenc, Gomez, Francisco Real, Zemp, Elisabeth
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.2010; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Allergy and Immunology; Asthma; Asthma - epidemiology; Asthma - physiopathology; Biological and medical sciences; bronchial hyperreactivity; Bronchial Hyperreactivity - epidemiology; Bronchial Hyperreactivity - physiopathology; Chronic obstructive pulmonary disease, asthma; Cohort Studies; Contraceptives, Oral - administration & dosage; epidemiology; Female; Females; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Heart attacks; Humans; Hypotheses; Immunopathology; Logistics; Medical sciences; Menstruation; methacholine challenge test; Methacholine Chloride - administration & dosage; Middle Aged; oral contraceptives; Pneumology; Premenopause; premenstrual; Prevalence; Questionnaires; Response rates; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Studies; Surveys and Questionnaires; Womens health; Young Adult; CRP; oral contraceptives; OR; methacholine challenge test; premenstrual; PMA; BHR; Asthma; epidemiology; FEV 1; OC; menstruation; bronchial hyperreactivity; SAPALDIA; BMI; C-reactive protein; Premenstrual asthma; Body mass index; Forced expiratory volume in 1 second; Swiss cohort study on Air Pollution And Lung Disease In Adults; Odds ratio; Oral contraceptive; Agonist; Hyperreactivity; Methacholine chloride; Respiratory system; Epidemiology; Respiratory tract; Cholinergic receptor; Immunology; Estroprogestagen; Cohort study; Bronchus disease; Female; Obstructive pulmonary disease; Woman; Human; Lung disease; Immunopathology; Menstruation; Premenopause; Respiratory disease; Oral administration; Bronchus; Increase; Parasympathomimetic; Young adult; Muscarinic receptor; Contraceptive; Provocation test
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2009.12.938

Studies on perimenstrual asthma are inconsistent, and different methodologies limit comparisons. To investigate cyclic variations in bronchial hyperreactivity (BHR) to methacholine in premenopausal women in a population-based cohort and assess effect modification by oral contraceptives (OCs). Day of menstruation cycle at the time of methacholine challenge was calculated in 571 menstruating women without hormonal treatment, age 28 to 58 years, on the basis of questionnaire data from the Swiss cohort study on Air Pollution And Lung Disease In Adults (SAPALDIA) cohort 2001/2002. A window of risk was defined 3 days before and after the first day of menstruation. Logistic and linear regression analyses were performed adjusting for main predictors of BHR and stratifying for asthma status. The impact of OCs was studied in the same sample enlarged by 130 women taking OCs. The prevalence of BHR was 13% (fall of ≥20% in FEV 1 up to a maximal cumulative dose of 2 mg), and 6% had asthma. A total of 143 women had undergone methacholine challenge within the risk window. We observed a significant increase in BHR within the window of risk (odds ratio [OR], 2.3; 95% CI, 1.27-4.29). A cyclic association pattern was confirmed by trigonometric functions. Effect modification by asthma status and oral contraceptive use was found, with lower OR in subjects without asthma and OR <1 in women using OCs. The data provide evidence of a systematic variation in BHR during the menstruation cycle, supporting the hypothesis of a hormonal influence. OCs appear to have a protective effect. Cyclicity of BHR could be of clinical importance in view of future medication recommendations and timing of respiratory function tests in women.