Published online Nov 28, 2015. doi: 10.5320/wjr.v5.i3.180
Peer-review started: July 10, 2015
First decision: July 31, 2015
Revised: September 22, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: November 28, 2015
Processing time: 149 Days and 15.2 Hours
The study of asthma in fertile women needs to consider its potentially recurrent exacerbation in a specific phase of the menstrual cycle. Premenstrual asthma (PMA) refers to the deterioration of asthma in some women of fertile age during the premenstrual phase. Prevalence varies considerably according to studies (11%-47.44%) mainly because there is no standardized definition of the illness. There is a possible link between PMA and premenstrual syndrome, which is a set of physical and psychic manifestations that occur in some fertile women during the same premenstrual phase. This relation has been widely studied but there are still several unknowns. PMA etiopathogeny is not known. It involves possible causes such as hormonal variations in the premenstrual phase, the coexistence of atopy, variations during the cycle in substances related to inflammation, like LTC4 leukotrienes, catecholamines, E2 and F2α prostaglandins and certain cytokines. Also considered are psychological factors related to this phase of the menstrual cycle, a high susceptibility to infection or increased bronchial hyperreactivity prior to menstruation. Yet no factor fully explains its etiology, consequently no specific treatment exists. Researchers have investigated hormones, anti-leukotrienes, prostaglandin synthesis inhibitors, diuretics, phytoestrogens and alternative therapies, but none has been shown to be effective.
Core tip: Premenstrual asthma (PMA) refers to the exacerbation of asthma in women of fertile age during the premenstrual phase. Whether or not it is an asthma phenotype, its definition, etiopathogeny and treatment are issues still to be resolved. PMA seems to be a female asthma phenotype despite contradictory results. It can occur at any level of asthma severity and it is usually associated with poorer disease control. Its etiology is not well known, and there is no specific widely recognized treatment. We need new well-designed studies to compare asthmatic women with or without PMA, and good quality clinical trials.