Near-fatal asthma related to menstruation

J Allergy Clin Immunol. 2004 Feb;113(2):242-4. doi: 10.1016/j.jaci.2003.11.002.


Background: Menstruation has been suggested as a possible trigger of near-fatal asthma (NFA), but the evidence supporting this association remains weak.

Objective: We sought to assess the role of menstruation as a contributing factor in the development of NFA episodes in women of reproductive age.

Methods: Forty-four female patients of reproductive age with near-fatal attacks were enrolled in a multicenter study. Data on patient and clinical characteristics were collected. We also performed spirometric and allergy studies when the patients were in stable condition.

Results: Significantly more NFA episodes were observed on the first day of menstruation (11 [25%] patients) than on the remaining days (33 [75%] patients, P =.022), and patients who presented for care on the first day of menstruation used more inhaled salbutamol as rescue medication (9 [9.5] vs 1.8 [3.7] microg/d during the 7 days before the asthma exacerbation, P =.003).

Conclusion: Menstruation might act as a contributing factor in the development of NFA episodes in patients with unstable asthma. Specific recommendations should be included in educational programs, and the self-management plans of asthmatic women of reproductive age should include the systematic recording of their asthma symptoms and pulmonary function in the perimenstrual phase.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adult
  • Albuterol / administration & dosage
  • Albuterol / therapeutic use
  • Asthma / drug therapy
  • Asthma / mortality
  • Asthma / physiopathology*
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / therapeutic use
  • Female
  • Humans
  • Menstruation*
  • Risk Factors


  • Bronchodilator Agents
  • Albuterol