Menstrual cycle and respiratory symptoms in a general Nordic-Baltic population

Am J Respir Crit Care Med. 2013 Feb 15;187(4):366-73. doi: 10.1164/rccm.201206-1112OC. Epub 2012 Nov 29.


Rationale: There is little knowledge of variations in respiratory symptoms during the menstrual cycle in a general population, and potential modifying factors are not investigated.

Objectives: To investigate menstrual cycle variation in respiratory symptoms in a large general population, using chronobiology methodology, and stratifying by body mass index (BMI), smoking, and asthma status.

Methods: A total of 3,926 women with regular cycles less than or equal to 28 days and not taking exogenous sex hormones answered a postal questionnaire regarding the first day of their last menstruation and respiratory symptoms in the last 3 days. Moving 4-day means were computed to smooth uneven records of daily sampling; best-fitting 28-day composite cosine curves were applied to each time series to describe rhythmicity.

Measurements and main results: Significant rhythmic variations over the menstrual cycle were found in each symptom for all subjects and subgroups. Wheezing was higher on cycle Days 10-22, with a midcycle dip near the time of putative ovulation (approximately Days 14-16) in most subgroups. Shortness of breath was higher on days 7-21, with a dip just before midcycle in many subgroups. Cough was higher just after putative ovulation for subjects with asthma, BMI greater than or equal to 23 kg/m(2), and smokers, or just before ovulation and menses onset for low symptomatic subgroups.

Conclusions: Respiratory symptoms varied significantly during the menstrual cycle and were most frequent from the midluteal to midfollicular stages, often with a dip near the time of ovulation. The patterns varied by BMI, smoking, and asthma status. These relations link respiratory symptoms with hormonal changes through the menstrual cycle and imply a potential for individualized chronotherapy for respiratory diseases.

MeSH terms

  • Adult
  • Asthma / epidemiology
  • Baltic States / epidemiology
  • Body Mass Index
  • Comorbidity
  • Europe / epidemiology
  • Female
  • Humans
  • Menstrual Cycle / physiology*
  • Middle Aged
  • Respiration Disorders / epidemiology*
  • Respiratory Physiological Phenomena*
  • Smoking / epidemiology
  • Surveys and Questionnaires