ASTIM TANILI ERGENLERDE MENSTRUASYONUN ASTIM KONTROLÜ ÜZERİNE ETKİSİ

Abstract

Perimenstrual asthma (PMA) is a clinical condition characterized by an increase in asthma symptoms toward the end of the luteal phase and at the beginning of the menstrual phase of the menstrual cycle. The aim of this study was to investigate the presence of PMA in adolescent girls with asthma and to evaluate asthma symptoms, morning-evening peak expiratory flow (PEF) values, and PEF variability according to menstrual cycle phases. The study included 54 adolescent girls diagnosed with asthma who had been postmenarcheal for at least two years. Participants recorded their daily symptoms and morning-evening PEF measurements throughout one menstrual cycle. Thirty-eight participants completed their follow-up over at least one menstrual cycle. The relationships between participants’ asthma control levels, spirometric parameters, inflammatory markers, and the presence of premenstrual syndrome (PMS) and their PEF values and symptom scores were evaluated. In comparisons across phases, morning PEF, evening PEF, and PEF variability did not show statistically significant differences between menstrual phases. A difference approaching statistical significance was observed in PEF variability between the perimenstrual and luteal phases (p=0.056). Asthma symptoms were numerically higher during the perimenstrual phase; however, this difference did not reach statistical significance. No significant association was found between PEF values and asthma symptoms, asthma control, spirometric findings, inflammatory markers, or PMS. The fact that PMA was not detected in adolescents in our study may be related to the possibility that this phenotype could become more pronounced with advancing age as hormonal cycles mature and may be more frequently identified in the adult age group. In contrast, the tendency for symptoms to increase during the perimenstrual period suggests that PMA in this age group may be shaped more by symptom perception and mood changes than by objective airway obstruction. The findings support the need to clarify the adolescent PMA phenotype through prospective studies with larger sample sizes that simultaneously track symptoms and PEF measurements.