Clinical characteristics of women with menstrual-linked asthma

Background: Menstrual-linked asthma (MLA) is described in pre-menopausal women who experience a deterioration of asthma control peri-menstrually. The clinical characteristics of MLA remain incompletely defined. Our objective was to define the characteristics of MLA in a large female asthma cohort.

Methods: Cross-sectional population survey. A comprehensive health questionnaire that included questions about MLA was administered to 1260 consecutive female asthma patients aged 12-55 years. Univariate and multivariate analyses were completed.

Results: The survey response rate was 43% (540/1260). The prevalence of self-reported MLA was 11% (60/540). Univariate: women with MLA compared to women without MLA had more urgent/emergent asthma-related healthcare visits/year, 6.18 (SD = ± 6.67) vs. 4.71 (SD = ± 5.91) (p=0.033), more emergency room visits, 1.50 (SD = ± 3.57) vs. 0.88 (SD = ± 2.27) (p=0.035), higher asthma-related absenteeism, 33/60 (57%) vs. 170/471 (37%) (p=0.003), and used almost twice the number of B(2)-agonist rescue doses/day, 1.13 (SD = ± 1.70) vs. 0.68 (SD = ± 1.32) (p=0.015). Multivariate: statistical significance was retained for absenteeism (p=0.016) and B(2)-agonist use (p=0.007) but lost for urgent healthcare visits (p=0.150) and emergency room visits (p=0.068).

Conclusions: Self-reported MLA is common. Women with MLA in our population had a greater frequency of urgent healthcare visits, a higher rate of absenteeism, and used significantly more B(2)-agonist rescue than women without MLA. The association of increased health services use was not confirmed on multivariate analysis indicating that baseline characteristics associated with MLA in our population affected this outcome. MLA should be considered by healthcare providers when developing an asthma management plan.