Skip to main content
Thorax logoLink to Thorax
. 2005 Jun;60(6):445–450. doi: 10.1136/thx.2004.032615

Association of asthma and hay fever with irregular menstruation

C Svanes 1, F Real 1, T Gislason 1, C Jansson 1, R Jogi 1, E Norrman 1, L Nystrom 1, K Toren 1, E Omenaas 1
PMCID: PMC1747439  PMID: 15923242

Abstract

Background: There is some evidence that asthmatic women are more likely to have abnormal sex hormone levels. A study was undertaken to determine whether asthma and allergy were associated with irregular menstruation in a general population, and the potential role of asthma medication for this association.

Methods: A total of 8588 women (response rate 77%) participated in an 8 year follow up postal questionnaire study of participants of the ECRHS stage I in Denmark, Estonia, Iceland, Norway, and Sweden. Only non-pregnant women not taking exogenous sex hormones were included in the analyses (n = 6137).

Results: Irregular menstruation was associated with asthma (OR 1.54 (95% CI 1.11 to 2.13)), asthma symptoms (OR 1.47 (95% CI 1.16 to 1.86)), hay fever (OR 1.29 (95% CI 1.05 to 1.57)), and asthma preceded by hay fever (OR 1.95 (95% CI 1.30 to 2.96)) among women aged 26–42 years. This was also observed in women not taking asthma medication (asthma symptoms: OR 1.44 (95% CI 1.09 to 1.91); hay fever: OR 1.27 (95% CI 1.03 to 1.58); wheeze preceded by hay fever: OR 1.76 (95% CI 1.18 to 2.64)). Irregular menstruation was associated with new onset asthma in younger women (OR 1.58 (95% CI 1.03 to 2.42)) but not in women aged 42–54 years (OR 0.62 (95% CI 0.32 to 1.18)). The results were consistent across centres.

Conclusions: Younger women with asthma and allergy were more likely to have irregular menstruation. This could not be attributed to current use of asthma medication. The association could possibly be explained by common underlying metabolic or developmental factors. The authors hypothesise that insulin resistance may play a role in asthma and allergy.

Full Text

The Full Text of this article is available as a PDF (109.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abu J. I., Konje J. C. Leukotrienes in gynaecology: the hypothetical value of anti-leukotriene therapy in dysmenorrhoea and endometriosis. Hum Reprod Update. 2000 Mar-Apr;6(2):200–205. doi: 10.1093/humupd/6.2.200. [DOI] [PubMed] [Google Scholar]
  2. Adams J., Polson D. W., Franks S. Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Br Med J (Clin Res Ed) 1986 Aug 9;293(6543):355–359. doi: 10.1136/bmj.293.6543.355. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Balzano G., Fuschillo S., Melillo G., Bonini S. Asthma and sex hormones. Allergy. 2001 Jan;56(1):13–20. doi: 10.1034/j.1398-9995.2001.00128.x. [DOI] [PubMed] [Google Scholar]
  4. Barrett-Connor E., Frette C. NIDDM, impaired glucose tolerance, and pulmonary function in older adults. The Rancho Bernardo Study. Diabetes Care. 1996 Dec;19(12):1441–1444. doi: 10.2337/diacare.19.12.1441. [DOI] [PubMed] [Google Scholar]
  5. Becklake M. R., Kauffmann F. Gender differences in airway behaviour over the human life span. Thorax. 1999 Dec;54(12):1119–1138. doi: 10.1136/thx.54.12.1119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Burney P. G., Luczynska C., Chinn S., Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994 May;7(5):954–960. doi: 10.1183/09031936.94.07050954. [DOI] [PubMed] [Google Scholar]
  7. Camargo C. A., Jr, Weiss S. T., Zhang S., Willett W. C., Speizer F. E. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med. 1999 Nov 22;159(21):2582–2588. doi: 10.1001/archinte.159.21.2582. [DOI] [PubMed] [Google Scholar]
  8. Chinn Susan. Obesity and asthma: evidence for and against a causal relation. J Asthma. 2003 Feb;40(1):1–16. doi: 10.1081/jas-120017202. [DOI] [PubMed] [Google Scholar]
  9. Cordain Loren, Eades Michael R., Eades Mary D. Hyperinsulinemic diseases of civilization: more than just Syndrome X. Comp Biochem Physiol A Mol Integr Physiol. 2003 Sep;136(1):95–112. doi: 10.1016/s1095-6433(03)00011-4. [DOI] [PubMed] [Google Scholar]
  10. Davis Wendy A., Knuiman Matthew, Kendall Peter, Grange Valerie, Davis Timothy M. E., Fremantle Diabetes Study Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care. 2004 Mar;27(3):752–757. doi: 10.2337/diacare.27.3.752. [DOI] [PubMed] [Google Scholar]
  11. DerSimonian R., Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2. [DOI] [PubMed] [Google Scholar]
  12. Engström G., Hedblad B., Nilsson P., Wollmer P., Berglund G., Janzon L. Lung function, insulin resistance and incidence of cardiovascular disease: a longitudinal cohort study. J Intern Med. 2003 May;253(5):574–581. doi: 10.1046/j.1365-2796.2003.01138.x. [DOI] [PubMed] [Google Scholar]
  13. Engström G., Janzon L. Risk of developing diabetes is inversely related to lung function: a population-based cohort study. Diabet Med. 2002 Feb;19(2):167–170. doi: 10.1046/j.1464-5491.2002.00652.x. [DOI] [PubMed] [Google Scholar]
  14. Forbes L. Do exogenous oestrogens and progesterone influence asthma? Thorax. 1999 Mar;54(3):265–267. doi: 10.1136/thx.54.3.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Franks S. Polycystic ovary syndrome. N Engl J Med. 1995 Sep 28;333(13):853–861. doi: 10.1056/NEJM199509283331307. [DOI] [PubMed] [Google Scholar]
  16. Grodstein F., Goldman M. B., Ryan L., Cramer D. W. Self-reported use of pharmaceuticals and primary ovulatory infertility. Epidemiology. 1993 Mar;4(2):151–156. doi: 10.1097/00001648-199303000-00011. [DOI] [PubMed] [Google Scholar]
  17. Gunnbjörnsdóttir M. I., Omenaas E., Gíslason T., Norrman E., Olin A. C., Jõgi R., Jensen E. J., Lindberg E., Björnsson E., Franklin K. Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms. Eur Respir J. 2004 Jul;24(1):116–121. doi: 10.1183/09031936.04.00042603. [DOI] [PubMed] [Google Scholar]
  18. Harborne Lyndal, Fleming Richard, Lyall Helen, Norman Jane, Sattar Naveed. Descriptive review of the evidence for the use of metformin in polycystic ovary syndrome. Lancet. 2003 May 31;361(9372):1894–1901. doi: 10.1016/S0140-6736(03)13493-9. [DOI] [PubMed] [Google Scholar]
  19. Harel Z., Lilly C., Riggs S., Vaz R., Drazen J. Urinary leukotriene (LT) E(4) in adolescents with dysmenorrhea: a pilot study. J Adolesc Health. 2000 Sep;27(3):151–154. doi: 10.1016/s1054-139x(00)00123-3. [DOI] [PubMed] [Google Scholar]
  20. Hokken-Koèlega Anita C. S. Timing of puberty and fetal growth. Best Pract Res Clin Endocrinol Metab. 2002 Mar;16(1):65–71. doi: 10.1053/beem.2002.0181. [DOI] [PubMed] [Google Scholar]
  21. Hull M. G. Epidemiology of infertility and polycystic ovarian disease: endocrinological and demographic studies. Gynecol Endocrinol. 1987 Sep;1(3):235–245. doi: 10.3109/09513598709023610. [DOI] [PubMed] [Google Scholar]
  22. Kos-Kudła B., Ostrowska Z., Marek B., Ciesielska-Kopacz N., Sieminska L., Kajdaniuk D., Nowak M., Kudla M. Hormone replacement therapy in postmenopausal asthmatic women. J Clin Pharm Ther. 2000 Dec;25(6):461–466. doi: 10.1046/j.1365-2710.2000.00310.x. [DOI] [PubMed] [Google Scholar]
  23. Lange P., Groth S., Kastrup J., Mortensen J., Appleyard M., Nyboe J., Jensen G., Schnohr P. Diabetes mellitus, plasma glucose and lung function in a cross-sectional population study. Eur Respir J. 1989 Jan;2(1):14–19. [PubMed] [Google Scholar]
  24. Lawlor D. A., Ebrahim S., Smith G. Davey. Associations of measures of lung function with insulin resistance and Type 2 diabetes: findings from the British Women's Heart and Health Study. Diabetologia. 2003 Dec 24;47(2):195–203. doi: 10.1007/s00125-003-1310-6. [DOI] [PubMed] [Google Scholar]
  25. Lazarus R., Sparrow D., Weiss S. T. Impaired ventilatory function and elevated insulin levels in nondiabetic males: the Normative Aging Study. Eur Respir J. 1998 Sep;12(3):635–640. doi: 10.1183/09031936.98.12030635. [DOI] [PubMed] [Google Scholar]
  26. Lithell H. O., McKeigue P. M., Berglund L., Mohsen R., Lithell U. B., Leon D. A. Relation of size at birth to non-insulin dependent diabetes and insulin concentrations in men aged 50-60 years. BMJ. 1996 Feb 17;312(7028):406–410. doi: 10.1136/bmj.312.7028.406. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Maskell Nicholas A., Davies Christopher W. H., Nunn Andrew J., Hedley Emma L., Gleeson Fergus V., Miller Robert, Gabe Rhian, Rees Glyn L., Peto Timothy E. A., Woodhead Mark A. U.K. Controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med. 2005 Mar 3;352(9):865–874. doi: 10.1056/NEJMoa042473. [DOI] [PubMed] [Google Scholar]
  28. Nelson-Piercy C. Asthma in pregnancy. Thorax. 2001 Apr;56(4):325–328. doi: 10.1136/thorax.56.4.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Olesen C., Steffensen F. H., Nielsen G. L., de Jong-van den Berg L., Olsen J., Sørensen H. T. Drug use in first pregnancy and lactation: a population-based survey among Danish women. The EUROMAP group. Eur J Clin Pharmacol. 1999 Apr;55(2):139–144. doi: 10.1007/s002280050608. [DOI] [PubMed] [Google Scholar]
  30. Romieu I., Trenga C. Diet and obstructive lung diseases. Epidemiol Rev. 2001;23(2):268–287. doi: 10.1093/oxfordjournals.epirev.a000806. [DOI] [PubMed] [Google Scholar]
  31. Rubio Ravelo L., Gago Rodríguez B., Almirall Collazo J. J., Bell Heredia L., Fernández Fernández L. Comparative study of progesterone, estradiol and cortisol concentrations in asthmatic and non-asthmatic women. Allergol Immunopathol (Madr) 1988 Jul-Aug;16(4):263–266. [PubMed] [Google Scholar]
  32. Schatz M., Harden K., Forsythe A., Chilingar L., Hoffman C., Sperling W., Zeiger R. S. The course of asthma during pregnancy, post partum, and with successive pregnancies: a prospective analysis. J Allergy Clin Immunol. 1988 Mar;81(3):509–517. [PubMed] [Google Scholar]
  33. Shaheen S. O., Sterne J. A., Montgomery S. M., Azima H. Birth weight, body mass index and asthma in young adults. Thorax. 1999 May;54(5):396–402. doi: 10.1136/thx.54.5.396. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Sinaii N., Cleary S. D., Ballweg M. L., Nieman L. K., Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod. 2002 Oct;17(10):2715–2724. doi: 10.1093/humrep/17.10.2715. [DOI] [PubMed] [Google Scholar]
  35. Solomon C. G., Hu F. B., Dunaif A., Rich-Edwards J., Willett W. C., Hunter D. J., Colditz G. A., Speizer F. E., Manson J. E. Long or highly irregular menstrual cycles as a marker for risk of type 2 diabetes mellitus. JAMA. 2001 Nov 21;286(19):2421–2426. doi: 10.1001/jama.286.19.2421. [DOI] [PubMed] [Google Scholar]
  36. Solomon Caren G., Hu Frank B., Dunaif Andrea, Rich-Edwards Janet E., Stampfer Meir J., Willett Walter C., Speizer Frank E., Manson Joann E. Menstrual cycle irregularity and risk for future cardiovascular disease. J Clin Endocrinol Metab. 2002 May;87(5):2013–2017. doi: 10.1210/jcem.87.5.8471. [DOI] [PubMed] [Google Scholar]
  37. Svanes C., Omenaas E., Heuch J. M., Irgens L. M., Gulsvik A. Birth characteristics and asthma symptoms in young adults: results from a population-based cohort study in Norway. Eur Respir J. 1998 Dec;12(6):1366–1370. doi: 10.1183/09031936.98.12061366. [DOI] [PubMed] [Google Scholar]
  38. Troisi R. J., Speizer F. E., Willett W. C., Trichopoulos D., Rosner B. Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study. Am J Respir Crit Care Med. 1995 Oct;152(4 Pt 1):1183–1188. doi: 10.1164/ajrccm.152.4.7551368. [DOI] [PubMed] [Google Scholar]
  39. Walter Robert E., Beiser Alexa, Givelber Rachel J., O'Connor George T., Gottlieb Daniel J. Association between glycemic state and lung function: the Framingham Heart Study. Am J Respir Crit Care Med. 2003 Mar 15;167(6):911–916. doi: 10.1164/rccm.2203022. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES