title: Near-fatal asthma related to menstruation.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Sección de Neumología, Hospital de Sagunto, Valencia, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Martinez-Moragón
authors.forename: Vicente
authors.initials: V
authors.lastname: Plaza
authors.forename: José
authors.initials: J
authors.lastname: Serrano
authors.forename: Cesar
authors.initials: C
authors.lastname: Picado
authors.forename: Juan Bautista
authors.initials: JB
authors.lastname: Galdiz
authors.forename: Antolín
authors.initials: A
authors.lastname: López-Viña
authors.forename: Joaquín
authors.initials: J
authors.lastname: Sanchis
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008598:Menstruation; D012307:Risk Factors
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol