title: Menstrual cycle and respiratory symptoms in a general Nordic-Baltic population.
abstract: BACKGROUND
  There is little knowledge of variations in respiratory symptoms during the menstrual cycle in a general population, and potential modifying factors are not investigated.
  
  
  OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Gynecology and Obstetrics, Haukeland University Hospital, 5021 Bergen, Norway.  ferenc.macsali@med.uib.no.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Macsali
authors.forename: Cecilie
authors.initials: C
authors.lastname: Svanes
authors.forename: Robert B
authors.initials: RB
authors.lastname: Sothern
authors.forename: Bryndis
authors.initials: B
authors.lastname: Benediktsdottir
authors.forename: Line
authors.initials: L
authors.lastname: Bjørge
authors.forename: Julia
authors.initials: J
authors.lastname: Dratva
authors.forename: Karl A
authors.initials: KA
authors.lastname: Franklin
authors.forename: Mathias
authors.initials: M
authors.lastname: Holm
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
authors.forename: Ane
authors.initials: A
authors.lastname: Johannessen
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.forename: Ernst R
authors.initials: ER
authors.lastname: Omenaas
authors.forename: Vivi
authors.initials: V
authors.lastname: Schlünssen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Zemp
authors.forename: Francisco Gómez
authors.initials: FG
authors.lastname: Real
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology; D001454:Baltic States / Q000453:epidemiology; D015992:Body Mass Index; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D012120:Respiration Disorders / Q000453:epidemiology*; D012143:Respiratory Physiological Phenomena; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires