Perimenstrual asthma as a gynecological and pulmonological clinical problem

Asthma is one of the most common chronic diseases of the respiratory system. It is estimated that up to 40% of asthmatic women of childbearing age may experience a cyclical exacerbation of asthmatic symptoms during the perimenstrual period, which is called perimenstrual asthma (PMA). The precise prevalence of this particular phenotype of asthma is difficult to determine due to a lack of explicit diagnostic criteria and appropriate epidemiological surveys. According to one of the best documented hypotheses regarding perimenstrual exacerbations of asthma, the impact of female steroid sex hormones on the function of the respiratory system and inflammations in the bronchi may play a central role in this phenomenon. Although the basic medical approach to PMA is similar to that used in other asthma phenotypes, unconventional methods of "experimental" treatment have also been tried. Unfortunately, current knowledge about the pathogenic mechanisms of this phenotype of asthma is incomplete and inconsistent, which justifies the need for further interdisciplinary studies with the participation of specialists in both gynecology and lung diseases. The knowledge thus acquired will help to individualize and focus future therapy on specific cellular and/or hormonal mechanisms to optimize asthma control in patients with PMA.