Association of asthma and hay fever with irregular menstruation
- C Svanes1,2,
- F Gomez Real1,3,
- T Gislason4,
- C Jansson5,
- R Jögi6,
- E Norrman7,
- L Nyström8,
- K Torén9,
- E Omenaas2
- 1Institute of Medicine, University of Bergen, 5021 Bergen, Norway
- 2Department of Thoracic Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- 3Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5021 Bergen, Norway
- 4Department of Pulmonary Medicine, Landspitali University Hospital, 105 Reykjavik, Iceland
- 5Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, 77185 Uppsala, Sweden
- 6Foundation Tartu University Clinics, Lung Clinic, 51014 Tartu, Estonia
- 7Department of Pulmonary Medicine and Allergology, Umeå University, 90185 Umeå, Sweden
- 8Department of Public Health, Clinical Medicine, Epidemiology, Umeå University, 90185 Umeå, Sweden
- 9Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, 41266 Göteborg, Sweden
- Correspondence to:
Dr C Svanes
Department of Thoracic Medicine, Haukeland Hospital, 5021 Bergen, Norway;
- Received 5 August 2004
- Accepted 17 February 2005
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.
The study was supported financially by the Icelandic Research Council, the Swedish Heart and Lung Foundation, the Vårdal Foundation for Health Care Science and Allergy Research, the Swedish Association Against Asthma and Allergy, the Norwegian Research Council project 135773/330, the Norwegian Asthma and Allergy Association, the Danish Lung Association and the Estonian Science Foundation grant no 4350.
Competing interests: Cecilie Svanes has received 5000 Nkr (approximately 600 Euro) from MSD in January 2004 for giving a speech on asthma in women and an independent educational grant of 100 000 Nkr (approximately 11 800 Euro) from GlaxoSmithKline in 2002 for the project “Asthma in women”.