Menstrual Cycle-Related Changes in Spirometric Lung Function Among Young Women With and Without Asthma: A Prospective Comparative Study
Keywords:
Respiratory Diseases, Asthma, Women, Menstrual CycleAbstract
Background: Bronchial asthma is a prevalent chronic respiratory disease with significant sex disparities that emerge during reproductive years, suggesting a role for ovarian hormones in disease expression. The influence of menstrual cycle-related hormonal fluctuations on pulmonary function remains incompletely understood, with inconsistent findings across previous studies. Objective: To compare spirometric lung function parameters across different phases of the menstrual cycle among young women with well-controlled asthma and healthy non-asthmatic women, and to determine whether the magnitude and pattern of menstrual cycle-related changes differ between the two groups. Methodology: This prospective longitudinal comparative study was conducted from January to December 2025. A total of 140 young women (70 asthmatics and 70 age- and BMI-matched non-asthmatics) were enrolled. Spirometric assessment including FEV?, FVC, FEV?/FVC ratio, PEFR, and mid-expiratory flow rates (FEF?????, FEF??, FEF??) was performed during three menstrual cycle phases: menstrual (Days 1-3), follicular (Days 7-10), and luteal (Days 20-23). Within-group variations were analyzed using repeated measures ANOVA, while between-group comparisons were performed using independent t-tests. Results: Asthmatic women demonstrated significantly lower spirometric parameters across all phases compared to non-asthmatics (p < 0.001 for FEV?, FEV?/FVC, PEFR, and mid-expiratory flows). In asthmatic women, FEV? and mid-expiratory flow rates were lowest during menstrual phase and highest during luteal phase, while FVC and PEFR showed the opposite pattern. Non-asthmatics exhibited similar but smaller magnitude changes. Asthmatics demonstrated substantially greater percentage changes from menstrual to luteal phase for expiratory flow parameters (FEV?: +5.6% vs. +2.4%; FEF?????: +9.5% vs. +4.3%). However, within-group variations did not reach statistical significance (p > 0.05) in either group. Conclusion: Asthmatic women exhibit greater menstrual cycle-related variation in lung function compared to non-asthmatics, with lowest values during menstrual phase, supporting the concept of perimenstrual asthma. These findings have important clinical implications for monitoring and managing asthma in reproductive-aged women.References
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