Ciclo menstrual y asma en la mujer

Antonio Pereira Vega, José Luís Sánchez-Ramos, Michael Alwakil Olbah

Resumen


El ciclo menstrual puede influir en las manifestaciones y características de algunas enfermedades padecidas por la mujer en edad fértil. Entre estas enfermedades se encuentra el asma bronquial.

Esta influencia del ciclo menstrual en el asma de la mujer se puede manifestar especialmente en el empeoramiento cíclico de sus síntomas en un periodo específico del ciclo menstrual, destacando por su frecuencia y significación clínica el periodo premenstrual, entidad definida como asma premenstrual.

Actualmente se considera el asma premenstrual como un fenotipo especial del asma en la mujer fértil en el que persisten muchos interrogantes respecto a su definición, manifestaciones clínicas, nivel de gravedad, etiopatogenia y tratamiento. 

Aunque las variaciones de las hormonas sexuales femeninas a través del ciclo menstrual parecerían ser la hipótesis más sugerente para explicar su patogenia, los datos no confirman dicha hipótesis, al menos al estudiar los niveles sanguíneos de las mismas a través del ciclo en mujeres asmáticas con o sin asma premenstrual. La posible influencia de dichas hormonas en los distintos mediadores inflamatorios (leucotrienos o citoquinas) o la interacción de factores metabólicos (tejido adiposo y obesidad) pueden influir en su relación. Tampoco
existe un tratamiento específico actualmente consensuado.

Futuros estudios multidisciplinares bien diseñados, con criterios específicos en su definición y una clara comparación entre mujeres
asmáticas con y sin asma premenstrual nos podrán aportar luces sobre esta entidad.


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