What should you know about premenstrual asthma?

Hormonal changes around the menstrual cycle may coincide with increased airway sensitivity in some people with asthma. You may notice more wheezing, cough, chest tightness or shortness of breath before bleeding begins, with improvement later in the cycle. Symptoms can also be influenced by allergies, infection, smoke, exercise, sleep disruption or missed preventer doses, so a cycle pattern should be recorded rather than assumed.

A diary can compare symptoms, reliever use, period dates, triggers and peak-flow readings if your clinician has recommended them. Asthma is a condition of variable airway narrowing; symptoms that repeatedly worsen at a particular time can help guide a treatment review.

Use your asthma medicines exactly as prescribed and keep your reliever accessible. Record symptoms across several cycles, including night waking and activity limits, then take the record to your clinician. Reduce known triggers such as smoke and dust, and manage associated allergic rhinitis if it is contributing to nasal or airway symptoms. Do not change inhaler doses or start hormonal treatment without medical advice.

Follow your asthma action plan and seek emergency help if breathing becomes severe, speaking is difficult, lips look blue or grey, you feel exhausted or confused, or your reliever is not helping as expected. A flare can become serious regardless of where you are in your cycle. Urgent assessment may include inhaled treatment, oxygen checks and other medicines.

Ask how to record your cycle-related symptoms, whether your inhaler technique is effective and whether your preventer plan needs review before your period. Mention contraception, pregnancy plans, allergies and any medicines that seem to affect breathing.