Advances in perimenstrual asthma / 医学研究生学报

Perimenstrual asthma (PMA) is a manifestation of asthma, occurred in a special physiological period of women. It has clinical manifestations of asthma and its own characteristics. It can be caused by not only general asthma inflammatory mediators, such as leukotrienes, prostaglandins, and abnormal immune factors, but also the change trend of sex hormones in the special period. For example, the balance between the proportion of estradiol and progesterone in the circulation may convert allergic reactions into anti-inflammatory reactions, which reduces eosinophils lung recruitment and increases IL10 production, or estradiol may produce proinflammatory effect, which increases the regeneration of IL4, IL1β, and TNFα, exacerbates allergic pulmonary inflammation, causes and aggravates premenstrual or menstrual asthma. Therefore, the treatment of PMA is also different from that of the general asthma. This article focuses on the understanding of this special type of asthma, and reviews the current situation of its risk factors, pathogenesis, clinical manifestations, treatment plan and other aspects.

Gender-Specific Asthma Treatment

Because genetic characteristics vary among subjects, the therapeutic effects of a certain drug differ among patients with the same disease. For this reason, special interest has focused on tailored treatments. Although it is well known that sex is genetically determined, little attention has been paid to sex differences in the clinical features and treatment of asthma. Females are more likely to suffer allergic asthma, to have difficulty controlling asthma symptoms, and to show adverse effects to drugs. As asthma symptoms show cyclic changes depending on female hormone levels in many women of child-bearing age, the use of contraceptives may specifically help to treat female patients with asthma such as those with perimenstrual asthma and severe asthma. Generally, testosterone seems to suppress asthma, and dehydroepiandrosterone (DHEA), a less virilizing androgen, may be effective for treating asthma. Evidence exists for a therapeutic and steroid-sparing effect of DHEA. However, further studies on the optimal dose and route of DHEA for each sex are needed. Monitoring of the serum DHEA-S level is necessary for patients with asthma on inhaled steroid treatment, and at minimum, replacement therapy for patients with a low level of DHEA may be helpful for treating their asthma.

Patterns of Perimenstrual Symptoms and Related Dietary Factors to Premenstrual Syndromes / 여성건강간호학회지

PURPOSE: The purpose of this study was to differentiate between women with three perimenstrual symptom severity patterns : premenstrual syndrome (PMS), premenstrual magnification (PMM), and low symptom (LS), and to explore the related dietary factors to premenstrual symptoms. METHOD: Women were asked to keep a diary record of perimenstrual symptoms and food intake for 50 days. RESULT: Symptom patterns were defined for 26 among 38 women ; Eight (21.1%) demonstrated a PMS pattern, three (7.9%) demonstrated a PMM pattern, and fifteen (39.5%) exhibited a LS pattern. There were significant differences in symptom scores during the premenstrual phase (x2=19.30, p=.000), menstrual phase (x2=13.32, p=.001), and post menstrual phase (x2=9.93, p=.007) for three groups. Protein, vit E, vit C, niacin, folic acid, and phosphorus in the premenstrual phase, and energy, and vit B6 in the menstrual period were significantly different between the three groups. Among dietary compositions, amino acids, lipids, fatty acids, saturated fatty acids, natrium, vit B6, niacin, and vit E were negatively related to PMS symptoms. CONCLUSION: Pattern of perimenstrual symptoms should be differentiated for individualized PMS management. As a more efficient diet assessment for PMS women, randomized nutritional analysis during the 3 phases of the menstrual cycle should be done and a replication study is necessary with a larger sample.

Study on the Effects of the Nursing Intervention Program for Perimenstrual Discomfort of the Female University Students / 간호학회지

Management of perimenstrual discomfort could be an effective strategy for women's health promotion. This study was designed to develop and test the nursing intervention program for the reduction of the perimenstrual discomfort. The data were collected from a group of 76 female university students(34 in the intervention group, 42 in the control group) during November 20, 1997 and March 10, 1998. Measurements were taken concerning perimenstrual discomfort, self care behavior, and perimenstrual discomfort from both groups, at pre and post intervention. Intervention program involves education, support, counselling, and relaxation training, via individual and group levels over a twelve- week period. Listed are the summarized results: 1. The intervention group had more knowledge concerning perimenstrual discomfort(t=2.290, p=.025), self care behavior(t=3.198, p=.000), and lower perimenstrual discomfort score(t=-4.446, p=.000) than the control group at post intervention. 2. The intervention group showed an enhancement on the knowledge on perimenstural discomfort(t=2.35, p=.025), and decreased the perimenstrual discomfort score(t=-7.36, p=.000). However change of self care behavior was not significant during the intervention. According to this study a developed nursing intervention program is effective for reduction of the perimenstrual discomfort. For a future research, it is necessary that experiments concerning menstruation, and a correlational study of perimensturual discomfort and stress will be performed.

Transcultural Differences on Perimenstrual Discomforts, Menstrual Attitudes and Sex Role Acceptance between Korean and American college Students / 간호학회지

This study was performed to compare the transcultural differences on perimenstrual discomforts, menstrual attitudes and sex role acceptance between Korean and American college students. The subjects, 2557 nursing students were selected from 13 universities all around Korea, and 4 universities in the eastern, western, and middle areas of the United States. The data were collected using the MDQ(Menstrual Distress Questionnaire by Moos), the MAQ(Menstrual Attitude Questionnaire) and the Sex Role Acceptance Scale, the subjects answered the MDQ for three points(premenstrual, menstrual, intermenstrual based on their recollections) between July, 1996 and April, 1997. The findings are as follows : 1. There were significant differences in the age of menarche, duration of menstruation, and menstrual cycle between the Koreans and the Americans. 2. As for sex role acceptance, Americans more frequently denied the traditional female role than did Koreans. 3. There were significant differences between the two groups on five categories of menstrual attitude(menstruation is a phenomena that weakens women physically and psychologically, menstruation is a bothersome phenomena. menstruation is a natural phenomena, and menstruation is a phenomena that does not influence women's behaviors non is expected to). 4, For the menstrual discomfort scores, there were significant differences between the two groups on all six categories of the MDQ(pain, attention deficit, behavioral changes, ANS response, water retention, and negative emotion) for the three points(premenstrual, menstrual, intermenstrual period). 5. The most common complaints for the Korean women were pain during the perimenstrual period and fatigue during the intermenstrual period. In contrast, for the Americans the most common complaint was negative emotions during the perimenstrual period, but less pain than the Koreans, and a similarity to Koreans during the intermenstrual period. 6. Regularity of the menstrual cycle was positively correlated with age of menarche, menstrual cycle, and duration of menstruation. 7. For the interrelationship between of Perimenstrual discomforts, menstrual attitudes, and sex role acceptance, there were significant correlations for both group as follows : First, the MA category "menstruation is a bothering phenomena" was negatively correlated with sex role acceptance, second, the MA category "menstruation is a phenomena that weakens the women physically and psychologically" was positively correlated with the MA category "menstruation onset is a predictable phenomena." For the further research, it is recommended that efficient nursing intervention programs for perimenstrual discomforts, be developed and qualitative re search to demonstrate the cultural differences as the feminism view point be done.