(A-025) Is there an impact of menstrual cycles on chronic diseases outcomes?

Background: Women with chronic diseases may face variability of symptoms due to menstrual cycles. While this association was first reported in 1956, there is a lack of measurement of menstrual cycle information in women in clinical trials. There remains a lack of understanding of which chronic diseases are impacted by menstrual cycles and which level of impact can be measured.

Objectives: To better understand relationships between menstrual cycles and clinical outcomes in women suffering from chronic diseases.

Methods: A literature review was performed on published studies reporting results on clinical outcomes in women at different times of menstrual cycles, focusing on select chronic diseases. The key words used are as follows: ‘Female hormones’ OR ‘ Menstrual cycle’ OR ‘Estrogen’ OR ‘Hormonal fluctuations’ AND ‘Chronic diseases’ OR ‘Rheumatoid arthritis’ OR ‘Epilepsy’ OR ‘Asthma’ OR ‘Irritable bowel syndrome’ OR ‘Diabetes’ OR ‘Hidradenitis suppurativa’. A total of 21 papers were retained to describe the impact of menstrual cycle on clinical outcomes of selected chronic diseases

Results: The pathophysiology of chronic diseases is affected by the menstrual cycle. Symptoms are worsening at time of menstruation in epilepsy with more seizures observed on the first day or the last day of the cycle, in asthma with more emergency visits, in rheumatoid arthritis with more tender joints and in diabetes with higher frequency of hypoglycemia. In hidradenitis suppurativa, twice more prevalent in women, the majority of women (77%) had worsening symptoms or flares during or in the week preceding their menses. In inflammatory bowel disease where symptoms are usually fluctuating, half of women (40% to 55%) had worsening symptoms before and during menstruation.

Conclusions: This literature review confirms the impact of the menstrual cycle on various chronic diseases, highlighting the interaction between hormonal fluctuations and disease pathophysiology. These findings highlight the importance of considering the dynamics of the menstrual cycle in clinical practice and during clinical trials to take into account variations in symptoms severity due to hormone fluctuations.