Medication Used for Perimenstrual Asthma Poses Health Risk

from Monroe East- Genesee Valley Penny Saver- 5-12-23

ARMED FORCES DAY FEATURE: KYLE SOLIZ, US ARMY

DEAR DR. ROACH: I’m a 55-year-old perimenopausal woman who developed asthma a few years ago. My symptoms always start right before my menstrual cycle. My doctor ruled out allergies as the cause. I used to get colds and sinus infections premenstrually in my younger years. Most medical practitioners don’t see the correlation between hormones and respiratory symptoms. I sometimes take 10 mg of prednisone when I’m wheezing more than usual, and it seems to help. Is this dose putting me at risk for diabetes if taken regularly? -- B.S.

ANSWER: Perimenstrual asthma is a wellrecognized condition that is nevertheless not well-known by most nonexperts. It is less likely to be caused by allergies and more likely to be aspirin-sensitive -- meaning that aspirin, or other anti-inﬂammatory drugs (like ibuprofen) commonly taken by women during menstruation, can trigger an asthma attack. Maybe a quarter of women with asthma have perimenstrual asthma. As you say, it is thought to be the hormone changes around menstruation that trigger the asthma.

Oral contraceptives used continuously prevent large changes in progesterone and estradiol, and may be helpful in managing perimenstrual asthma. Although I didn’t ﬁnd a lot about it in literature, I suspect that when your periods stop, your asthma symptoms will get better.

Increased medication at the time of menses is frequently needed. However, because prednisone, even at the fairly small dose of 10 mg, does increase risk of diabetes, osteoporosis, high blood pressure, glaucoma, cataracts and many other conditions, oral prednisone is not my ﬁrst choice for medication in this situation.

Inhaled steroids would be one choice, but they take a while to begin working. One recommended treatment is the oral medicine montelukast (Singulair), which has been proven effective in a small study and starts working right away.

***

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

Unique Ways To Reduce Cancer Risk Every Day

Drink more fluids. Drinking more fluids is one of the easier things people can do every day to reduce their cancer risk. The American Cancer Society recommends individuals consume eight cups of water per day, but millions likely fall far short of that amount. That’s unfortunate, as research presented at the American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research in 2011 found that high fluid intake was associated with a 24 percent reduced bladder cancer risk among men. In addition, a separate study funded by the Strauss Institute and published in 2020 in the International Journal of Environmental Research and Public Health found that women with breast cancer consumed less water and total fluids than women who did not have breast cancer. The researchers concluded more investigation into the link between drinking more water and reducing breast cancer risk is necessary, but noted that drinking water is harmless, convenient and beneficial to many aspects of health.

Sue DeBruyne, Au.D. Doctor of Audiology

Health Benefits Of Vegetarian Diets

Many people change their lifestyles in an effort to improve their overall health. Changing the foods one eats is one of the more common ways people try to get healthy, and many people ﬁnd adopting a vegetarian diet helps them realize their goals.

Adopting a vegetarian diet can be a great way to improve personal health. Vegetarians may now find it easier to maintain their lifestyles than ever before thanks to the year-round availability of a variety of fresh produce and more vegetarian dining options offered at restaurants. Even premade vegetarian foods are more widely available at markets and grocery stores. Approximately six to eight million adults in the United States eat no meat, fish or poultry, according to a Harris Interactive poll commissioned by the Vegetarian Resource Group, a nonprofit organization that disseminates information about vegetarianism. Many more avoid red meat while still eating fish and poultry.

Although studies into vegetarianism long pointed out the potential nutritional deficiencies of such a diet, the tides have shifted, and many nutrition experts now note how eating plant-based foods offers sufficient nutrition and can reduce the risk for chronic illnesses. A vegetarian diet may offer protection against cardiovascular disease, some cancers, type 2 diabetes, and obesity. Data published in the Proceedings of the Nutrition Society found vegetarian diets are high in carbohydrates, dietary fiber, essential vitamins and minerals; offer an abundance of antioxidants; and are very low in saturated fat. However, switching to a vegetarian diet is not enough to lose weight or get healthier. Choosing the right type of vegetarian foods - including whole grains, fruits, vegetables, and proteinrich legumes - and controlling portions is key.

Vegetarians may have low cholesterol, as well as fewer incidences of stroke and obesity and cardiovascular incidents than non-vegetarians. Whether this is entirely food-based, or because vegetarians tend to also embrace other healthy habits, has not yet been determined.