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<p>Perimenstrual atopy (PMA) has been reported in otherwise healthy females, and studies find associations with hormone, immune, or autonomic nervous system (ANS), while the percentages of PMA in females without atopy are rarely studied, and the correlation of these variables in combination with the symptoms and PMA is not assessed. This study aims to evaluate the frequency of PMA in fertile females without atopy and find the degree of correlation of ovarian hormones, immune markers, and ANS with PMA frequency and symptoms. This study comprised both cross-sectional and longitudinal components, with 103 apparently healthy fertile women in the cross-sectional analysis and 45 completing the longitudinal follow-up. In the cross-sectional component, PMA frequency and symptom scores were measured; blood samples were taken for eosinophil counts, serum immunoglobulin E (IgE), estradiol, and progesterone; and ANS was assessed using heart rate variability (HRV) parameters, including time domain and frequency domain measures. Variables were compared between PMA and non-PMA groups and across three menstrual phases using t-tests, ANOVA, or non-parametric equivalents; repeated measures analyses were applied for longitudinal data, and correlations between variables were assessed using Spearman’s method. Negative binomial regression was used to evaluate predictors of symptom severity, with a significance level set at <i>p</i> ≤ 0.05. PMA frequency was 32% with PMA women showing lower eosinophil counts (0.110 vs. 0.155, <i>p</i> = 0.007) and higher family history of atopy (75% vs. 37.1%, <i>p</i> &lt; 0.001) compared to non-PMA women. Hormonal and immune differences between groups varied by menstrual phase, including lower peri-ovulatory estradiol (123.35 vs. 100.56, <i>p</i> = 0.035) and lower IgE and eosinophil in PMA females. A lower low-frequency/high-frequency (LF/HF) ratio predicts a greater symptom severity (B = -0.278, <i>p</i> = 0.038). PMA was present in about one-third of the females studied and was associated with a higher frequency of a family history of atopy. There are menstrual phase-dependent variations in hormonal and immune markers among PMA females. Autonomic disturbances, reflected by the LF/HF ratio, emerged as a significant predictor of symptom severity during the follicular phase. Thus, PMA is driven by dynamic hormonal-immune-autonomic interactions rather than fixed physiological imbalance.</p>

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Evaluation of perimenstrual atopy in apparently healthy females through hormonal, immune, and autonomic changes across menstrual phases: a prospective study

  • 期刊论文

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  • 发表日期：

    2026年8月4日

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  • Darya S. Abdulateef,
  • Tara R. Salih

摘要

Perimenstrual atopy (PMA) has been reported in otherwise healthy females, and studies find associations with hormone, immune, or autonomic nervous system (ANS), while the percentages of PMA in females without atopy are rarely studied, and the correlation of these variables in combination with the symptoms and PMA is not assessed. This study aims to evaluate the frequency of PMA in fertile females without atopy and find the degree of correlation of ovarian hormones, immune markers, and ANS with PMA frequency and symptoms. This study comprised both cross-sectional and longitudinal components, with 103 apparently healthy fertile women in the cross-sectional analysis and 45 completing the longitudinal follow-up. In the cross-sectional component, PMA frequency and symptom scores were measured; blood samples were taken for eosinophil counts, serum immunoglobulin E (IgE), estradiol, and progesterone; and ANS was assessed using heart rate variability (HRV) parameters, including time domain and frequency domain measures. Variables were compared between PMA and non-PMA groups and across three menstrual phases using t-tests, ANOVA, or non-parametric equivalents; repeated measures analyses were applied for longitudinal data, and correlations between variables were assessed using Spearman’s method. Negative binomial regression was used to evaluate predictors of symptom severity, with a significance level set at p ≤ 0.05. PMA frequency was 32% with PMA women showing lower eosinophil counts (0.110 vs. 0.155, p = 0.007) and higher family history of atopy (75% vs. 37.1%, p < 0.001) compared to non-PMA women. Hormonal and immune differences between groups varied by menstrual phase, including lower peri-ovulatory estradiol (123.35 vs. 100.56, p = 0.035) and lower IgE and eosinophil in PMA females. A lower low-frequency/high-frequency (LF/HF) ratio predicts a greater symptom severity (B = -0.278, p = 0.038). PMA was present in about one-third of the females studied and was associated with a higher frequency of a family history of atopy. There are menstrual phase-dependent variations in hormonal and immune markers among PMA females. Autonomic disturbances, reflected by the LF/HF ratio, emerged as a significant predictor of symptom severity during the follicular phase. Thus, PMA is driven by dynamic hormonal-immune-autonomic interactions rather than fixed physiological imbalance.