MENSTRUATION-ASSOCIATED (CATAMENIAL) PNEU MOTHORAX AND CATAMENIAL HEMOPTYSIS

We report on 2 patients with catamenial pneumothorax and one patient w ith catamenial hemoptysis. The pathogenesis of these diseases is not c lear, and intrathoracic endometriosis is often assumed. Catamenial pne umothorax is rare and differs from primary spontaneous pneumothorax in its prevalence in the fourth decade and in mainly multiparous women, its recurrent and almost exclusively right-sided occurrence within 72 hours of the beginning of menstruation, and the generally small size o f the pneumothorax. About 5% of women under 50 presenting with primary pneumothorax have catamenial pneumothorax. Prevention of recurrence i s difficult, as the recurrence rate is high, treatment duration is pot entially long, and residual thoracic pain during menstruation is somet imes seen. The combination of medication (Gn-RH analogues, danazol, po ssibly hormonal anticonceptive drugs or progestagens) with efficient p leurodesis (e.g. thoracoscopic talcage, preferentially performed durin g menstruation) seems so far to be the most efficient, although no con trolled studies have yet been performed. Catamenial hemoptysis is very rare and hormonal treatment alone is frequently successful in the lon g term. In the event of relapse, resection of the implicated endometri otic or angiomatous lesion localized by computed tomography can be per formed.