Title
Subscribe to the Magazine for free
Subscribe for free to keep reading! If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.

Catamenial Pneumothorax: Understanding and Managing Menstrual-Related Lung Collapses

Why This Was Updated?

Our specialists regularly review advancements in health and wellness, ensuring our articles are updated with the newest information as it becomes accessible.
Medically Reviewed by

Catamenial pneumothorax is a rare condition in which a woman's lung collapses during her menstrual cycle. It usually occurs 48 to 72 hours before or after menstruation and is often linked to endometriosis in the chest. Awareness of this condition is important for both healthcare professionals and patients, as it can be easily overlooked, given the respiratory symptoms.Β Β Β 

This article explains catamenial pneumothorax, how it is diagnosed and treated, and how patients can manage living with it. Understanding this condition can help improve patient care and prevent recurrences.

[signup]

What is a Catamenial Pneumothorax?

Catamenial pneumothorax is a rare condition in which the lung collapses during a woman's menstrual cycle. It is typically associated with thoracic endometriosis, a disorder in which endometrial tissue, which normally lines the uterus, grows in the chest (thoracic) cavity.Β 

The exact mechanism linking the menstrual cycle to lung collapse has yet to be entirely understood, but several theories have been proposed. One theory suggests that hormonal fluctuations during menstruation lead to the proliferation of endometrial tissue in the thoracic cavity, which can cause air to enter the pleural space and result in pneumothorax (collapsed lung).

Another theory involves the presence of small holes in the diaphragm that allow air from the abdominal cavity to enter the chest, leading to lung collapse.

Prevalence and Epidemiology

Catamenial pneumothorax accounts for approximately 3-6% of spontaneous pneumothorax cases in women. It most commonly affects women of reproductive age, particularly those between 30 and 40 years old. The condition is often underdiagnosed, partly because it is rare and shares symptoms with other respiratory disorders.

Risk factors include a history of endometriosis and previous episodes of pneumothorax. Women who smoke or have a family history of endometriosis may be more susceptible to developing this condition. Early diagnosis and treatment are critical for management and prevention of recurrence.

Catamenial Pneumothorax Symptoms

Catamenial pneumothorax is characterized by a recurrent pneumothorax (collapsed lung) that typically occurs within 72 hours before or after the onset of menstruation.Β 

The most common symptoms include sudden chest pain, often sharp and localized on one side, and shortness of breath. These symptoms may also be accompanied by shoulder pain, which is referred pain from irritation of the diaphragm.Β 

The cyclical nature of these symptoms, coinciding with the menstrual cycle, is a key feature that distinguishes catamenial pneumothorax from other types of pneumothorax. Recognizing this pattern is crucial for an accurate diagnosis.

Differential Diagnosis

Differentiating catamenial pneumothorax from other forms of pneumothorax and conditions with similar symptoms, such as pleuritis or pulmonary embolism, is essential. Unlike spontaneous pneumothorax, which can occur in both men and women without a clear pattern, catamenial pneumothorax is specifically linked to the menstrual cycle.Β 

Additionally, patients with catamenial pneumothorax may have a history of pelvic endometriosis. Clinicians should consider this condition in women of reproductive age presenting with recurrent pneumothorax, mainly if it occurs in synchrony with their menstrual cycle.

How to Diagnose Catamenial Pneumothorax

Evaluation and various tests are required for diagnosis.

Clinical Evaluation

A thorough patient history is vital for diagnosing catamenial pneumothorax. Clinicians should inquire about the timing of symptoms in relation to the menstrual cycle, previous history of pneumothorax, known endometriosis, and reproductive health.Β 

Questions should also address the severity and location of pain, any history of infertility, or prior gynecological surgeries, which might suggest underlying endometriosis.

Diagnostic Tests

Imaging studies, including chest X-rays and CT scans, are often the first step in confirming the presence of a pneumothorax. However, thoracoscopy, a minimally invasive procedure allowing direct visualization of the thoracic cavity, is particularly useful for detecting diaphragmatic defects and thoracic endometriosis associated with catamenial pneumothorax.Β 

Biochemical markers, such as elevated CA-125 levels, may also support the diagnosis, although they are not specific to this condition.

Catamenial Pneumothorax Treatment

Certain medications can be helpful and surgical interventions may be necessary for certain patients.

Medical Management

The treatment of catamenial pneumothorax often begins with medical management aimed at reducing the frequency and severity of pneumothorax episodes.Β 

  • Hormonal therapies are the cornerstone of this approach, particularly because the condition is linked to the menstrual cycle. Gonadotropin-releasing hormone (GnRH) analogs are commonly used to suppress ovulation and menstruation, thereby reducing the risk of lung collapse.Β 
  • Oral contraceptives are another option, especially for women seeking a less aggressive hormonal intervention.Β 

These medications help to stabilize hormone levels and prevent the cyclical hormonal changes that can trigger pneumothorax.Β 

Additionally, pain management is essential for symptom control. Pain can be controlled by using nonsteroidal anti-inflammatory drugs (NSAIDs) to manage chest pain and discomfort associated with lung collapse.

Surgical Interventions

Surgical interventions may be necessary in cases where medical management alone is insufficient or when there is a significant risk of recurrence.Β 

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure that allows surgeons to view and treat the affected area directly.Β 

  • During VATS, the surgeon can perform pleurodesis, which involves fusing the lung's pleural layers to prevent the lung from collapsing again.Β 
  • Additionally, any visible endometrial tissue in the thoracic cavity can be excised.Β 
  • The diaphragm is often repaired during surgery, mainly if there are diaphragmatic defects or endometriotic lesions, common in catamenial pneumothorax.Β 

Surgical interventions aim to provide a long-term solution and significantly reduce the risk of recurrence.

Post-Treatment Care and Follow-up

After treatment, ongoing monitoring is essential to detect and manage potential recurrences. A long-term care plan includes regular follow-up appointments with a healthcare provider, chest imaging, and evaluation of symptoms. In some cases, ongoing hormonal therapy may be recommended to maintain symptom control and prevent further episodes.Β 

Patients should also be educated about recognizing the early signs of pneumothorax and advised to seek immediate medical attention if symptoms reoccur. Effective post-treatment care and diligent follow-up are essential for achieving the best possible outcomes for patients with catamenial pneumothorax.

Case Study

A 25-year-old woman presented to the emergency department with severe right-sided chest pain and mild shortness of breath. Her medical history was unremarkable except for cyclical, painless abdominal distention since she was 21 years old. The patient's vital signs were stable, with an oxygen saturation of 97%.Β Β 

The patient did not take any medications aside from oral contraceptive pills. Two years prior, she developed abdominal pain and sudden onset of heavy menstrual bleeding. The patient was prescribed oral contraceptive pills, which successfully reduced her menstrual bleeding and pain.

DiagnosisΒ 

A chest X-ray revealed a right-sided pneumothorax and pleural effusion. To evaluate the condition further, a chest CT scan was performed, confirming the presence of a large pneumothorax and pleural effusion. The scan also revealed a porous diaphragm, suggesting the presence of diaphragmatic defects.

Treatment Plan

A chest tube was inserted into the pleural cavity to drain the fluid and re-expand the lung. Approximately 2 liters of dark, coffee-ground fluid were drained, which raised suspicion of a connection to endometriosis.Β 

Upon further questioning, the patient recalled a previous episode of sharp right shoulder pain and shortness of breath, which had resolved spontaneously about two years earlier. She also confirmed that her current and prior symptoms coincided with her menstrual cycle, typically starting within two days of menstruation.

The patient was then taken to the operating room for video-assisted thoracoscopic surgery (VATS) to examine the thoracic cavity. A patch of endometrial tissue was observed within the chest cavity. To prevent future episodes of pneumothorax, a chemical pleurodesis was performed.

Outcomes and Learnings

The patient recovered well, with her lung fully re-expanding after the surgery. This case highlights the importance of considering menstrual history in women presenting with pneumothorax, as it can provide critical clues to the underlying cause, such as catamenial pneumothorax, which might otherwise be overlooked.

Living with Catamenial Pneumothorax

Living with catamenial pneumothorax involves careful management and support. Educating patients about the condition is key, helping them recognize symptoms like sudden chest pain and shortness of breath that align with their menstrual cycle. Understanding this link enables timely medical intervention.

Lifestyle adjustments play a crucial role. Avoiding strenuous activities, especially around menstruation, and quitting smoking are essential due to their adverse effects on lung health. A healthy lifestyle incorporating regular, moderate exercise and a balanced diet supports overall well-being.

Self-care is vital for managing symptoms. Keeping a symptom diary that tracks the timing and severity of symptoms in relation to the menstrual cycle can help personalize treatment plans. Support resources, such as online communities, can offer emotional support and practical advice.Β 

[signup]

Key Takeaways

  • Catamenial pneumothorax is a rare condition in which the lung collapses during a woman's menstrual cycle.Β 
  • Risk factors include a history of endometriosis and previous episodes of pneumothorax.Β 
  • Common symptoms include sudden chest pain, often sharp and localized on one side, and shortness of breath.Β 
  • The cyclical nature of these symptoms, coinciding with the menstrual cycle, is a key feature that distinguishes catamenial pneumothorax from other types of pneumothorax.Β 
  • Treatments include VATS pleurodesis, diaphragm repair, and oral contraceptives.
  • Early diagnosis is essential for avoiding worsening and recurrent episodes of pneumothoraces.Β Β 

Catamenial pneumothorax is a rare condition in which a woman's lung collapses during her menstrual cycle. It usually occurs 48 to 72 hours before or after menstruation and is often linked to endometriosis in the chest. Awareness of this condition is important for both healthcare professionals and patients, as it can be easily overlooked, given the respiratory symptoms.Β Β Β 

This article explains catamenial pneumothorax, how it is diagnosed and managed, and how patients can live with it. Understanding this condition can help improve patient care and reduce the likelihood of recurrences.

[signup]

What is a Catamenial Pneumothorax?

Catamenial pneumothorax is a rare condition in which the lung collapses during a woman's menstrual cycle. It is typically associated with thoracic endometriosis, a disorder in which endometrial tissue, which normally lines the uterus, grows in the chest (thoracic) cavity.Β 

The exact mechanism linking the menstrual cycle to lung collapse has yet to be entirely understood, but several theories have been proposed. One theory suggests that hormonal fluctuations during menstruation may lead to the proliferation of endometrial tissue in the thoracic cavity, which can cause air to enter the pleural space and result in pneumothorax (collapsed lung).

Another theory involves the presence of small holes in the diaphragm that might allow air from the abdominal cavity to enter the chest, potentially leading to lung collapse.

Prevalence and Epidemiology

Catamenial pneumothorax accounts for approximately 3-6% of spontaneous pneumothorax cases in women. It most commonly affects women of reproductive age, particularly those between 30 and 40 years old. The condition is often underdiagnosed, partly because it is rare and shares symptoms with other respiratory disorders.

Risk factors include a history of endometriosis and previous episodes of pneumothorax. Women who smoke or have a family history of endometriosis may be more susceptible to developing this condition. Early diagnosis and management are critical for reducing the risk of recurrence.

Catamenial Pneumothorax Symptoms

Catamenial pneumothorax is characterized by a recurrent pneumothorax (collapsed lung) that typically occurs within 72 hours before or after the onset of menstruation.Β 

The most common symptoms include sudden chest pain, often sharp and localized on one side, and shortness of breath. These symptoms may also be accompanied by shoulder pain, which is referred pain from irritation of the diaphragm.Β 

The cyclical nature of these symptoms, coinciding with the menstrual cycle, is a key feature that distinguishes catamenial pneumothorax from other types of pneumothorax. Recognizing this pattern is crucial for an accurate diagnosis.

Differential Diagnosis

Differentiating catamenial pneumothorax from other forms of pneumothorax and conditions with similar symptoms, such as pleuritis or pulmonary embolism, is essential. Unlike spontaneous pneumothorax, which can occur in both men and women without a clear pattern, catamenial pneumothorax is specifically linked to the menstrual cycle.Β 

Additionally, patients with catamenial pneumothorax may have a history of pelvic endometriosis. Clinicians should consider this condition in women of reproductive age presenting with recurrent pneumothorax, mainly if it occurs in synchrony with their menstrual cycle.

How to Diagnose Catamenial Pneumothorax

Evaluation and various tests are required for diagnosis.

Clinical Evaluation

A thorough patient history is vital for diagnosing catamenial pneumothorax. Clinicians should inquire about the timing of symptoms in relation to the menstrual cycle, previous history of pneumothorax, known endometriosis, and reproductive health.Β 

Questions should also address the severity and location of pain, any history of infertility, or prior gynecological surgeries, which might suggest underlying endometriosis.

Diagnostic Tests

Imaging studies, including chest X-rays and CT scans, are often the first step in confirming the presence of a pneumothorax. However, thoracoscopy, a minimally invasive procedure allowing direct visualization of the thoracic cavity, is particularly useful for detecting diaphragmatic defects and thoracic endometriosis associated with catamenial pneumothorax.Β 

Biochemical markers, such as elevated CA-125 levels, may also support the diagnosis, although they are not specific to this condition.

Catamenial Pneumothorax Management

Certain medications can be helpful and surgical interventions may be necessary for certain patients.

Medical Management

The management of catamenial pneumothorax often begins with medical approaches aimed at reducing the frequency and severity of pneumothorax episodes.Β 

  • Hormonal therapies are the cornerstone of this approach, particularly because the condition is linked to the menstrual cycle. Gonadotropin-releasing hormone (GnRH) analogs are commonly used to suppress ovulation and menstruation, thereby potentially reducing the risk of lung collapse.Β 
  • Oral contraceptives are another option, especially for women seeking a less aggressive hormonal intervention.Β 

These medications help to stabilize hormone levels and may help prevent the cyclical hormonal changes that can trigger pneumothorax.Β 

Additionally, pain management is essential for symptom control. Pain can be managed by using nonsteroidal anti-inflammatory drugs (NSAIDs) to help with chest pain and discomfort associated with lung collapse.

Surgical Interventions

Surgical interventions may be necessary in cases where medical management alone is insufficient or when there is a significant risk of recurrence.Β 

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure that allows surgeons to view and treat the affected area directly.Β 

  • During VATS, the surgeon can perform pleurodesis, which involves fusing the lung's pleural layers to help prevent the lung from collapsing again.Β 
  • Additionally, any visible endometrial tissue in the thoracic cavity can be excised.Β 
  • The diaphragm is often repaired during surgery, mainly if there are diaphragmatic defects or endometriotic lesions, common in catamenial pneumothorax.Β 

Surgical interventions aim to provide a long-term solution and significantly reduce the risk of recurrence.

Post-Treatment Care and Follow-up

After treatment, ongoing monitoring is essential to detect and manage potential recurrences. A long-term care plan includes regular follow-up appointments with a healthcare provider, chest imaging, and evaluation of symptoms. In some cases, ongoing hormonal therapy may be recommended to maintain symptom control and help prevent further episodes.Β 

Patients should also be educated about recognizing the early signs of pneumothorax and advised to seek immediate medical attention if symptoms reoccur. Effective post-treatment care and diligent follow-up are essential for achieving the best possible outcomes for patients with catamenial pneumothorax.

Case Study

A 25-year-old woman presented to the emergency department with severe right-sided chest pain and mild shortness of breath. Her medical history was unremarkable except for cyclical, painless abdominal distention since she was 21 years old. The patient's vital signs were stable, with an oxygen saturation of 97%.Β Β 

The patient did not take any medications aside from oral contraceptive pills. Two years prior, she developed abdominal pain and sudden onset of heavy menstrual bleeding. The patient was prescribed oral contraceptive pills, which successfully reduced her menstrual bleeding and pain.

DiagnosisΒ 

A chest X-ray revealed a right-sided pneumothorax and pleural effusion. To evaluate the condition further, a chest CT scan was performed, confirming the presence of a large pneumothorax and pleural effusion. The scan also revealed a porous diaphragm, suggesting the presence of diaphragmatic defects.

Treatment Plan

A chest tube was inserted into the pleural cavity to drain the fluid and re-expand the lung. Approximately 2 liters of dark, coffee-ground fluid were drained, which raised suspicion of a connection to endometriosis.Β 

Upon further questioning, the patient recalled a previous episode of sharp right shoulder pain and shortness of breath, which had resolved spontaneously about two years earlier. She also confirmed that her current and prior symptoms coincided with her menstrual cycle, typically starting within two days of menstruation.

The patient was then taken to the operating room for video-assisted thoracoscopic surgery (VATS) to examine the thoracic cavity. A patch of endometrial tissue was observed within the chest cavity. To help prevent future episodes of pneumothorax, a chemical pleurodesis was performed.

Outcomes and Learnings

The patient recovered well, with her lung fully re-expanding after the surgery. This case highlights the importance of considering menstrual history in women presenting with pneumothorax, as it can provide critical clues to the underlying cause, such as catamenial pneumothorax, which might otherwise be overlooked.

Living with Catamenial Pneumothorax

Living with catamenial pneumothorax involves careful management and support. Educating patients about the condition is key, helping them recognize symptoms like sudden chest pain and shortness of breath that align with their menstrual cycle. Understanding this link enables timely medical intervention.

Lifestyle adjustments play a crucial role. Avoiding strenuous activities, especially around menstruation, and quitting smoking are essential due to their adverse effects on lung health. A healthy lifestyle incorporating regular, moderate exercise and a balanced diet supports overall well-being.

Self-care is vital for managing symptoms. Keeping a symptom diary that tracks the timing and severity of symptoms in relation to the menstrual cycle can help personalize treatment plans. Support resources, such as online communities, can offer emotional support and practical advice.Β 

[signup]

Key Takeaways

  • Catamenial pneumothorax is a rare condition in which the lung collapses during a woman's menstrual cycle.Β 
  • Risk factors include a history of endometriosis and previous episodes of pneumothorax.Β 
  • Common symptoms include sudden chest pain, often sharp and localized on one side, and shortness of breath.Β 
  • The cyclical nature of these symptoms, coinciding with the menstrual cycle, is a key feature that distinguishes catamenial pneumothorax from other types of pneumothorax.Β 
  • Management options include VATS pleurodesis, diaphragm repair, and oral contraceptives.
  • Early diagnosis is essential for avoiding worsening and recurrent episodes of pneumothoraces.Β Β 
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
Learn More
No items found.

Lab Tests in This Article

No lab tests!

Alifano, M., Trisolini, R., Cancellieri, A., & Regnard, J. F. (2006). Thoracic Endometriosis: Current Knowledge. The Annals of Thoracic Surgery, 81(2), 761–769. https://doi.org/10.1016/j.athoracsur.2005.07.044

Azizad-Pinto, P. (2014). Thoracic Endometriosis Syndrome: Case Report and Review of the Literature. The Permanente Journal, 18(3), 61–65. https://doi.org/10.7812/tpp/13-154

Bryant, A. (2024a, April 3). Diaphragmatic Paralysis: Understanding Causes and Exploring Treatments. Rupa Health. https://www.rupahealth.com/post/diaphragmatic-paralysis-understanding-causes-and-exploring-treatments

Bryant, A. (2024b, July 26). Thoracic endometriosis syndrome: Causes, diagnosis, treatment. Rupa Health. https://www.rupahealth.com/post/thoracic-endometriosis-syndrome

Christie, J. (2022a, March 25). The Most Common Causes Of Infertility In Men and Women. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-infertility

Christie, J. (2022, April 7). 5 Common Root Causes Of Endometriosis And How To Treat Them. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-endometriosis

Cleveland Clinic. (2023, January 18). A Fancy Name for Fluid Around Your Lungs. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17373-pleural-effusion

Cleveland Clinic. (2021, November 6). Diaphragm: Hiatal Hernia, Diaphragmatic Breathing, What Is the Diaphragm. Cleveland Clinic. https://my.clevelandclinic.org/health/body/21578-diaphragm

Cleveland Clinic. (2023a). Pneumothorax | Collapsed Lung Symptoms & Treatment | Cleveland Clinic. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15304-collapsed-lung-pneumothorax

Costumbrado, J., & Ghassemzadeh, S. (2022). Spontaneous Pneumothorax. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459302/

DeCesaris, L. (2023, January 25). How to Support a Healthy Menstrual Cycle. Rupa Health. https://www.rupahealth.com/post/how-to-support-a-healthy-menstrual-cycle

Gil, Y., & Tulandi, T. (2019). Diagnosis and Treatment of Catamenial Pneumothorax: A Systematic Review. Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2019.08.005

Kalaichandran, A. (2024, February 23). Extinguishing the Habit, Igniting Life: The Transformative Impact of Quitting Smoking. Rupa Health. https://www.rupahealth.com/post/extinguishing-the-habit-igniting-life-the-transformative-impact-of-quitting-smoking

Kirschner, P. A. (1998). Porous diaphragm syndromes. Chest Surgery Clinics of North America, 8(2), 449–472. https://pubmed.ncbi.nlm.nih.gov/9619316/

MarjaΕ„ski, T., Sowa, K., Czapla, A., & Rzyman, W. (2016). Catamenial pneumothorax – a review of the literature. Polish Journal of Cardio-Thoracic Surgery, 2, 117–121. https://doi.org/10.5114/kitp.2016.61044

Mayo Clinic. (2020). Pulmonary embolism - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pulmonary-embolism/symptoms-causes/syc-20354647

National Organization for Rare Disorders. (2015). Catamenial Pneumothorax - NORD (National Organization for Rare Disorders). NORD (National Organization for Rare Disorders); NORD. https://rarediseases.org/rare-diseases/catamenial-pneumothorax/

Paliouras, D., Barbetakis, N., Lazaridis, G., Baka, S., Mpoukovinas, I., Karavasilis, V., Kioumis, I., Pitsiou, G., Papaiwannou, A., Karavergou, A., Lampaki, S., Katsikogiannis, N., Mpakas, A., Tsakiridis, K., Korantzis, I., Fassiadis, N., Zarogoulidis, K., & Zarogoulidis, P. (2015). Video-assisted thoracic surgery and pneumothorax. Journal of Thoracic Disease, 7(Suppl 1), S56–S61. https://doi.org/10.3978/j.issn.2072-1439.2015.01.35

Peikert, T., Gillespie, D. J., & Cassivi, S. D. (2005). Catamenial Pneumothorax. Mayo Clinic Proceedings, 80(5), 677–680. https://doi.org/10.4065/80.5.677

Stanford, J. (2024, June 20). NSAIDs Fact Sheet: Uses, Benefits, Risks, and More. Rupa Health. https://www.rupahealth.com/post/nsaids-fact-sheet

Varanasi-Diaz, S. (2024, April 18). 5 Key Interactions with Hormonal Birth Control You Should Know About. Rupa Health. https://www.rupahealth.com/post/5-key-interactions-with-hormonal-birth-control-you-should-know-about

Visouli, A. N., Darwiche, K., Mpakas, A., Zarogoulidis, P., Papagiannis, A., Tsakiridis, K., Machairiotis, N., Stylianaki, A., Katsikogiannis, N., Courcoutsakis, N., & Zarogoulidis, K. (2012). Catamenial pneumothorax: a rare entity? Report of 5 cases and review of the literature. Journal of Thoracic Disease, 4 Suppl 1(Suppl 1), 17–31. https://doi.org/10.3978/j.issn.2072-1439.2012.s006

Visouli, A. N., Zarogoulidis, K., Kougioumtzi, I., Huang, H., Li, Q., Dryllis, G., Kioumis, I., Pitsiou, G., Machairiotis, N., Katsikogiannis, N., Papaiwannou, A., Lampaki, S., Zaric, B., Branislav, P., Porpodis, K., & Zarogoulidis, P. (2014). Catamenial pneumothorax. Journal of thoracic disease, 6(Suppl 4), S448–S460. https://doi.org/10.3978/j.issn.2072-1439.2014.08.49

Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
See All Magazine Articles
Trusted Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
CDC
Government Authority
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
National Institutes of Health
Government Authority
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Brain
Peer Reviewed Journal
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source