Catamenial Pneumothorax: Breathing Through The Menstrual Cycle

Catamenial pneumothorax (CP) is a unique disease related to thoracic endometriosis. It is often diagnosed in females of reproductive age presenting with recurrent spontaneous pneumothorax aligned with their menstrual cycle. We present a case of a woman presenting with recurrent episodes of dyspnoea coinciding with her menstrual cycle. Radiographic imaging confirmed a recurrent pneumothorax, and thoracoscopy with a pleural biopsy revealed diaphragmatic fenestrations and thoracic endometriosis. Multiple approaches, including medical pleurodesis, surgical pleurodesis, and hormonal therapy were used in her treatment. She recovered well after started on continuous oral Dienogest, and she has been asymptomatic for three years. This case illustrates the importance of recognizing the cyclical pattern of symptoms and a thorough diagnostic workup to confirm CP. This ensures timely management, which includes hormonal therapy and surgical intervention.