Abstract
Familial Mediterranean fever （FMF） is a common autoinflammatory disease characterized by recurrent episodes of fever and serositis. The pathomechanism of the febrile attacks is still not fully understood, but clinically, various factors may trigger the attacks. In our study, menstruation was the most common trigger in female patients with FMF compared to other factors such as tiredness and psychological stress. We need to consider FMF in patients who have fever and serositis during every menstrual period. Menstrual-related patients had a younger age of onset, higher frequency of peritonitis, and higher rate of endometriosis. The mechanism by which menstruation is associated with attacks has been postulated to be the decrease in sex hormones during menstruation or the stimulation of the endometrial tissue by menstruation itself. Although colchicine is the first choice of treatment for FMF, there have been reports that sex hormone is effective in FMF patients in whom attacks are associated with menstruation. Therefore, this may be an option in the future for patients who are refractory or intolerant to colchicine treatment.
