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Asthma in Women

The impact of female hormones on asthma.
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WebMD Feature

When it comes to women and asthma, the ability to breathe can be affected by pregnancy, the menstrual cycle, and menopause. Women who also have allergies and other asthma triggers may struggle to get a breath of fresh air. 

“Unequivocally, women with asthma face an extra challenge simply because they are women,” says Neil Kao, MD, an asthma and allergy specialist in Greenville, S.C.

“Not only are they challenged with balancing known triggers like pollen and mold, but they must also manage the fact that the female hormones in their bodies are constantly changing in ways that might impact how well they can breathe.”

Women must manage the effect of female hormones on asthma. Often they must manage asthma during pregnancy. Managing asthma poses greater challenges for women, but it can be done. Here’s how women with this chronic lung disease can start to breath easier.

Female Hormones and Asthma

Female hormones such as estrogen may have almost as much impact on the airways as allergies and hay fever. But estrogen itself is not the culprit in triggering the symptoms of asthma. Rather, it’s the fluctuation of estrogen -- the up and down of hormone levels -- that may cause inflammation in the airways.  

“Fluctuating estrogen levels can activate proteins that produce an inflammatory response, which can bring on asthma symptoms,” says Christiana Dimitropoulou-Catravas, PhD, assistant professor in the department of pharmacology and toxicology at the Medical College of Georgia.

Dimitropoulou-Catravas, who was the lead author on a study investigating the role of estrogen in asthma, explains that by stabilizing estrogen levels, inflammation and asthma may be better controlled.

“With any medication, it’s a balance of risk vs. benefit,” says Dimitropoulou-Catravas. “Estrogen replacement therapy, which can bring estrogen levels into balance, has been associated with an increased cardiovascular risk, such as a higher risk of stroke. But if someone has severe asthma and it can be linked to low levels of estrogen, replacement therapy might be an answer.”

Asthma and Female Milestones, Pregnancy, and Menopause

Most women living with asthma are conscious of the seasons and specific allergies that might trigger their symptoms. They should be aware of their menstrual cycles, as well. Shifting hormone levels can impact the state of their airways. So can pregnancy and menopause, when hormones and other factors may affect asthma symptoms. 

Menstrual Cycles: A woman’s hormone levels change dramatically over the course of her menstrual cycle -- whether it’s regular, or irregular. The trouble spot, however, may be right before her period starts, when estrogen levels are at a cycle low.

“Most hospitalizations for asthma in women occur around the peri-menstrual stage of the menstrual cycle -- right before a woman’s period begins,” says Maeve O’Connor, MD, an allergist and immunologist in Charlotte, N.C. “This is when estrogen levels drop down to almost zero.”

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