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Asthma in Women

The impact of female hormones on asthma.
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Asthma and Female Milestones, Pregnancy, and Menopause continued...

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.”

Pregnancy: It’s a roll of the dice whether pregnancy has an impact on asthma. Kao says pregnant women with asthma are broken down into thirds: in 1/3 of women, asthma symptoms worsen; in the next 1/3 they improve; and in the last 1/3, they stay the same.

Whatever group you fall into, the good news is that asthma during pregnancy, if kept under control, does not increase the risk of maternal or infant complications.  

Menopause: Menopause causes peaks and valleys in a woman’s estrogen levels -- in many cases, more valleys than peaks. By keeping these levels more constant and avoiding dramatic drops that might trigger inflammation, asthma symptoms can be better managed. Women with asthma triggered by menopause should talk to their doctor about temporarily using hormone replacement therapy, and gradually tapering it off.

Keeping Asthma in Check

For women living with chronic asthma, the trick to keeping your symptoms in check is working closely with your doctor to manage your ability to breath. Here are practical tips from the experts on how to keep your airways open, despite what’s happening with your hormones:

  • For women with regular menstrual cycles: Avoid your known allergens right before your period is about to begin, suggests Kao.
  • For women with irregular menstrual cycles: Watch your symptoms carefully, says O’Connor. Use a peak flow meter to measure your ability to push air out of your lungs. Decreasing numbers can help indicate when your period might be approaching -- and you can be vigilant about avoiding triggers.
  • For all women: Always use maintenance medication, at the direction of your doctor, instead of relying on rescue inhalers. It’s far more important for lung health to prevent symptoms, Kao says, instead of treating symptoms once they have started.  
  • For pregnant women with asthma: Take maintenance medication; It’s critical. “For women who are dealing with asthma during pregnancy, maintenance medications are essential for your health and for the health of your baby, so talk to your health care provider,” says Clifford Bassett, MD, medical director of Allergy & Asthma Care of New York.  

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