The Connection Between Hormones and Asthma

Estrogen and testosterone are 2 types of sex hormones. Sex hormones are involved in more than just puberty. They can also affect the immune system and inflammation in the body. The levels of these hormones vary throughout a person’s life.1,2

Experts have found a link between the levels of sex hormones and asthma. Changes in estrogen and testosterone levels may play a part in changes in asthma symptoms over your lifetime.1,2

Asthma changes as you age

Experts have noticed interesting patterns in asthma symptoms. Asthma symptoms seem to change over time based on your age and sex. For example, boys tend to have worse asthma symptoms than girls until age 14. Women tend to have worse asthma symptoms than men throughout their teenage years and into their 50s and 60s. After the age of 60, men are more likely to have severe asthma symptoms than women.2

What causes these asthma changes?

Experts have found that the lungs do not work as well when estrogen is high or testosterone is low.2

For men, testosterone levels rise at puberty. Before puberty, testosterone levels are lower. This may explain why boys are more likely than girls to have severe asthma symptoms before age 14.2

For women, estrogen is highest between puberty and menopause. This may explain why women experience their worst asthma symptoms after puberty. These symptoms then sometimes improve after menopause.2

Generally, estrogen can boost the immune system. In contrast, testosterone can suppress the immune system. The immune system enables inflammation to take place, and inflammation affects asthma symptoms. This may explain the relationship between hormones and asthma.1

High estrogen levels can cause stronger immune responses to lung irritants. High testosterone levels reduce immune responses. Without testosterone, the immune system may be more responsive to lung irritants.1

Asthma and the menstrual cycle

In the menstrual cycle (often called a period), estrogen spikes before ovulation. Ovulation is when the ovary releases an egg. This is about halfway through the menstrual cycle. Up to a third of women notice more severe asthma symptoms around this time. Women are also more likely to visit the emergency room for asthma symptoms around this time.2

Asthma symptoms also seem to be worse for people with polycystic ovary syndrome (PCOS) and those who have had multiple pregnancies. PCOS and pregnancy are both conditions that raise estrogen levels.2

Some women find that their asthma symptoms improve when they use hormonal birth control. However, this is a possible side effect of hormonal birth control. Not everyone who uses hormonal birth control will experience this. That is to say, birth control pills are not an asthma treatment.1

Asthma and menopause

Menopause, the time in life when you are no longer getting menstrual periods, signals a sharp drop in estrogen levels.3

The effect of menopause on asthma is a bit complex. Some studies show that asthma symptoms improve after menopause. This makes sense since research has shown that estrogen can worsen the inflammation that causes asthma. But some studies show that asthma symptoms can worsen after menopause.3

One treatment for menopause is hormone replacement therapy (HRT). HRT involves taking estrogen supplements to improve symptoms of menopause. Experts believe that the estrogen in HRT may cause increased asthma symptoms in these women.3

Menopause usually occurs around 50 years of age. This is an age when people may begin to develop other diseases. These other diseases can be confused with asthma or can worsen asthma symptoms. Lung function also tends to worsen as you age. This can result in more infections that cause asthma flares.3

If you menstruate and have asthma, tracking your asthma symptoms along with your menstrual cycles may be helpful. For example, you may notice your asthma symptoms tend to worsen before your cycle starts. If you have questions about your asthma, speak to your primary care doctor or lung doctor.

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