Ovarian Hormones and Asthma

The time finally came for me to confront my asthma symptoms and the potential link to ovarian hormones and my menstrual cycle. Although I had a conversation with my pulmonologist several years ago, I did not feel the symptoms were necessarily connected or even that bothersome. This seems to have changed over the last few months.

Using my trusty asthma journal, I was able to track a pattern of increased symptoms before and just after menstruation. Since I also had a few other things going on with my asthma such as an infection a few months ago that was still linked to a random cough and the possibility that my current treatment plan was not doing an adequate job of keeping eosinophils at bay. This sent me off on a quest to know just a bit more about this topic.

Here is what I found:

Links between asthma and menstrual cycles

Can asthma symptoms vary during menstrual cycles?

Yes, they can. The changes in ovarian hormone concentrations during each cycle contribute to worsening asthma symptoms. This may include lower peak flows, more rescue medication use during the premenstrual or perimenstrual phases of a cycle.¹

What are the pre and peri-menstrual phases of the menstrual cycle?

The premenstrual phase occurs on day 14 of the cycle and can last 10-14 days. It may also be known as the luteal ovulatory phase. The perimenstrual phase is on day 25- through day 5. These days are based on normal cycles being 25-36 days in length.²

Can the use of oral contraceptives be helpful?

In regards to oral contraceptives, research studies have been mixed on this. Some studies have shown that there are negative effects, others have shown no changes in asthma symptoms and others have shown a decrease in urgent care use. The conclusion is that more research is needed to get a better sense of its applicable use in premenopausal asthmatics.³

What is the link to allergic asthma?

Researchers have explored the role of estrogen in allergic asthma in mice models. There may be some connections to airway inflammation, however, further research is needed. This will be especially important to develop a better sense of how estrogen and progesterone may influence airway inflammation pathways.⁴

Continued research

While the exact mechanisms may not yet be known, there is hope that continued research will help to draw a more definitive conclusion about the mechanisms of understanding. Researchers have been interested in looking at the relationship between estrogen signaling and effector T cell responses to know more about the relationship and its effects. In particular, studies have looked at the relationship in Th17 mediated diseases and whether this can help drive research for personalized treatments for women in different reproductive phases.

In the interim, I will continue to explore the impact of these symptoms with my care team. 

Menstrual cycles, asthma, and you

Have you experienced these symptoms or been through this? Has your asthma improved? I would love to hear about your experiences in the comments below.