While studies looking at the prevalence of asthma in boys vs. girls go back to at least 1997, how the disease affects women is a fairly under-researched area. It appears that during childhood, more boys have asthma than girls, but then during adolescence (about 12 to 20 years old, and roughly the timespan in which puberty will take place), the tables turn and more girls are diagnosed with asthma than boys—and, boys are more likely to experience dormant, or non-existent, asthma symptoms in adolescence/adulthood (I prefer to use the term dormant, or ’in remission’, as asthma is not actually outgrown and may return later in life—so, it can be dangerous to assume asthma no longer exists!).
The timing at which our statistics flip and girls with asthma outnumber boys happens around puberty. This leads us to believe that hormones, like estrogen and progesterone, can play a pretty crucial role in the asthma symptoms that women experience. It’s fair to somewhat liken this to the effects of stress on asthma—stress hormones within the body can trigger inflammation, leading to worsening asthma symptoms—female sex hormones are much the same, and can actually cause both increased and inflammation levels in the body. A 2011 study notes that there are a few key stages in which asthma may worsen for women, in addition to onset of symptoms sometimes occurring during puberty:
- Menstrual cycle related asthma: Approximately a third of women will experience a worsening in asthma symptoms just before or just after their period begins. Medscape also notes that, while it would seem sensible, that use of oral contraceptive (hormone pills) has not proven to be an effective way to reduce asthma symptoms—which may be severe enough to warrant hospitalization—for women who deal with asthma related to their menstrual cycles. Some women might not realize that their asthma worsens around the time of their period, so if you have unexplained symptoms, this might be something to consider. And, if you’ve considered that your symptoms might get worse around this time of your cycle, but then thought you were just crazy… well, you’re not! Science can back you up.
- Pregnancy and asthma: Much like how about 1/3 of women will experience asthma symptoms related to their periods, being pregnant splits women into three different response groups—a third will have worsening asthma symptoms attributed to the hormone changes the body endures during pregnancy, a third will have no change in asthma symptoms while pregnant, and—you guessed it—the final group of women will actually experience an improvement in asthma control during the gestational period.
- Menopause and asthma: Another timespan where more women seem to develop asthma is around menopause—there is a peak of asthma diagnoses in women around age 50, who previously have not experienced asthma symptoms. The addition of hormone therapy to ease symptoms of menopause may also trigger asthma symptoms, either indefinitely or during the span of time that the body takes to adjust to increased levels of these synthetic hormones. Asthma symptom increases or new diagnoses are common during different stages of menopause, so it is worth discussing different options to help you deal with this with your physician.
While the use of synthetic hormones, of varying types and doses, during the menstrual cycle is not a failsafe treatment to avoid menstrual-related asthma or menopause-related asthma, it may be worth discussing with your doctor. There are also other options available to ease asthma symptoms during hormonal fluctuations—for example, you might choose to talk to your doctor about increasing certain inhaled medications a few days before your period is due to begin to avoid symptom flares. You may also notice you are more sensitive to other inhaled asthma triggers during these times. Taking increased care to avoid your triggers may help you to deal with hormone-related asthma more effectively.