The ability of a woman’s breathing can be affected throughout her life by pregnancy, her menstrual cycle and menopause.
It is the fluctuation of estrogen (particularly when estrogen levels drop) which may cause inflammation of the airways, in other words it is not the estrogen itself but rather the alternating up and down of hormone levels.
There isn’t a great deal of information out there on this subject and what is available is a little conflicting, however, I will endeavour to inform you of the current situation from two angles. One angle being that HRT can be a solution to treatment of asthma triggered by menopause and the other being that HRT taken for at least 10 years after menopause can cause asthma in some women.
Although you can have asthma at any age and it is also a hereditary disease, women who go through menopause can develop asthma for the first time. Likewise, current allergies can worsen or you may have new allergies. Women who have already been diagnosed with asthma may find that their symptoms worsen at menopause.
The cause of this change to the airways is due to fluctuating hormones, in particular estrogen. Any woman who finds herself coughing and wheezing for the first time should not ignore these symptoms.The female hormone can have the same knock on effect on the airways as allergies and hay fever.
Asthma in women is a serious health issue and is more common in women than men. Studies show that cases of asthma have increased in women v men over the last two decades. Studies also show that women suffer more hospitalisation and deaths related to asthma.
It is well documented that a woman’s menstrual cycle has a trouble spot for respiratory type symptoms which is just before her period when estrogen levels are at their lowest. Most hospitalisations occur at that time.
Studies have also shown that perimenopausal women who have not had their period for 6 months experienced an 80% increase in respiratory symptoms associated with asthma compared to those who were menstruating regularly.
Estrogen Replacement Therapy – A Potential Solution to Asthma In Menopause
Studies presented to the Annual Congress of European Respiratory Society in Stockholm, are the first to show that hormone replacement therapy has an important part to play in lung protection and repair.
Christiana Dimitropoulou-Catravas, PhD, Assistant Professor in the Department of Pharmacology and Toxicology at the Medical College of Georgia, US, 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.
Dimitropoulou-Catravas says that “fluctuating estrogen levels can activate proteins that produce an inflammatory response, which can bring on asthma symptoms. With any medication, it’s a balance of risk vs. benefit. 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.”
The Mayo Clinic states that “hormone replacement therapy may improve asthma symptoms in women who have gone through the menopause but point out that studies remain conflicting as hormone replacement appears to worsen asthma in some women.”
Increased Risk Of Osteoporosis for Women with Asthma
According to Asthma.UK, for some women with asthma, the chances of suffering from osteoporosis are marginally higher than average. Studies show that this is due to the necessity to take steroid medications or inhaled steroids on a continual basis. Taking either of these medications for a number of years may lead to an increased risk of osteoporosis. This is certainly the case with the woman I used as an example at the beginning of the article.
• Dry cough, particularly at night or in response to triggers.
• Difficulty breathing.
• Tightness or pressure in the chest.
• Wheezing when breathing out.
• Shortness of breath after exercise.
Asthma symptoms can range from being mild and intermittent to severe and persistent.
Other Reasons Why The Onset of Adult Asthma is Likely
• Women who take estrogen following menopause for 10 years or longer
• Menstrual Cycle
• Environmental irritants (smoke, mould, detergent sprays), exercise, medications.
You may or may not be a candidate for hormone replacement therapy depending on when your symptoms occurred, family history, and medical history. However, this is something to discuss with your Healthcare Professional if it found that your asthma was triggered by menopause.
You may be prescribed medications specifically for Asthma.
Learn about asthma and stay aware of new medical developments.
Check your lungs daily with a peak flow meter.
Together with your Healthcare Professional, establish an asthma management plan.
It is clear that more studies need to be carried out in this area. The best advice would be to consult with your Healthcare Professional if you think your already diagnosed asthma is worsening with menopause or if you have asthma for the first time which may have been triggered by menopause. All studies to date do make a point of stating that women with asthma should be treated with a personalised medication regime due to the part that low estrogen levels can play in the respiratory system.
Expect to give your Healthcare Professional a full family/medical history and an explanation of your symptoms. He/she will most likely follow up with a physical examination and lung functioning tests. Hormone tests can be carried out to check your hormone levels and it is at that point that you may wish to discuss short term replacement therapy as part of your personalised medication.
Li. J. T.C., M.D., Ph.D. (Oct 2014) Retrieved from http://www.mayoclinic.org/diseases-conditions/asthma/expert-answers/asthma/faq-20058190
Hormone Replacement Therapy. A Risk Factor for Asthma? Pulmonary Reviews.com Vol. 5. No. 12 December 2000
Women and Asthma. (Aug 2015) Retrieved from http://www.asthma.org.uk/advice-women
Hormones. Retrieved from http://www.asthmaaustralia.org.au/Hormones.aspx