Can Hormones Make Asthma Worse, Especially for Women? Expert Decodes

Asthma is a complex condition that affects millions of people worldwide, but research suggests that hormonal fluctuations may play a significant role in exacerbating symptoms, particularly in women. From menstrual cycles to menopause, hormonal changes can have a profound impact on respiratory health. In this article, we'll explore the intricate relationship between hormones and asthma, and what women can do to manage their symptoms with Dr Ravi Dosi, Consultant, Pulmonary Medicine Kokilaben Dhirubhai Ambani Hospital, Indore.

How Hormones Can Make Asthma Worse?

When we refer to asthma, we tend to think of wheezing, shortness of breath, and inhalers. What we do not discuss sufficiently is how hormones, particularly in women, may exacerbate, destabilise, and complicate asthma symptoms.

Asthmatic women frequently say to me, "Doctor, its worse just before my period," or "My breathing is tighter during menopause." That's not chance but its biology. Hormones like estrogen and progesterone have direct effects on airways, the immune system, and inflammation.

This is how:

• Premenstrual asthma (PMA) isn't a figment of your imagination. In the premenstrual period, progesterone levels drop, which can result in tightening of airways and increased inflammation.
• Pregnancy is also a hormonal rollercoaster. Asthma improves for some and worsens for others—every breath becomes a battle.
• Menopause may affect asthma control as hormone levels vary wildly which in some cases render medications less effective.
• Birth control pills or hormone therapy may also affect the effectiveness of asthma control.

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I remember one patient, Meera, 29, who had virtually perfect asthma control—until her periods started impacting her lung function. As soon as we realised the connection, we realigned her treatment plan with her cycle, and it made all the difference. She felt heard, understood, and most of all it is relieved.

What is key to learn is that asthma is not only a lung problem—it's a body problem, particularly for women. Knowing how hormones affect it can mean more effective control and fewer attacks.

If you’re a woman and you’ve noticed your asthma is worse at certain times of the month or life stages, talk to your doctor. Keep a symptom diary that includes your menstrual cycle, medication use, and peak flow readings. It can provide powerful clues.

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Finally, let's leave behind the notion that asthma is "one-size-fits-all." Women's bodies run on rhythms, and our medical care must respect that. With the proper knowledge, you can breathe easier both literally and figuratively.

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