Asthma and Hormones in Women

Asthma is a very common disease. Asthma sufferers have probably never heard that there is a correlation between hormones and asthma symptom flare-ups, but hormonal imbalances and fluctuations in hormones can both have serious impacts on asthma. Surprisingly, many doctors are aware of this connection, yet continue to prescribe inhalers without even checking the patient’s hormone levels. Learning a bit more about how your hormones can affect your asthma symptoms can be an important first step toward getting it under control. Statistically, males most commonly have asthma before puberty, while it is more common in females after puberty. After menopause and andropause, men and women have equal chances of suffering from asthma. These facts clearly demonstrate a connection between hormones and the onset of asthma as well as flare-ups of the symptoms themselves. Females experience more asthma symptoms after they hit puberty due to the fact that the menstrual cycle causes estrogen fluctuations that can cause and/or instigate asthma symptoms. As an example, a woman’s estrogen levels drop precipitously to almost zero between five and ten days before a woman's period. Interestingly enough, this is, coincidentally, also when most hospitalizations for women suffering from asthma occur. Right before a woman's menstrual cycle begins, when estrogen levels are extremely low, women's ovaries normally produce progesterone; however, young women commonly have ovarian dysfunction, which means that little or no progesterone is being produced during this phase of their menstrual cycle. Despite the fact that estrogen levels are extremely low during this time, the fact that progesterone is not being produced in sufficient quantities makes a woman “estrogen dominant”. At appropriate levels estrogen can increase nitric oxide, which helps to keep the airways open and relaxed. Too much estrogen causes inflammation in the body, which, for obvious reasons, interferes with the benefits of the nitric oxide, allowing the airways to become inflamed as well. Being estrogen dominant can be catastrophic for asthma sufferers. Recent studies have shown that low progesterone levels are also strongly correlated with asthma symptoms in women. Oddly enough, many of the inhalers that are typically prescribed to women with asthma can actually worsen symptoms because they contain synthetic corticosteroids (synthetic adrenal steroid hormones). These synthetic corticosteroids occupy the progesterone receptors in the cells, blocking the action of a woman's natural, biologically produced progesterone. This creates even more “estrogen dominance” and worsens a woman's asthma symptoms rather than making them better. The relationship between asthma and hormone levels is not as simple as a supply and demand; it is complicated. Asthma symptoms will not improve by simply dosing them with more estrogen or more progesterone; it actually requires the hormones to be balanced with each other. It is a delicate balance of hormones in the body that keeps women healthy. It is important to get the advice of a bioidentical hormone specialist or an endocrinologist to help you determine a course of action and a treatment protocol for your asthma if you have noticed that your asthma symptoms get worse in correlation to your menstrual cycle.