Women and Asthma

I attended a very interesting talk about the question of the possible prevalence of asthma in premenopausal and premenstrual women presented by Dr. Nancy Ostrom and Dr. Andrea Apter at the American Academy of Allergy Asthma and Immunology (AAAAI) conference in Philadelphia. Ostrom's short answer was: "Yes, there is higher prevalence of asthma in women in these phases of their lives." (This is for women who already experience mild to severe asthma). Ostrom said she probed the literature and there isn't a clear reason as to why this is, but she says that it is inarguable that there is an increase in asthma symptoms in adult women during these two crucial times.

 

The question of premenstrual asthma and hormonal influences was raised. I found this particularly interesting as that has always been the case with me, around the time of my period, I've noticed an increase in wheezing or an increased sensitivity to the irritants in my environment; this usually led to increased asthma symptoms. Ostrom said there is little literature to support this connection but that: "Asthma response in the perimenstrual period may, theoreticallly, be influenced by the loss of progesterone hormonal effect on the airways."

 

Twenty to 40 percent of Ostrom's allergy and asthma patients reported an increase of asthma around day 4 of their cycle; these are usually women with more serve asthma symptoms generally.

 

You might be wondering, if asthma spikes around hormones, would changing or introducing a different hormone regimen change the asthmatic response? The answer, as presented in this forum, was that for some women that might work for others, not necessarily. There have been a few small case studies of women on hormone replacement therapy or oral contraception that have shown differing results. However Ostrom stresses that this is "a real phenomenon" and that we will be seeing more literature soon to corroborate what she sees in her practice daily.

 

If you feel that your asthma increases around these sensitive times, talk with your allergist about looking into your asthma medication plan.