All people with asthma have good days when their asthma is well controlled and bad days when an asthma attack is more likely. Many women have an additional risk factor due to monthly hormone changes. Up to 40 percent of women report that their asthma symptoms are worse just prior to the start of their periods.
Asthma is a chronic disease that causes difficulty breathing. Common asthma symptoms include coughing, tightness in the chest, and wheezing. Approximately 20 million people in the United States have asthma. During an asthma attack, the airways can become inflamed and swollen which makes it harder for air to pass in and out of the lungs. This swelling also results in excess mucus which clogs airways. At the same time, the muscles around the airways can contract, which makes the airways even smaller.
Studies show that women are 30 percent more likely than men to have asthma and are 40 percent more likely to die as a result of asthma. During childhood, boys are more likely to experience asthma than are girls. By the time they reach puberty, girls have caught up to boys and by age 24, more women than men have asthma. (AAAAI)
Research has shown that many women report worse asthma symptoms just prior to the start of their monthly periods. This condition, which is known as premenstrual asthma (PMA) affects up to 57 percent of women with asthma. Scientists believe the condition is partially controlled by changes in women’s hormone levels during the monthly cycle.
Just prior to menstruation each month, the levels of the hormones progesterone and estrogen decrease. These hormones are known to affect the cells in the body’s immune system as well as cells in the airways which makes an asthma attack more likely to occur when the levels are low. These hormones also affect how blood vessels are formed in the lungs, which can impact how much oxygen is able to get into the bloodstream.
However, researchers also recognize that hormones are not solely responsible for PMA. Studies have shown that oral contraceptives, which keep hormone levels from fluctuating as much, do not prevent PMA. They also noted that menopausal women who use hormone replacement therapy to maintain higher hormone levels are more likely to develop adult onset asthma.
If you believe you have PMA, tracking your symptoms in an asthma diary can help your doctor determine the best treatment to counteract hormone related changes. He may want to increase your controller medications just prior to the start of your period. You may also benefit from avoiding any other asthma triggers during that time of the month, and should always keep your rescue inhaler handy, especially before your period.
Sources:
American Academy of Allergy Asthma & Immunology
About.com: Asthma
Medscape
National Institutes of Health: PubMed Health
Reviewed May 26, 2011
Edited by Alison Stanton