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The Science Of Health: How Hormonal Changes Affect Asthmatic Women, Ways To Avoid Exacerbation

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Asthmatic Women And Reproductive Hormones: Welcome back to “The Science Of Health”, ABP Live’s weekly health column. Last week, we discussed the instances in which head and neck cancers metastasise, or spread to other locations in the body and cause tumours to grow there. This week, we explain the scientific reasons behind hormonal changes exacerbating asthma symptoms in women, and ways to prevent the worsening of conditions. 

Women are more prone to asthma than men. During menstruation, perimenopause, menopause and pregnancy, women experience a multitude of changes in their bodies because hormones such as oestrogen and progesterone are at play. These changes are even more pronounced in asthmatic women because the interplay of hormones can increase inflammation in the body, and affect the airways. 

Check ABP Live’s stories explaining the science behind various health phenomena, and the articles appearing in the weekly health column here.

According to Asthma + Lung UK, the UK’s lung health charity, women are more likely to notice worse symptoms around times of hormonal change during puberty, periods, pregnancy and perimenopause, with one-third of women reporting worse asthma symptoms before or during a period. 

Female reproductive or sex hormones can also make asthmatic women more sensitive to other triggers such as hay fever, colds, and flu. 

ABP Live spoke to Dr Asmita Mehta, Professor and Head, Department of Respiratory Medicine, Amrita Hospital, Kochi, and Dr Arjun Khanna, Head, Department of Pulmonary Medicine, Amrita Hospital, Faridabad, and asked them about how hormonal changes during menstruation, perimenopause, menopause, and pregnancy impact asthmatic women, and what they must do to prevent such symptoms. 

How hormonal changes trigger symptoms in asthmatic women

Oestrogen levels in the body increase during menstruation and pregnancy. The steroid reproductive hormone affects the immune system and the airways.

According to Dr Mehta, the following are the different ways hormonal changes affect asthmatic women during menstruation, perimenopause and menopause, and during pregnancy:

Menstruation

Airway inflammation and bronchial reactivity are affected during menstruation due to fluctuations in the levels of oestrogen and progesterone.

Perimenopause and menopause

Women can experience exacerbated asthma symptoms during perimenopause and menopause due to decreased oestrogen levels. Also, anxiety during perimenopause and menopause can result in shortness of breath in women, triggering asthma attacks.

Pregnancy

During pregnancy, several hormonal changes occur, which can exacerbate symptoms of asthma. However, about one-third of pregnant women are likely to experience improvement in their symptoms, one-third experience no change, and one-third are likely to experience worsended symptoms. Hormonal changes may trigger allergic reactions, exacerbating asthma symptoms.

The scientific basis behind hormonal changes exacerbating asthma symptoms in women

While the scientific basis underlying the exacerbation of asthma symptoms in women due to hormonal changes is not fully understood, some of the mechanisms proposed by researchers as being responsible for worsened conditions are changes in the levels of oestrogen and progesterone, immune response, and allergic response.

Oestrogen has an anti-inflammatory effect, and improves lung function. However, fluctuations in oestrogen levels during menstruation or menopause can lead to increased airway inflammation and hyperresponsiveness of the bronchi, Dr Mehta said. “Airway inflammation makes the air passages narrowed and more sensitive, making it harder to breathe for those with asthma.”

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Progesterone also fluctuates during the menstrual cycle and pregnancy, plays a role in airway constriction, and can exacerbate asthma symptoms by causing smooth muscle contraction in the airways. “This leads to airway narrowing and worsening of asthma,” Dr Mehta said.

Hormonal changes also impact immune cell function, and trigger the release of inflammatory mediators. These mediators alter airway inflammation and reactivity.

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Fluctuations in hormone levels can also lead to allergic responses. For instance, oestrogen modulates immune responses to allergens, and influences the severity of allergic asthma, Dr Mehta said.

Research is underway to understand the scientific mechanisms in detail.

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Ways to avoid exacerbation of asthma symptoms due to hormonal changes

A healthy and well-balanced diet can help manage asthma symptoms and prevent exacerbation due to hormonal changes. Obese women are more likely to suffer from exacerbated asthma symptoms during puberty, pregnancy, menstruation, perimenopause and menopause.

“Weight gain can worsen asthma attacks. Food with preservatives, high spices and tartness should be avoided. Patients with asthma should consult their pulmonologist before starting exercise. Right exercises can help asthmatics remain fit and will actually improve the overall well being of patients with asthma. Obesity not only causes hormonal imbalance, but can also worsen asthma. Any food stuff, which can cause significant weight gain, should be avoided by asthmatics,” Dr Khanna suggested.

He also advised that asthmatics must avoid very cold foods, and also those which trigger allergy. He stated that the fact that asthmatics must avoid foods like curd, milk, rice and bananas is a myth. This is because these foods are not known to exacerbate asthma symptoms.

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