Hormones And Asthma
Asthma is a common respiratory problem where there is chronic inflammation in the airways.
Patients suffer from shortness of breath, wheezing, chest tightness and frequent cough and cold. In the present scenario with increasing pollution levels there has been a steady rise in the incidence of asthma in adults as well as children. What many of us are unaware about is the role that our hormones play in the occurrence and the control of asthma.
Worldwide women are more often affected by asthma than men and the mechanisms underlying the gender differences in asthma prevalence are mostly due to hormonal differences and differences in lung capacity. Women experience more severe symptoms, which seem to change with the various life stages such as menstruation, pregnancy and menopause. These variations occur due to the changes in the levels of female sex hormone levels. As children, boys have an increased prevalence of asthma compared with girls, with increased symptoms and use of asthma medications. But as they switch over to puberty this prevalence reverses with females having an increased prevalence and severity in symptoms due to the change in the level of oestrogen and progesterone (female sex hormones).
Asthmatic women experience increased symptoms in the premenstrual period due to the change in the hormone levels post ovulation. Females with irregular menstrual cycles also are prone to suffer from increased symptoms compared to rest. Around the menopause and perimenopause (the time leading up to the menopause), some people find that their symptoms get worse and there is increased use of rescue medications. Some even develop asthma for the first time because of the interplay between the hormones and asthma.
Sometimes hormonal medications like contraceptive pills or hormone replacement therapies may increase or sometime improve asthma symptoms.
Pregnancy affects asthmatics in different ways. Approximately a third of pregnant people with asthma will experience worsening of their symptoms, a third will see improvement of their symptoms, and a third will see no change indicating the complex nature of the relationship between sex hormones and asthma. Asthmatics with difficult to control symptoms before pregnancy, can have even more increased symptoms during pregnancy
Obesity in childhood is associated with higher asthma prevalence and morbidity in girls, but not in boys. In girls older than 11 years and women, asthma is five to seven times more common in obese people compared to those of normal weight. Obese females also have difficulty in controlling asthma symptoms despite adequate medications.
The increase in the levels of thyroid hormones also affect the asthma symptoms. Hyperthyroid state and hypothyroidism both may cause worsening of asthma symptom which improve with treatment of the thyroid condition. Enlarged thyroid gland may cause compression of the trachea causing breathing difficulty and asthma like symptoms. Hyperthyroidism also increases the side effects of the asthma medications. Corticosteroids used in severe asthmatic states have an increased metabolism in hyperthyroid patients and thus inadequate thyroid control may decrease the efficacy of these medications.
Diabetic patients who are also asthmatics need to take special care with their asthma control.
Frequent use of oral corticosteroids in these patients may increase the sugar levels and play havoc with diabetes control. So it is important to keep the asthma symptoms under adequate control with regular use of inhalers and other non-steroidal medications to prevent frequent oral corticosteroids use.
Proper knowledge about the triggers and aggravating factors of asthma is important to maintain sufficient control over the disease and lead a healthy and comfortable life. If the asthma symptoms remain uncontrolled or patient experiences frequent attacks then one of the above reasons should be looked into. Knowing about these hormonal interactions may help in the goal of a problem free, healthy life and better asthma control.
