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Allergy & Asthma Issues: Winter 2009/2010Asthma and Allergies in WomenDessislava Ianakieva, BS and Richard W Honsinger, MD, MACP, FAAAAIRecent studies indicate that women's menstrual cycles can play a role in asthma symptoms. 
Prior to puberty, asthma and hospitalizations for asthma are more common in boys than in girls. At the time of puberty, asthma occurs equally in boys and girls. By age 24, more women are affected than men1. Overall, women are 30% more likely to have asthma and have a 40% higher asthma death rate than men4. Premenstrual asthma (PMA) is a condition in which asthma symptoms and lung function worsen a few days before menstruation2. According to one study, 57% of women with asthma, experience worsening of symptoms and increased medication use and 14% had a significant decrease in lung function before their menstruation1. During days 22-28 of the menstrual cycle, the hormones progesterone and estrogen decrease, reaching their lowest levels at day 28. Progesterone and/or estrogen affect the airways or the cells of the immune system, making an asthma attack more likely1. Also, blood vessels in the lungs are found to form and disappear in rhythm with a woman's hormones, leading to increasing and decreasing ability of the lungs to take in oxygen. During the first two weeks of menstruation, estrogen levels increase and signal the formation of new blood vessels in the uterus and in the lungs. As estrogen levels decrease dramatically before menstruation, the decrease in blood vessels can also help explain the worsening of asthma symptoms experienced in PMA4. However, hormones by themselves do not explain the entire reasoning of PMA. The use of oral contraceptives does not prevent PMA and use of hormone replacement therapy (synthetic estrogen) in postmenopausal women increases the risk of developing adult onset asthma3. If you have PMA, keep a diary of asthma symptoms in relation to your menstrual period. Also, talk to your doctor about increasing preventative medication before menstruation. Allergic Rhinitis5Allergic rhinitis is the inflammation of nasal mucous membranes. Symptoms include sneezing, itchy nose and roof of the mouth, throat, eyes and ears, runny nose, congestion and watery eyes. These symptoms are thought to be hormonally induced during pregnancy and menstrual cycles. Studies have shown that symptoms of allergic rhinitis increased in one-third of pregnant patients because of increased sinus congestion from the blood vessels in the nose expanding and increased blood volume. Pregnancy rhinitis occurs without an infection, allergic, or medication-related cause. The condition starts before the last six weeks of pregnancy (corresponding to 34 weeks gestation), continues until delivery and clears up within two weeks after delivery. There may also be an association of nasal congestion with ovulation and the rise of estrogen during the menstrual cycle in some women. Sources:
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